Mason is an 8 year old male who recently visited his pediatrician, and was found to have a BMI in the 96 percentile for his age. His BMI for age has trended up over the past three years. Mason's father reports that Mason is in the 3rdgrade and takes the bus to school each day. He usually brings his lunch to school, which typically consists of a peanut butter and jelly sandwich, chips and a juice box. Mason enjoys playing video games after school with his brother, and watches TV or plays more video games after supper until bedtime. Snacks after school include cookies, juice or soda, and cheese curls or chips. Both of Mason's parents work, and so dinner is often a take-out order of chicken nuggets, French fries and a soda picked up after work, a frozen pizza or a quickly prepared meal or hot dogs or sloppy joes, chips and green beans or corn. Mason's mother is obese however his father is normal weight.
1. What is your assessment of Mason's body weight, given the growth chart information you have been given?
2. Is the fact that Mason's mother is obese significant? How is this relevant to Mason's weight status?
3. What factors likely are contributing to Mason's weight status?
4. What specific recommendations could you make to Mason's parents to improve his eating and physical activity habits?
Scenario #3
EJ is a 14-year-old male who currently resides at a behavioral health resident treatment facility. He has been diagnosed with obesity and hyperlipidemia, most likely due to side effects from the medications he is taking for bipolar disorder. The registered dietitian has been asked to speak with EJ about his new diet order for a low-fat diet and to provide suggestions to EJ's family. EJ is expected to return home next month. His family has been participating in family counseling weekly with EJ while he has been at the facility. Currently EJ is 195 pounds and 70 inches tall. EJ's mother reports that EJ typically eats at fast-food restaurants after school three or four days a week. His intake of fruits and vegetables has only been 1-2 daily while at the facility, and his mother indicates this is more than he eats at home. When EJ does drink milk, it's usually whole milk. EJ's family is very busy, and often EJ and his two older siblings prepare their own dinner.
Questions:
1. What is EJ's BMI? How does this classify his weight at this time?
2. What dietary recommendations do you have, specific to EJ's situation, that can help him improve his nutritional intake and reduce his fat consumption?
3. What guidelines do you need to keep in mind as you provide nutrition education and counseling to adolescents?
4. How might family meals impact EJ's nutritional intake?