Eating Disorders during Adolescence

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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
1 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)

Disclaimer

This Web Site is a reference for health care professionals, students and educators; it is not intended to provide treatment. If you have a health problem see a health care specialist.