Childhood obesity: Motivation to exercise is hard to come by

In the summer, Danielle Puckett swims and walks her dog around her Susquehanna Twp. neighborhood. When the weather turns cold, she just wants to hibernate.

“In the winter, I lose my energy, and I don’t want to exercise,” said Danielle, who, at 385 pounds, knows she has to combine exercise with healthy eating to combat her weight problem.

Her doctor, Ronald Williams, directs Penn State Milton S. Hershey’s Pediatric Multidisciplinary Weight Management Program, and his advice to her on what to do for exercise is simple: “Anything that gets your heart pumping.”

But doing it can be a challenge.

“I know I’ve got to try to do it,” Danielle said. “I have to basically tell myself I’ll find a way.”

It doesn’t help that Danielle gets out of breath easily, has trouble bending over and gets pain in her lower back when she walks too far. One reason Danielle likes to swim is that she feels lighter in the water.

“Motivating Danielle to exercise is very hard,” said her mother, Dawn Keller, who is worried about her daughter’s high blood pressure. “I’m constantly trying to get her to do more.”

Danielle, who will graduate from Susquehanna Twp. High School this spring, has completed all her credits, so she no longer attends classes, which means no more gym class.

Keller, who reports her own weight at 260 pounds, tries to exercise with her daughter. They take walks together and ride bikes in nice weather. Actually, Danielle’s inactivity isn’t that unusual. Behavioral risk surveys have found that only 38 percent of Pennsylvania children are engaging in the recommended one hour per day of physical activity, according to state Secretary of Health Everette James.

Yet with statistics showing that one-third of Pennsylvania children are overweight: “You cannot afford not to find that hour,” James said.

Dr. James Mosher, a pediatrician with Jones, Daly, Coldren Associates in Camp Hill, said he often hears parents lamenting that they try to change their child’s exercise habits, but it’s not working.

“I’ll ask them: What is the one thing that’s holding you back the most?” he said. “If it’s video games, I’ll ask them to commit to cutting back one half-hour a day, and I’ll involve them in picking the activity they’ll do instead. Could they do Wii Fit or just go for a walk?”

Mosher said he will acknowledge any genetic factors that might account for a child’s weight issues. But, “it doesn’t change the fact that if you remain obese, you will have health problems. We can make a dent in it.”

In an effort to do that, Highmark Inc. four years ago began covering two additional preventive office visits per year and two annual nutrition counseling visits specifically for obesity for children with a BMI (body mass index) of the 85th percentile or higher. Those with a BMI in the 95th percentile, which is considered obese, are also covered for certain laboratory studies, including a lipid profile and hemoglobin. Capital BlueCross has also expanded nutritional counseling benefits for overweight children and adults in many of its insurance contracts.