I received a frantic call from a nurse/colleague, Liz, who just came back from her pediatrcian’s office with a long list of questions concerning recent abnormal laboratory results for her five-year-old daughter, Sarah. Her physician had reviewed the lab results with her, but she wasn’t satisfied with his answers. Sarah was being evaluated for obesity. Her height was calculated at the 50th percentile and her weight was above the 97th percentile on the growth chart, with a BMI of 27.1 (placing the BMI-for-age at greater than 99th percentile consistent with the diagnosis of obesity). Her lab results were remarkable for an elevated fasting blood glucose, concerning hemoglobin A1C of 6.1 and a lipid profile noted to have an elevated triglyceride level of 160. I was also concerned when the mom told me her ALT (liver function test) was 40 and her physician told her to “…Stop being a nervous Nelly!” and that it was “fine.” (Clearly, he wasn’t familiar with lab value recommendations for kids!)¹ Her MD’s advice was to increase Sarah’s exercise and put her on a Weight Watcher’s diet along with Mom who was also overweight and trying to manage her Type II diabetes. Oy vey!

It was disheartening to learn that some of my colleagues had not moved out of the dated 1970s medical mantra that obese patients (even kids) overate and were lazy. I’ve been out of the mainstream medicine world so long that I forgot that pediatricians are undernourished with nutritional knowledge and overfed with drug information. Not to mention, there is a global lack of awareness of the myriad number of other factors that can contribute to obesity in kids. In the age of technology-driven learning/play and fast-food delivery services, indeed, getting kids to move and eat well are a big part of the conversation. However, let’s talk about the elephant in the room.