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The Healthy House - A Novel Pediatric Obesity Prevention and Treatment Program

H. Vondell Clark, MD, MPH

The pediatric obesity literature indicates that successful childhood obesity programs are centered among family involvement. The Wellness FAN (Fitness, Awareness & Nutrition) program targets childhood obesity by observational learning and active participation in the context of a simulated home environment (The Healthy House). The approach is to model conscious, healthy lifestyle choices in a real-life setting that may be translated into healthy behaviors in the home and community setting. The current obesity epidemic is in large part caused by a dysfunctional relationship with energy. The Healthy House/FAN program embraces a holistic philosophy of healthy living as an energy system. In our model, "Energy in" (Nutrition) is mindfully nourishing ourselves with delicious, healthy calories in moderation. We also nourish ourselves with healthy thoughts, feelings, books, media, experiences, and relationships. "Energy out" (Fitness) embraces activity as play, ranging from exergames to creative activities, both in and out of doors, including our sustainable garden. Awareness is the recognition that forming new habits and changing old habits are difficult unless new behaviors are brought into conscious awareness and reinforced in positive ways. In our model, we view habitual behavior as a type of trance state that is very susceptible to environmental cues. We explore how to structure our environment to reinforce healthy behaviors so that they become habitual. We demonstrate the effects of stress on contributing to habitual behaviors rather than goal directed behaviors. We also explore methods of mindfulness and awareness to decrease the stress response and hopefully form "mindful habits."

Attendees should be able to assess barriers to healthy lifestyles in their patients - to "start where the behavior is." Attendees should be able to create innovative ways to teach healthy living in a fun and practical venue that increase the likelihood that the patients will actually adopt new behaviors. Attendees will become instrumental in helping patients and their families to change their attitudes and relationships with food and activity, especially in their home setting. Attendees should be able to implement certain applications of behavioral economics to pediatric obesity utilizing techniques such as framing, choice architecture, cognitive persuasion, and the use of default techniques to overcome behavioral inertia. Attendees will also review the applications of cognitive and affective neuroscience with respect to pediatric obesity. They will explore the role of the health care worker to the family and children in the larger context of relational neuroscience.

The role of habit formation and maintenance with respect to environmental cues will be emphasized. Although some of the research components of the presentation will be presented with the cognitive/academic approach of PowerPoint, the emphasis will be to stimulate the emotional and motivational centers of the participants. The presentation will be interactive in that the audience will be asked to participate in selected mindfulness and awareness activities. These activities may require the audience to sit with their eyes closed for a few seconds while paying attention to their breathing patterns.