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Adolescent Nutrition and Eating Disorders
N.W. Regional Web Symposium

Adolescent eating disorder issues summarized

Adolescent weight management summarized

Adolescent weight management evaluation table

Healthy nutrition for children:  an interview

Pregnancy in Adolescence

Risky Eating Behaviors

Presentations
MPH Student Research 
Eating Disorders during Adolescence:  
Weight Management

Jane Mitchell Rees, PhD, RD, CD
Departments of Health Services and Pediatrics 
Maternal Child Health and Adolescent Medicine 
University of Washington, Seattle, WA 98195


Eating Disorders
   2    3

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Pregnancy

Puberty

Risky Eating Behaviors

Weight Management

Adolescent Weight Management Evaluation Table

Introduction: This table provides the knowledgeable professional a tool for evaluating an adolescent undergoing a weight management program.  It includes assessment of Nourishment, Energy/Time Management, and Psychosocial Health, as well as a set of Objective Measures. It can be used in whole or in parts over time as long term intervention proceeds

To download this table in Adobe Acrobat (pdf) format click here
To download this table in Microsoft Excel format click here


Suggested Use: Rate on a scale of 1 to 5 the contribution to weight management (1=minimum, 5=maximum) by placing the date under the most recent "earned" score on issues at left.

I. Nourishment

1. Knowledge of:

1 2 3 4 5

Meaning of term "calories"

         

Role of food in life

         

Relationship of energy intake to output

         

Major nutrients: 

         
                         Physiologic role

                         Energy value

         

                         Amount needed

         

                         Food sources

         

                         Amount of food needed to obtain

         

Choosing food in any situation

         

Behavior modification techniques to manage intake

         

Appropriate wt/ht/genetic heritage

         

 

2. Attitude:

1 2 3 4 5

Acceptance of responsibility for nourishing self

         

Commitment to:

         

                      Health-promoting habits

         

                      Obtaining appropriate foods

         

                      Nutrition education

         

 

3. Eating Behavior:

1 2 3 4 5

Control of: 

         
                      Food supply

                      Fat content

         

                      Types of food

         

                      Amounts

         

                      Meal pattern

         

                      Between meal eating

         

                      Binges/night eating/other aberrations

         

Uses behavior modification techniques

         

Eats in: 

         
                      Social situations

                      With family

         

                      With peers

         

 

4. Family:

1 2 3 4 5

Eats meals together:

         

                       Place

         

                       Distractions (e.g. TV)

         

                       Serving methods

         

Support for weight control, via:

         

                       Use of food

         

                       Knowledge

         

Autonomy allowed to patient to choose food

         

 

II. Energy and Time Management

1. Knowledge of:

1 2 3 4 5

Exercise in energy balance

         

Fitness: 

         
                       Cardiorespiratory          

                       Muscular

         

Exercise: 

         
                       Aerobic          

                       Anerobic

         

Monitoring pulse

         

 

2. Attitude:

1 2 3 4 5

Commitment to exercising regularly without others, equipment, or money, if necessary

         

Interest in fitness education

         

Pleasure in moving

         

 

3. Behavior:

1 2 3 4 5

Fitness: 

         
                       Tested

                       Program planned

         

Program maintained

         

Level of fitness

         

Relaxation

         

Rest/sleep

         

Activities shared: 

         
                       With friends

                       With family

         

Consciously plans exercise/relaxation/rest

         

 

4. Family:

1 2 3 4 5

Support of activities

         

Family activities

         

Understanding of exercise in weight management

         

 

III. Psychosocial Health

1. Knowledge of:

1 2 3 4 5

Emotional factors in weight management

         

Cues to eat: 

         
                       Internal

                       External

         

Impact on emotional health of:

         

                       Physical activity

         

                       Nourishment

         

Responsibility for weight management

         

Need to seek guidance for insoluble problems

         

 

2. Attitude:

1 2 3 4 5

Commitment to:

         
                        Mental health          

                        Learning about weight control

         

                        Solving problems

         

 

3. Behavior:

1 2 3 4 5

Pleasurable experiences

         

Relationships: 

         
                        Peers          

                        Family

         

                        Teachers

         

                        Counselors

         

School activities

         

Social skills

         

Intellect: 

         
                         Insight          

                         Communications

         

                         Problem solving

         

                         School performance

         

Goal setting: 

         
                         Short term          

                         Long term

         

                         Self-awards

         

 

4. Emotional status:

1 2 3 4 5

Body image

         

Self-efficacy

         

Locus of control

         

Depression vs. non-depression

         

Sense of humor

         

Oral gratification

         

Coping skills

         

Compulsivity

         

Perfectionism

         

Independence

         

 

5. Parental:

1 2 3 4 5

Perception of weight problem

         

Support vs. intrusion: 

         
                         Emotional

                         Financial

         

Rigidity

         

Conflict resolution

         

Commitment to treatment

         

 


Objective Measures

Date_________   Age (y)__________  Birthday__________

    Measures
History

Maturation stage

             0 

1 2 3 4 5
Menarche 0 +1 yr +2 yr +3 yr +4 yr +5 yr
Spermarche 0 +1 yr +2 yr +3 yr +4 yr +5 yr
Length of obesity Infancy Toddler Early childhood Elementary school Junior high Senior high
Reduction attempt Yo-yo Severe Diets Exercise 0 Reasonable Anorexia Bulimia
Parents Natural Adoptive Anorexia Bulimia Obesity Overweight
Grandparents Natural Adoptive Anorexia Bulimia Obesity Overweight
Initial & Subsequent Thyroid screen Normal Abnormal        
Cholesterol Cholesterol(mg/dl)_____________   HDL(mg/dl)_____________ LDL(mg/dl)_____________ Triglycerides(mg/dl)_____________
Blood pressure (mm Hg)_______________
Wt. %tile >95 95 95-75 75 75-50 50
Ht. %tile 95 90 75 50 25 10
Wt/Ht %tile >95 95 95-75 75 75-50 50
BMI %tile >95 95 95-75 75 75-50 50
TSF %tile >95 95 95-75 75 75-50 50
SSF %tile >95 95 95-75 75 75-50 50
MAC %tile >95 95 95-75 75 75-50 50
AMC %tile >95 95 95-75 75 75-50 50
Waist Circumference   (in)___________
Hip Circumference   (in)___________
Waist/Hip Ratio   ______________
Exercise to reach 120 bpm (training rng) Slow walk Moderate walk Fast walk Walk up hill Walk/Jog Jog

 

  Date of Entry +3 mo. +6 mo. +12 mo. +18 mo. +24 mo.

+10 lb            
+5 lb            
Wt._____lb            
-2.5 lb            
-5 lb            
-10 lb            
-15 lb            

Rate of Gain (lbs/mo.)            
  Previous 1 yr_______________   Previous 5 yr_______________

+ 3            
+ 2            
+ 1            
Ht.____in            

+ 500            
+ 200            
+ 100            
AMA____mm2            
- 100            
- 200            

+ 3            
+ 2            
%BF____%            
- 2            
- 5            

+ 5            
+ 3            
RHR____bpm            
- 3            
- 5            

To download this table in Adobe Acrobat format click here
  To download this table in Microsoft Excel format click here  


References

Barlow SE, Dietz WH.  Obesity evaluation and treatment:  Expert Committee recommendations.  Pediatrics. 1998;102:e29.

Savoye M, et al. Effects of a weight management program on body composition and metabolic parameters in overweight children: A randomized controlled trial. JAMA. 2007; 297:2697-2704.

Rhodes ET, Ludwig DS. Childhood Obesity as a Chronic Disease:  Keeping the Weight Off.  JAMA. Oct 10, 2007; Vol. 298, No. 14.

Barlow SE and the Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics. Dec 2007; 120:S164.  http://pediatrics.aappublications.org/cgi/reprint/120/Supplement_4/S164 (Accessed April 2, 2012)

Wisotsky W, Swencionis C.  Cognitive-behavioral approaches in the management of obesity Adolescent Medicine. Feb 2003; 14(1) 61-75.

Maternal and Child Health Library web site. Overweight and Obesity in Children and Adolescents Knowledge Path - July 2008.  http://www.mchlibrary.info/KnowledgePaths/kp_overweight.html (Accessed April 2, 2012)

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