Pediatric obesity is a serious health issue, recently amplified by the COVID -19 pandemic. Obesity affects nearly 30% of children and adolescents and is associated with unfavorable health outcomes including cardiovascular disease, type 2 diabetes, and low self-esteem. Sadly, over 70% of obese adolescents will become obese adults. The Fit Kids for Life (FKFL) program is an interdisciplinary pediatric obesity program that enlists faculty and students from several health professions including medicine, physical therapy, nursing, and athletic training and delivers a 10-week nutrition, physical activity and behavioral modification program to children, ages 8-17, with a BMI ≥ 85th percentile.

PURPOSE: The purpose of this clinical case study is to describe the FKFL program, and the evolution of one subject who has attended the program from age 9 -15 years old.

METHODS: The subject was interviewed using change talk/motivational interviewing and current stage of change (SOC) was determined. Baseline evaluation including body composition (Bod Pod/ Styku), vital signs, cardiovascular endurance (6MWT) and sub-maximal VO2 (3 min. step-test) was performed pre-post FKFL. Each subject provided with a Fit Bit for home use. The subject attended FKFL for a total of 80 hours/year, and returned for 5 years (10 sessions).

RESULTS: SOC for physical activity progressed from pre-contemplative to contemplative and now action stage. Importantly, the subject did not relapse during the Covid shutdown. BMI has decreased from 99.2%tile to 97.4%tile; percent body fat (%BF) from 41.6% to 26.1%, and blood pressure (systolic / diastolic) decreased by 20 and 15 points respectively. The 6MWT increased by nearly 100 meters and 3min step test is now above average (less than100 bpm).

CONCLUSION: The subject attributed his wellness success to lessons learned in FKFL (nutrition, exercise) as well as having a student trainer/mentor and a cohort of “like” kids to work with during the FKFL program. The subject moved from prepubescent-pubescent during this study, and this may have influenced body composition changes. %BF may be a better indicator of health vs. BMI. This case study describes the FKFL program as well as the evolution of one participant and identifies key factors that have inspired lasting fitness improvements in a child with obesity.



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