A recently released study indicates that some obese children or those with high cholesterol already show early warning signs of heart disease. The study was presented at an American Heart Association conference and raised the possibility that these children have developed heart disease risks similar to middle aged adults.

The results did not surprise Stephen J. Pont, MD, MPH , faculty member for the University Texas Medical Branch - Austin and UT-Austin who practices at Dell Children's Medical Center of Central Texas and at the East Austin Community Health Center. Dr. Pont leads the Healthy Living Happy Living Program, a grant-funded multidisciplinary after school obesity intervention sponsored by the Dell Childrens and Austin Community Foundations. He considers the news part of a growing body of evidence that the challenges of childhood obesity will create long-term health problems in multiple areas as these children grow up.

"We know this is a problem of epidemic proportions. The challenge is to identify a multidisciplinary program of prevention and intervention that may effectively reverse the obesity trend. Pediatricians may identify a child as overweight or obese, but currently do not have many effective treatment options" says Dr. Pont.

The added risk of heart disease is not the only challenge for overweight kids. "We've been working with health problems in children that we only used to see in elderly adults," notes Dr. Pont. "Now we see children with type 2 diabetes, adult cholesterol levels, hip and joint problems, gallbladder disease and non-alcoholic fatty liver disease as a result of being overweight. This is a vicious cycle and the trajectory suggests things will only get worse. If we don't take drastic steps, we will soon see the first generation of children who have shorter life spans than their parents, primarily due to obesity."

"We know that a child's body that is carrying more weight than it is designed to handle can cause organ systems to fail. It can lead to obstructive sleep apnea, cause damage to the lungs and lead to possible brain cell damage. It can desensitize the body to insulin and cause the heart to enlarge or fail. Joint and back pain may become so painful it requires surgery and with these conditions lifestyle begins to decline."

He adds that depression and anxiety are also common and can be worsened through teasing at school and emotional stress from being unable to find clothes that fit or that are stylish. For this reason, the Healthy Living Happy Living Program also will include a strong psychological component.

Addressing the Challenge

Dr. Pont was an overweight child himself and remembers facing similar problems to today's obese children: Teasing, inability to find clothes that fit and difficulty learning new habits. He maintains a healthy weight now, but learned how hard it is to make changes.

"I enjoy working with patients one-on-one and helping to empower them to make healthy choices, but we also need population level change. We currently have a toxic environment for children's health. Fast food is rampant, video games and TV are everywhere, streets are not safe enough for walking either because of crime or because housing developments have no sidewalks. We need to address issues on so many levels. Society needs to make changes."

Dr. Ponts team includes experts in medicine, psychology, nutrition and physical activity from Dell Childrens, UT-Austin, and the Texas Child Study Center, and they will begin working toward change in Austin later this month through the nine-week after school pilot program Healthy Living Happy Living. Dr. Pont hopes that the after school program will obtain continued funding and that with additional support, the core team of experts will form the Texas Center for the Prevention and Treatment of Childhood Obesity. The Center will then develop, implement and coordinate a broad range of multidisciplinary and multilevel obesity interventions preventing and treating childhood obesity and offering effective services for kids and their families.

"This is our first intervention. Right now, we have far more interest than we have space. We are operating a little in reverse, creating the program before we have a bricks-and-mortar location. But currently there are very limited services for obese children in Austin or Central Texas and many parents, teachers or school nurses want to have a place to refer children for help. We hope to partner with donors to establish a multidisciplinary center capable of working with all children and families that seek help and to develop and document the most effective interventions. Right now, we have plenty of information to tell us how bad things are but only have a limited number of things we can do about it. Our goal is to work for action and positive change."

What's Next

The pilot program already is nearly full. Dr. Pont and his colleagues hope that what they learn over the next semester will form the basis of an ongoing treatment program and that funding can be found to offer it to other students. "There are many questions that need answers," he continues. "If we can apply what we learn, we can expand and meet the needs we have already found. Childhood obesity is hurting people today. We must address this immediate need and also work to prevent it in the future."

Texas Child Study Center

The Texas Child Study Center at Dell Childrens Medical Center of Central Texas was created to increase mental health services and give all Central Texas children access to quality mental health care so they can live their lives to the fullest. Treating the pediatric mental health patient is much more complex than treating an adult. The program is a joint effort between the University of Texas at Austin's Department of Educational Psychology and Dell Children's Medical Center.

Stephen J. Pont, MD, MPH
Assistant Professor of Pediatrics
Medical Director, AISD Student Health Services
UTMB-Austin Outpatient Faculty
UT-Austin Department of Kinesiology and Health Education

4900 Mueller Blvd, 3rd Floor
Austin, TX 78723
Phone: (512) 324-0165

Dr. Pont joined the ambulatory faculty of Dell Children's this year. He earned a B.A. from the University of Texas at Austin and attended medical school at the University of Texas Southwestern Medical School in Dallas, TX. Dr. Pont completed his pediatric residency training at Arkansas Childrens Hospital / University of Arkansas for Medical Sciences, Little Rock, AR and then completed an academic general pediatrics fellowship at Vanderbilt University Medical Center, Nashville, TN, where he also received his M.P.H. Dr. Ponts interests include underserved populations and childhood obesity.