Pleasurable way to new lifestyle

By on January 7, 2019
Max-Michel Kolij

Treating obesity in children and adolescents requires something very special. Now the very difficult-to-treat patient group is offered help in the form of a completely new partly digital treatment method at the Children’s Hospital Martina.

– Our method has proved successful in clinical trials that have been carried out at Karolinska Institutet. Now we try it on a full scale for all children with obesity who get treatment from us, says Claude Marcus, professor, pediatrician and medical manager for Center for Weight Health, which is part of the Children’s Hospital Martina.

The new method involves motivating the children to change their behavior and give their parents greater access to the specialists at the reception. A large part of the contacts take place digitally and remotely. Parents and children can thus get daily contact with the reception and answers to any questions within just over a day.

The contact is made via a digital platform and an application (a so-called app) that the parents download in their mobile phones. It is developed by game developers and is based on the game technology’s pedagogy where the reward system is triggered and motivates the user to continue with his behavior. Each child gets their own activity bracelet that is linked to the app and gives them, for example, points for good habits.

– Reward systems mean that the children are motivated to continue. We strive to make it a little more fun for the younger children, for example, that they are upgraded to new levels and should accumulate points, says Karin Kling, unit-responsible child nurse at the reception.

The lifestyle needs to be changed
Treating childhood obesity requires a lot from the whole family because it is often a matter of redesigning a whole lifestyle pattern for all family members. Many times the diet is the most difficult to change, according to Karin Kling.

– It may be easier to start moving a little more, compared to managing to eat a little less. Society is structured so that whatever age you are you get thrown into temptation wherever you go. There is a constant availability that is difficult to defend against.

The situation can be likened to nut allergy – you have to abstain, otherwise you are affected. Therefore, it is important that the whole family is involved and support in the program. Everyone around the child is needed as this is difficult to treat.

In the treatment, the children get their own specially designed personal scales where they do not see their weight. It to avoid weight fixation and instead focus on the path towards the result. The weight data from the wave is sent to the clinic, which feedback at least every week with instructions on what should be done or if you are on the right track. It has previously been seen that if it is long between visits, it is easy to cancel them, especially if the child has gained weight.

– The visits are then only static controls where you have to manage yourself between times. If only then it is found that it has not gone well, it is easy to give up, explains Karin Kling.

Think outside the frames
Children’s Hospital Martinas CEO Claude Kollin, who is basically a child surgeon, has built up Center for Weight Health during two years:

– I have been aiming for this long time and from the beginning was stimulated by the challenge that the group is very difficult to handle. It is important to think outside the framework.

The reception is integrated in the Children’s Hospital Martinas other activities, which provides a complete child care where the children are treated by expert staff on site. Here is the opportunity to take 24 hours of ECG, ultrasound on the heart, measure blood sugar, blood pressure and investigate the encumbrance of sequelae that the children can suffer.

– We have built up a unique experience. For example, we also have a reception for mental health with psychiatrists and psychologists. There is nothing we need to remit to for other receptions, says Claude Kollin.

Genetic vulnerability
Children suffering from obesity and fatness generally have a genetic vulnerability to easily gain weight. The environment also plays a major role, and it has been seen that children are more often affected in socio-economically vulnerable groups where the parents have lower education. Another problem is sedentary with continuous eating, often in solitude, in front of computer screens. The new method offered by the Children’s Hospital Martina will be evaluated scientifically by researchers at Karolinska Institutet.

– For us, it is extremely important to follow up the results and evaluate whether it really is as we think – that the method works, says Claude Kollin.

The Center for Weight Health currently has 90 referrals from all over Stockholm and also from other parts of the country. Since the treatment is done remotely, one must not live in close proximity to the hospital. In the future, the reception will be able to receive 500 patients.

Text: Chi An Gramfors Englund

Helena Olofsson, Training & Health | Stockholm