SMG Prof Battles Obesity in Kids

Every day, on average, 17 New England residents die waiting for kidney transplants, and nearly every death is related to complications from diabetes, brought on by obesity. When Roberta Clarke, a School of Management associate professor of marketing and vice chair of the board of the New England Organ Bank, learned of these numbers, she took action.

Collaborating with Stanley Goldstein (GSM’76), chairman of Sleep HealthCenters LLC, Clarke founded Great Moves, a medically supervised, family-based weight management program for children and their parents. “The biggest indicator of whether you will be an obese adult,” Clarke says, “is whether you are an obese child. Obesity is a national epidemic that’s bordering on a worldwide one. So why not go to the root of the problem?”

Overweight children have problems far greater than a few extra pounds. They are ridiculed by classmates, and they often suffer from depression and alienation. Health disorders such as heart and kidney disease, cancer of the central organs, and type 2 diabetes — complications formerly associated only with middle-aged and elderly adults — are now occurring in children as young as 12. “It is a crisis when children 12 and 14 years old are being treated for high cholesterol,” Clarke says. “It’s a crisis when a 15-year-old has a heart attack and teenagers are developing type 2 diabetes. By the time they’re in their 30s, they’ll probably be on dialysis.”

At Great Moves, which opened in April in Newton, at least one parent is required to accompany each child. “We’re educating the parents as well as the children,” Clarke says, “because, to be frank, children don’t become heavy by themselves. They’re not feeding themselves. Parents and children need to work together to achieve optimum health."

The six-month program, which works in partnership with the physicians of Children’s Hospital Boston and is based on research from the hospital’s Optimal Weight for Life program, takes a multidisciplinary approach to weight management. It includes physical activity, nutrition, and behavioral support. The focus is to help children and families develop healthy lifestyle habits that can be sustained over a lifetime, Clarke says.

During the nutrition portion of the program, children and parents learn to cook healthful meals at the facility’s on-site kitchen. Each class addresses nutrition topics such as fast food, breakfast, and snacks, and families meet individually with a registered dietitian each month to address issues specific to the child or family.

Great Moves also emphasizes the importance of physical activity. To entice reluctant children, the activity room is modeled after an arcade. In place of treadmills, the room is equipped with popular video games — such as Dance, Dance Revolution and Wi-Fit — that promote physical movement. There are hula-hoops and jump ropes, but no elliptical machines or stationary bikes. “Kids tend to think exercise is boring, and obese children in particular are intimidated by it,” Clarke says. “But they enjoy the video games. Even when they’re jumping all over the place, they don’t feel like they’re exercising because they’re having fun.”

“Most of the kids in the program are still growing,” she explains. “So if they can just stop gaining weight, they could grow into their existing weight and achieve a normal BMI over time.”

There are no weekly weigh-ins, and parents are discouraged from weighing their children at home. Instead, the program focuses on helping participants achieve lower cholesterol and glucose levels, as well as higher levels of physical endurance. “We’re concentrating on the overall health of the child,” Clarke says, “not the numbers on the scales.”

“I have great empathy for these children,” she says. Although Clarke has never been overweight, obesity runs in her family. Her father, a strapping six-foot-two, weighed 270 pounds before dropping to 180 pounds “through sheer willpower,” and both of her aunts died of kidney failure brought on by obesity complications.

While research indicates that weight problems are genetic, Clarke points out that the recent surge in obesity rates suggest the epidemic is related more to changes in behavior than to genetics. “Thirty years ago, 60 percent of the population wasn’t overweight, 30 percent wasn’t obese, and 15 percent of our kids weren’t obese,” she says. “Our genes haven’t changed that much in 20 years. We need to make a change, and we need to do it now.”

For more information, visit the Great Moves Web site. There is a $300 registration fee and an additional $450 monthly fee for six months. Although the program isn’t currently covered by insurance, some individual services, such as the physical checkup, might qualify for insurance reimbursement.

Vicky Waltz can be reached at vwaltz@bu.edu.