The Big Idea: Weighty Matters

by Claudia Dreifus Published Spring 2017
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Tell me more about the FIT Center and why you have made it your life’s work to study and treat the special problems of overweight children.
As we’ve discussed, most adults find it really hard to lose weight and keep it off. Only about 15 percent are successful. That number hasn’t changed in thirty years.

Children seem to do much better. They are better able to make changes in their lifestyles. Because they’re growing, they usually don’t have to lose weight — only slow down weight gain so they gain inches faster than they gain pounds. They can become slimmer over time and sustain that.

“After weight loss, our bodies fight back by decreasing how many calories we burn and increasing our appetites.”

At the FIT program at CUMC, we blend genetics, physiology, and behavioral science to identify the characteristics of a child that are most treatable. For example, if we find that a child has very high triglycerides, we will work with the family and our nutritionist to create a diet — with foods that the child likes and are easy to prepare — that addresses that need.

Our team of experts in pediatric endocrinology, gastroenterology, cardiology, molecular genetics, nutrition, and exercise work together to provide the best possible care and, at the same time, learn more about childhood obesity to the point that it does not persist into adulthood.

Michael Rosenbaum / Photograph by Dennis Cacho

What makes your FIT program different from other types of services available to obese children?

Unlike most if not all similar clinics, which require referrals to multiple subspecialists, the FIT program offers all the help and encouragement the young patient needs, in one visit, at one place. The program is modeled after Columbia’s highly successful Naomi Berrie Diabetes Center, which works with adults. We’re still looking for a primary sponsor for the center, and we think that over the long term, this is the most effective way to address the obesity epidemic.

With adults, what is your opinion of the various gastric surgeries?

On the whole, they result in more rapid and greater weight loss than other options. Generally, the amount of weight loss by Lap-Band surgery is about 15 percent. It’s usually more if you have gastric-sleeve or gastric-bypass surgery. As with most interventions, the weight-loss period lasts about six to eight months and is often followed by some regain. One bonus here: the more dramatic procedures often result in a rapid improvement in type 2 diabetes, which along with hypertension and fatty disease is a common complication of obesity. My hope is that we can develop non-surgical means to induce the same changes in the body.

Are Americans more obese than ever?

The world is more obese than ever. Not just Americans. China is having the same problem. We’ve increased access to calorically dense foods. We supersize things. At the same time, we’ve become more sedentary. At this point, 70 percent of the American population is overweight or obese.

So what would you tell a relative who needed to lose weight?

I would tell them that this is a biological disease. It’s not their fault. I would tell them that losing weight is hard, and that if they can’t do it I’ll still love them for trying. I would also say that within a decade we’re likely to have ways to make it easier.

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