How I practice: Obesity medicine physician steers kids to healthy choices

Nearly one-fifth of American children are obese, according to the Centers for Disease Control and Prevention. But in certain communities, the rate of childhood obesity is more than double the national average. Tyree Winters, DO, says almost half of the young patients he treats at his practice in Newark, New Jersey, are overweight or obese.

Dr. Winters, who heads the Pediatric Health and Weight Management Program at Children’s Hospital of New Jersey at Newark Beth Israel Medical Center, knows firsthand the struggles his young patients face with their weight. His personal experience led him to a career in obesity medicine for the pediatric population, and it gives him “street cred” among his patients and their families, he says. Following is an edited interview.

What is obesity medicine?

This field, which is still relatively new, is an extension of primary care. It means having a good understanding of weight management as a whole. It’s not just about eating properly and getting enough exercise. It means recognizing various factors such as biological markers that can lead to an elevated body mass index and certain illnesses in individuals.

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Today, one of the biggest illnesses I’m seeing with my patients is an increase in nonalcoholic fatty liver disease. What’s alarming is that I’m seeing this in children who are 4, 5 and 6 years old. In some cases, this condition may lead to cirrhosis, which could require a liver transplant.

How does your program help young patients?

The program I’m establishing here is very similar to a program I worked with at Nationwide Children’s Hospital in Columbus, Ohio, where I was the lead clinician for four years. At my position here in Newark, we’re recruiting patients for the program who are identified by the primary care physicians at the hospital.

The first step is to do an initial assessment of the child’s eating and exercise habits and note any challenges he or she is facing that could impact their ability to participate in the program. After that, we determine whether the patient is interested in participating and develop specific lifestyle modification goals that we want to hit in the next six months, which is the program’s duration. Success is determined by whether we’re meeting these target goals.

The patient will come in every two weeks to meet with me or one of the allied health professionals on the team, including a social worker, exercise physiologist and nutritionist.

As a DO, how do you care for the whole patient?

One thing I take great pride in as a DO is that I connect with my patients. I treat a lot of children who have been bullied by their peers and sometimes even by family members who use “endearing” nicknames that can lead to a negative self-image.

I share my own childhood weight struggles with these children. They appreciate that I can truly empathize with them. When I talk with patients, I make sure to stress that they are more than just their weight. They are individuals.

Also, we exercise together. In fact, I host a hip-hop dance class for kids in the community.

What advice would you give to someone who is interested in pursuing a career in obesity medicine?

Since it’s still a new field, there’s not a clear-cut pathway. The best advice I can give is to read as much as you can on the issues related to obesity. Also, understand this is not an easy field. It can be daunting, challenging and emotionally taxing. I give myself a break by dividing my time among the weight management program, administrative work as associate program director for a pediatrics residency and general pediatrics.