Childhood obesity is a serious medical problem that affects nearly 15 million children and adolescents in the United States. Without treatment, this disease can lead to diabetes, high blood pressure, and heart problems as adults.

With a growing number of adolescent patients facing obesity, J. Federico Andino, MD, family physician of the Montgomery Family Practice and Peggy Krepto who serves as a clinical care coordinator at the Einstein Healthcare Network collaborated with MossRehab Norristown to create the Pediatric Healthy Living Program (PHLP) to address the high incidence of pediatric obesity and promote a healthier lifestyle for these children.

“In my research, I found that nearly one in three children living in Montgomery County are obese or overweight – that’s an increase of almost 9,000 children in the last five years,” notes Krepto. “Over 1,700 of these children are patients of the Einstein Physician Montgomery practices.”

Finding that outside resources either could not accommodate all the children needing care for obesity or were not providing effective results, Krepto, who previously worked as a pediatric nurse, proposed the idea of an internal program for adolescents diagnosed with obesity. Working with Dr. Andino, the team initiated the PHLP that focuses on the weight management and health of children ages 8 to 12 who fall in the 95^th percentile or higher for weight.

“The program’s goal is to increase a child’s daily activities to become healthier by better managing their weight, cholesterol levels and body mass index,” explains Krepto.

Land and Water Exercises for Kids

PHLP started with a pilot program in November 2020 with a group of 10 children referred by Dr. Andino. Attending exercise sessions in groups of two, the children met with physical therapist Amanda Gagnon, DPT, who runs the aquatic program at MossRehab Norristown.

“My primary objective is to increase the amount of exercise that children perform daily to encourage a healthier lifestyle,” explains Gagnon, who splits her practice treating adults and pediatrics in the PHLP with both traditional land and water therapies. “As the term ‘exercise’ often has a negative connotation around kids, I encourage them to explore different types of exercise so they discover what they really enjoy.” 

After initially evaluating each child to determine the right exercise plan, Gagnon supervises their therapy sessions twice a week for four weeks: one day is spent doing land exercises and the other in the water. Each week, therapy follows a theme – one week might concentrate on aerobic exercise and another on strengthening or balance. Gagnon uses a combination of machines or body weight exercises in the gym and swimming or games in the pool.

“The pool is definitely their favorite,” says Gagnon. “I re-evaluate the children mid-way and at the end of the program to assess their response and progress to treatment.”

The children also are instructed to perform exercises at home and keep track of their daily activity. “The ultimate goal is for the kids to perform one hour of moderate-intensity exercise every day and have a plan to continue after the program ends,” notes Gagnon.   

Kids Have Fun While Getting Healthy

Children attending the program are so excited that they rarely miss an appointment. “In addition to improving their health, the experience makes them feel good about themselves and enjoy the camaraderie of others,” says Gagnon. “And as most kids are competitive, it increases their drive when exercising in a nonjudgmental space with peers.”

Since the pilot, the program has completed several sessions. “After going through the program, the children are more mindful about what they eat and are eager to exercise at home,” says Krepto.

The PHLP – the first program of its kind offered by Einstein – is receiving positive feedback from parents saying that their kids continue exercise at home. “One parent got a treadmill for their child since it was their favorite activity,” says Gagnon. “Others are signing up their children for sports, dance and other activities that incorporate exercise.”