What’s working for teens with severe obesity?

A new study online in the Archives of Pediatric and Adolescent Medicine (a JAMA Network publication) finds that although weight-loss surgery for teenagers saw a big jump from 2000 to 2003, after that, the numbers of teens undergoing these procedures plateaued to about 1,000 per year in the United States.

The study, conducted by Children’s National surgeons and experts from several divisions, including lead author and Surgery Research Fellow Deirdre Kelleher, MD, as well as pediatric bariatric surgeon and investigator from the Sheikh Zayed Institute Evan Nadler, MD, and the Chief of the Division of Trauma and Burns at Children’s, Randall Burd, MD, sought to quantify the number of surgeries, the types of surgeries (open vs. minimally invasive), and the demographic of the patients electing to undergo these procedures.

The hard data findings of a plateau in the number of surgical procedures contradicts several high profile commentary pieces citing an increase in the use of bariatric surgery for teens over the last 10 years.

In truth, the data from the Children’s study, which used the AHRQ’s KID database to track inpatient bariatric procedures, finds that, since 2003, the numbers of teens undergoing these procedures has remained static, even while the rate of children with morbid obesity continues to rise.

Interestingly, in the same journal edition, a 3 year longitudinal study out of Sweden found that the more traditional weight-loss interventions involving diet, exercise, and other lifestyle interventions, while successful with teens who have moderate obesity, were not effective at all for adolescents with morbid/severe obesity—the population who has the greatest number of obesity-related comorbidities and would benefit from direct intervention.

“New studies are being published every day, including this one, that show traditional behavioral interventions are not effective for adolescent patients with morbid obesity,” said Dr. Nadler. "If we aren’t treating them successfully with diet and exercise, and they aren’t undergoing surgery, how are we going to help these patients and how will the obesity epidemic end?”

Read the media release at ChildrensNational.org. 

Pediatric health care innovations presented by Children's at World Health Care Congress Middle East

During this week's World Health Care Congress Middle East, Children’s National held a special pediatric session featuring best practices in several key areas of children’s health that will help eliminate unnecessary complex procedures and reduce pain for children. Attendees included leaders in clinical care and policy development from the across the Middle East and Gulf region.The topics were selected based on requests from regional physicians, who were seeking more information about these subjects, including: 





Dr. Atabaki presents research to regional
physicians about assessing traumatic
brain injury in children.


• More precise and effective diagnosis of traumatic head injury, by Shireen Atabaki, MD, MPH, a pediatric emergency medicine specialist and director of Medical Student Education in the Division of Emergency Medicine at Children’s National.
• The reduction of preventable pain during and after surgery through the use of advanced minimally invasive surgical approaches tailored for children, by Craig A. Peters, MD, division chief of Surgical Innovation, Technology, and Translation at Children’s National, and lead of the Innovation and Education Initiative at the Sheikh Zayed Institute.
• The development of new integrated tools to diagnose, treat, and manage ongoing pain in children, by Julia Finkel, MD, associate division chief of Anesthesiology and Pain Medicine and lead investigator of the Pain Medicine Initiative at the Sheikh Zayed Institute.

Dr. Finkel demonstrates the pain algometer
to reporters in Abu Dhabi.

Drs. Finkel and Peters also had a little time to spend with the Abu Dhabi media to talk about the latest work of the Sheikh Zayed Institute in pain medicine and minimally invasive surgery. As this work is largely made possible by the historic gift from the government of Abu Dhabi on behalf of the people, there was much excitement and curiosity from the local media about the institute's recent and upcoming developments.

Building quality health systems is a key focus of the World Health Care Congress Middle East

This week, a delegation from Children’s National and the Sheikh Zayed Institute joined the 3rd Annual World Health Care Congress Middle East in Abu Dhabi, United Arab Emirates. The primary themes for this year's congress focused on collecting and using data transparently and effectively to improve the overall quality of health care providers around the world. In his opening remarks, H.E. Engineer Zaid Al Siksek, the CEO of the Health Authority Abu Dhabi, noted that technology advances are allowing providers to collect more information than ever before, and that health systems like those in Abu Dhabi are now learning how to use that information to truly improve care for patients.

Sessions focused on improving health
delivery and quality for patients.

The data and response generated by Abu Dhabi's Weqaya system, which provides health care to Emirati citizens of Abu Dhabi, is a good example of successful application of data to improve health outcomes. In 2008, Weqaya enrollees underwent a series of routine health screenings. It was found that 23 percent of the Emirati population had diabetes. Even more suprising, 30 percent of that group were not aware they had diabetes. The data about diabetes assessment and treatment in the emirate has resulted in an ability to compare quality at the patient level and improve effectiveness across the entire system. Today, the Health Authority has launched several educational programs and made policy changes to help providers do a better job of diagnosing and treating diabetes before it escalates into dangerous complications.

H.E. Al Siksek noted that this is simply the start, and successful health systems will need to use this data to transition to what he refers to as a "4P" health model to advance to the next level of health care: Predictive, personalized, preventive, and participatory. Not only that, but these systems will also need to begin measuring their progress and overall health care delivery by a measure of "quality divided by cost."

Doctors Peters and Finkel pose
in the Children's National/Sheikh Zayed
Institute booth at the World Health Care
Congress Middle East exhibition.  

These themes were echoed throughout the congress, with special emphasis on how the countries of the Middle East, especially the United Arab Emirates, could pioneer new models in research, clinical care, and data collection/analysis to revolutionize health care around the world.

Crowdfunding website with child health focus launched by Sheikh Zayed Institute

The Sheikh Zayed Institute recently launched the first child health focused crowdfunding website. The website, ChildrensNational.org/Crowdfunding, gives the general public access to directly support any of the four featured research projects. This pediatric crowdfunding program is designed as a pilot project to gauge both the need for additional funding sources from investigators and the interest of the general public in supporting specific research aimed at helping children.

“We know that government and philanthropic research funding is more competitive than ever before,” said Floortje Blindenbach-Driessen, PhD, head of the crowdfunding initiative. “We also know through our institute’s focus on pediatric innovation that there are many, many good project ideas out there that are either too small to qualify for that funding or need additional assistance to begin.”

Read the full media release, or visit www.ChildrensNational.org/Crowdfunding to learn more about the project.