Overview

Early in 2003, the Department of Pediatrics recognized the need to fully address the pressing health issues related to childhood obesity and created the Center for Nutritional Disorders and Obesity (CENDO). The Center was designed to systematically address the diagnostic and clinical treatment of obesity, to support research initiatives, to provide educational opportunities and to partner with community outreach programs related to the prevention, diagnosis and management of childhood obesity. The Healthy Lifestyles Program, under the direction of Dr. Sarah Armstrong, emerged as Duke’s comprehensive clinical treatment program for children and adolescents who are overweight or obese. Today, the Healthy Lifestyles team offers a six month comprehensive medical, dietary, exercise and behavioral modification treatment for children aged 0-22 at two clinical sites in Durham and Raleigh. In addition to individualized clinical treatment, Healthy Lifestyles offers a free exercise group for teens and their adult workout partners (Active TEENs) as well as peer support groups for young teens (8-12 years), older teens (13-16 years) and their parents that is rooted in stress-reduction and emotion regulation. Over 4000 families have participated in the Healthy Lifestyles Program. Children and adolescents who complete the program show a significant drop in body mass index, body fat percent, blood pressure, and cholesterol; as well as an increase in self esteem and nutritional knowledge. You can be a part of this successful group by making an appointment today!

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Treatments

Eligibility

To participate in the Healthy Lifestyles Program:

• A patient must meet the definition of childhood overweight.  Click here to enter your child’s birth date, height and weight to see if he/she qualifies.

• Fasting labs (FASTING Insulin, Lipid Panel, CMP, TSH, HbA1c, and Urine microalbumin) must be completed for all children aged three years and older. A referral from your child’s primary care physician is preferred but not mandatory.

• The parent or guardian must be willing to commit to six monthly appointments for the intensive phase of the program. We appreciate at least 48 hours notice if a cancellation is necessary. Three late cancellations or no-shows will disqualify the family from participation.

What to Expect

Making an Appointment
Once you have determined your child is eligible, either you or your child’s physician may refer the patient to the Healthy Lifestyles program and schedule an appointment.

Screening Visit
Prior to your visit, you will be mailed a letter of introduction and three forms. You may also download them here:

Healthy Lifestyles Program Introduction Letter (PDF, 168 KB)
Pediatric Symptom Checklist (PSC) (PDF, 176 KB)
Pediatric Symptom Checklist - Youth Report (Y-PSC) (PDF, 172 KB)
Medical History Form (PDF, 168 KB)

Additional Forms
Daily Food Log (PDF, 64 KB)
Tips for Completing the Food Log (PDF, 36 KB)

Please fill the forms out at home and bring them with you to your first appointment. You will meet with one of the Healthy Lifestyles medical providers who will perform a comprehensive history and physical to identify underlying medical causes of obesity, risk factors for chronic illness, and lifestyle risk factors. We will discuss your child’s individualized health profile based on measurements done in clinic, blood work results, family history, and your score on the surveys you have completed. At the conclusion of this visit, we will provide you with a "road map" of your child's health and identify the members of your family's Healthy Lifestyles Team, which will be tailored to your individual needs and goals. Please plan at least two hours for the first visit.

Intensive Phase
The intensive phase constitutes the next five monthly visits. Remember that this is a family-based program, so an adult will need to weigh-in with the child at each visit! Monthly visits will be with your personalized Healthy Lifestyles Team. As part of this journey, you and your dietician will develop meal plans, identify dietary needs based on medical conditions in the family, go on a grocery tour in our own “mini-grocery," and learn how to cook on a budget. You and your physical therapist will get moving on our treadmill, lifting weights, balancing on the exerball, and improving flexibility. You may meet individually with our eating disorders specialist, who will help you view food positively (not with guilt or shame). Additionally during this phase, you may choose to participate in our teen exercise group (Active TEENs) or in one of the Healthy Lifestyles Support Groups. During this phase, it is all about what you need to get--and how to stay--motivated.

Note:  The services listed above may not be available at both Healthy Lifestyles locations. Be sure to ask your Healthy Lifestyles provider for details.

Incentive Items!!! Your child should--and will be--rewarded for responsible behavior! At each visit, your child will have the opportunity to choose a “FitKit,” which is a gift that can be used to meet his or her goals for being healthy. Examples include hula hoops, pedometers, Frisbees, jump ropes, water bottles among many others. Also, if your child completes the six required visits within one year, he or she will receive a $50 gift card to Nike.com. Add another $25 Nike.com card for meeting twice with the exercise specialist and a $25 Food Lion card for meeting four times with the dietician. Even more incentives are available for those who join Active TEENs and the Healthy Lifestyles Support Groups!

Maintenance Phase
Once you and your child complete the intensive phase, you will be offered the option to move into the maintenance phase. This is a “check-in” visit every six months to ensure you’re staying on track. You may continue these visits indefinitely. If you ever need to re-enter the intensive phase, you may do so.

Additional Programs

E3: Teen and Parent Lifestyle Support Groups
E3 stands for emotion regulation, empowerment and excellence. This interactive peer-based curriculum is a fusion of expertise at Duke. Nancy Zucker, PhD, is internationally recognized for peer and parent-based group work. This is a hands-on workshop using art supplies, music, and media to engage teens--helping them to understand the events in their own lives and learning to manage the stress of being a teen. Michelle Bailey, MD, is trained in Integrative Medicine and merges the best of Eastern and Western therapies, blending her own expertise in mind-body medicine. E3 teen groups meet weekly for 90 minutes and run for 12 consecutive weeks. E3 will increase your teen’s awareness of self by fostering the ability to make choices that will be self-promoting rather than self-destructive and mastering knowledge and use of individual strengths.

Parents meet in a parent support group at the same time their teens are meeting. This curriculum focuses on the challenges of parenting a teen. You will develop the necessary skills to balance your desire to guide your teen with allowing them the freedom to make their own choices.

Active TEENS
For teens aged 12 and up, we offer a special peer-powered workout program on Tuesday, Wednesday, and Thursday evenings as well as Saturday mornings at Lenox Baker Children's Hospital in Durham. Staffed by qualified and motivational physical therapy students, teens workout with an adult partner on state-of-the-art exercise equipment, Wii Fit, and Dance-Dance-Revolution. All participants must be part of the Healthy Lifestyles program to join. For detailed information, please visit the Active TEENS web site.

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Physicians and Staff

Physicians

Staff

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Clinic Hours and Location

Clinic Hours:
Monday - Wednesday, 8:30 am to 5:00 pm
Friday, 8:30 am to 12:00 pm

Clinic Hours:
Monday, 1:00 pm - 5:00pm
Tuesday, Wednesday, and Friday, 8:00 am - 5:00 pm
Thursday, 8:30 am - 12:00 pm

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Appointments and Contact Information

To serve our patients and referring physicians, faculty physicians covering pediatric weight management are always on call to answer questions and provide consultation.

• For new and return appointments, please call 919-620-5356 or email us at healthylifestyles@duke.edu.**
• For urgent calls during business hours, call the divisional office at 919-620-5394 or 866-530-5356.
• For urgent calls after business hours, on weekends, or on holidays, please call your primary care provider.
• For physicians requesting consultations or making referrals, please call the division office at 919-620-5356 or 866-530-5356 and speak with Kim. You may also contact the Duke Consultation and Referral Center at 800-MED-DUKE (800-633-3853) or fax a referral form [PDF, 216KB] to (919) 471-6930.

**Please ensure that the following fasting labs (FASTING Insulin, Lipid Panel, CMP, TSH, HbA1c, and Urine microalbumin) are completed before the patient's appointment and faxed to 919-471-6930, Attn: Kim Yancey. This applies to all children over age 3, and it must be done while the patient is fasting (nothing to eat or drink for at least 8 hours).

Referrals

Referrals are accepted from providers, but family members may also call directly to set up an appointment. Please call 919-6220-5356 or 1-866-530-5356 to schedule an appointment.

Note: Although the current waiting list for appointments is relatively long, please contact Kim Yancey at 919-620-5394 when your labs are complete as your appointment may be rescheduled for an earlier time. For additional information about the program, please call 919-620-5394.

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