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An approach to obesity: Matt Sabin at DFTB18

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Associate Professor Matt Sabin is the Chief Medical Officer of the Royal Children’s Hospital in Melbourne. It was not in this role that we asked him to speak but rather in his clinical role as a paediatric endocrinologist running the largest tertiary hospital obesity service in Australia.

There are some conversations that we just don’t want to have. It may be because we think they are too hard, too risky, too political. But sometimes we have to have these fierce conversations because we care about the health of our patients. We wouldn’t think twice about counselling our adult patients about the lifestyle risks of smoking, drinking or being overweight but we shun the harder conversation about their children. As Matt points out we all have an opinion on how to lose weight, based on the lived experiences of friends and family, but it is not wise to bring this into the clinical space.

 

 

 

This talk was recorded live at DFTB18 in Melbourne, Australia. With the theme of ‘Science and Story‘ we pushed our speakers to step out of their comfort zones and consider why we do what we do. Caring for children is not just about acquiring the scientific knowhow but also about taking a look beyond a diagnosis or clinical conundrum at the patient and their families.

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Selected References

Berkey CS, Rockett HR, Gillman MW, Field AE, Colditz GA. Longitudinal study of skipping breakfast and weight change in adolescents. International journal of obesity. 2003 Oct;27(10):1258.

Brown MM, Milanes JE, Allison DB, Brown AW. Eating compared to skipping breakfast has no discernible benefit for obesity-related anthropometrics: systematic review and meta-analysis of randomized controlled trials. The FASEB Journal. 2017 Apr;31(1_supplement):lb363-.

Burgner DP, Sabin MA, Magnussen CG, Cheung M, Sun C, Kähönen M, Hutri-Kähönen N, Lehtimäki T, Jokinen E, Laitinen T, Viikari JS. Early childhood hospitalisation with infection and subclinical atherosclerosis in adulthood: the Cardiovascular Risk in Young Finns Study. Atherosclerosis. 2015 Apr 1;239(2):496-502.

Casazza K, Fontaine KR, Astrup A, Birch LL, Brown AW, Bohan Brown MM, Durant N, Dutton G, Foster EM, Heymsfield SB, McIver K. Myths, presumptions, and facts about obesity. New England Journal of Medicine. 2013 Jan 31;368(5):446-54.

Dhurandhar EJ, Dawson J, Alcorn A, Larsen LH, Thomas EA, Cardel M, Bourland AC, Astrup A, St-Onge MP, Hill JO, Apovian CM. The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial. The American journal of clinical nutrition. 2014 Jun 4;100(2):507-13.

Goran MI, Gower BA. Longitudinal study on pubertal insulin resistance. Diabetes. 2001 Nov 1;50(11):2444-50.

Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA, Srinivasan SR, Daniels SR, Davis PH, Chen W, Sun C. Childhood adiposity, adult adiposity, and cardiovascular risk factors. New England Journal of Medicine. 2011 Nov 17;365(20):1876-85.

Kral TV, Whiteford LM, Heo M, Faith MS. Effects of eating breakfast compared with skipping breakfast on ratings of appetite and intake at subsequent meals in 8-to 10-y-old children. The American journal of clinical nutrition. 2010 Nov 17;93(2):284-91.

Lazzeri G, Giacchi MV, Spinelli A, Pammolli A, Dalmasso P, Nardone P, Lamberti A, Cavallo F. Overweight among students aged 11–15 years and its relationship with breakfast, area of residence and parents’ education: results from the Italian HBSC 2010 cross-sectional study. Nutrition journal. 2014 Dec;13(1):69.

Sabin MA, Magnussen CG, Juonala M, Shield JP, Kähönen M, Lehtimäki T, Rönnemaa T, Koskinen J, Loo BM, Knip M, Hutri-Kähönen N. Insulin and BMI as predictors of adult type 2 diabetes mellitus. Pediatrics. 2015 Jan 1;135(1):e144-51.

Viner RM, White B, Barrett T, Candy DC, Gibson P, Gregory JW, Matyka K, Ong K, Roche E, Rudolf MC, Shaikh G. Assessment of childhood obesity in secondary care: OSCA consensus statement. Archives of Disease in Childhood-Education and Practice. 2012 Jun 1;97(3):98-105.

 

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