Background

Obesity-related co-morbid health conditions are the second leading cause of preventable death, following tobacco use. One-third of children and adolescents in the United States are overweight or obese, and the dramatic rise in the prevalence of pediatric obesity has been predicted to lead to a decline in overall life expectancy. Obese children are at high risk for dyslipidemia, hypertension, and type 2 diabetes mellitus. Obese children are also more likely to suffer from obesity as adults. Given the large number of children who are overweight or obese, there is an overwhelming need for effective treatment for overweight and obese children.

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Treatments

Treatment is based on empowering kids and families with the skills and knowledge needed to live a life of healthy eating and active lifestyles. There is no one solution for everyone, so treatment is individualized for the child and family’s specific needs. More than 5,000 families have received care from the Healthy Lifestyles clinic, and those who complete approximately one year of treatment 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.

Some patients come to clinic having attempted nutrition and activity programs before, with limited success. For these patients, and those who do not succeed with the standard intervention, we offer advanced treatments including specialized diets, pharmacotherapy and surgical options for qualifying adolescents.

The Healthy Lifestyles Clinic

Healthy Lifestyles is a one-year, family-based intervention for children with a body mass index (BMI) over the 95^th percentile. Click here to enter your child’s birth date, height and weight to see if he/she qualifies. You can schedule an appointment by contacting us directly or through a referral from your child’s pediatrician by calling 919-620-5356.

First Appointment
Your first appointment will be a half day session on a Tuesday or Friday morning. We will learn more about you and your specific goals, obtain labs (glucose, ALT, AST, insulin, HbA1c, CRP, TSH, urine microalbumin/creatinine ratio, 25-OH Vitamin D) from children aged five and older to screen for health problems and provide health, nutrition, and physical activity counseling in a group session with other families. Please bring your child fasting (nothing to eat or drink except sips of water for at least eight hours prior, or midnight the night before the visit) to this appointment. Due to space limitations, only the patient(s) and one adult guardian are permitted to attend the group session.

Return Appointments
Following this initial visit, you will be scheduled to return within two weeks to meet with your individual Healthy Lifestyles team which will include a medical provider and a registered dietician specializing in childhood weight management. You will be offered the option of meeting with a pediatric physical therapist and a mental health provider specializing in eating behaviors at any time during the year-long intervention. All services are provided on-site. You will make your plan for the frequency of visits over the one year treatment, which will be determined by your child’s health needs and by what you feel will work best for your family. Some people prefer more intense, frequent visits; others feel they need time to work on changes and would rather have fewer appointments. Regardless of your decision, we require all patients to return one year after they start the program to evaluate progress and plan next steps. We offer a $50 Nike gift card to all who follow up on time for their one-year follow-up visit.

Fees and Payment
Healthy Lifestyles visits (medical, dietary, and physical therapy visits) are billed to insurance. Mental health visits are not charged to insurance at this time, so there will be no co-payment or diagnosis in the child’s medical record. Your financial responsibility will be minimized as much as possible, however, Duke University Medical Center does not have the ability to waive co-payments, deductibles, or non-covered services. Duke Patient Resource Management Organization will investigate your insurance plan after the group visit if you decide to enroll in the one-year program. We will inform you of any financial responsibility that might be associated with the individual medical, dietary, physical therapy or mental health visits. If you have questions or concerns, please call the Customer Service Center at 919-620-4555 or 800-782-6945.

Community Outreach Programs

These programs advocate within Durham and the surrounding communities to prevent disease, promote health, and provide opportunities for healthy food access and active living. We partner with many local organizations to move toward our shared goal of a healthy tomorrow. Please contact Julia Wacker (julia.wacker@duke.edu) with any questions about our advocacy projects. A few of our signature programs include:

• Active Teens, Active Kids, Active Tots! Programs. Active Teens was founded in 2009 and is a community-based exercise program for teens (12-18) and their adult workout partners. In the fall of 2011, Active will expand to include Active Kids (5-11) and Active Tots (under 5). The Active Programs are free, open only to Healthy Lifestyles Clinic families, and involve a wide variety of programming, including fitness instruction, dance, sports, moderated peer support group sessions, gardening, cooking classes and more.
  
  
• Healthy Lifestyles Girls on the Run. Healthy Lifestyles Girls on the Run is a character development program for girls ages 8-12 years. Healthy Lifestyles has partnered with the Triangle Girls on the Run chapter to host its own Girls on the Run team, open only to Healthy Lifestyles participants. Twelve-week sessions are held twice a year and culminate with a 5k fun run and celebration.
  
  
• Briggs Avenue Community Garden. Healthy Lifestyles participates in the Duke Children’s community gardening project at the new Briggs Avenue Community Garden in downtown Durham.
  
  
• Community Awareness and Education Programs. Healthy Lifestyles conducts community awareness and education programs throughout the Triangle, including school and preschool teaching, a childhood wellness-promoting media campaign, and appearances at large community events, such as health fairs and the North Carolina State Fair.

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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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