Dr. Salvatore Anzalone

While many public health challenges have garnered significant attention over the years, one of the most pressing issues quietly escalating in communities across the nation is childhood obesity. This rising epidemic is a cause for concern both nationally and locally.

According to the National Institutes of Health, obesity levels in children have more than tripled in the past 30 years. That trend can be seen locally as well.

An obesity screening of 447 children in Immokalee found that nearly half - 49.4% - were overweight or obese. That rate of obesity is far higher than county, state and national averages. The study, conducted from April 2022 to March 2023, was funded by the Naples Children and Education Foundation, founders of the Naples Winter Wine Festival, and implemented through the University of Florida.

In addition, a detailed analysis conducted by Healthcare Network, Collier County’s largest pediatric care provider, examined patient records of 43,394 children, demonstrating that 43.3% were classified as overweight or obese.

Many factors contribute to childhood obesity, including lack of physical activity, genetics, poor diet, socioeconomic status, lifestyle and habits, accessibility to health care, level of education, transportation and level of participation in interventions.

Obese children are more likely to develop health conditions in adulthood such as high blood pressure, kidney disease and mental illness. They are at increased risk of chronic diseases such as type 2 diabetes, hypertension, cancer and stroke.

Why is that important? In addition to impacting the potential of children, childhood obesity increases the cost of health care for everyone. According to the federal Centers for Disease Control, costs to treat obesity annually in this country amount to about $512 per person. Annual health care costs for adults with obesity are $1,861 higher than costs for adults with healthy weight.

Addressing childhood obesity not only helps reduce the number of cases but also promotes healthy behaviors and habits that can last a lifetime.

As a pediatrician, I knew we had to do something. We started at Healthcare Network by referring patients concerned about obesity to a collaborative, culturally appropriate pilot program that included nutritional support, lifestyle changes and obesity treatment.

Outside pediatric providers also joined in referring patients, resulting in more than 600 overweight children and their families being offered opportunities for positive change.

Through that program, we learned that nearly half (48%) of the 600-plus children referred to Collier County’s 2023 obesity prevention program had parents, and sometimes even grandparents, living with diabetes, a debilitating chronic disease.

As a result, a new initiative has been developed to focus on referrals of patients with type 2 (adult-onset) diabetes at Healthcare Network for family therapy. Obesity is a risk factor for developing type 2 diabetes, so it’s important to address obesity in the home before other diseases develop.

Taking what we learned through the pilot childhood obesity program, Healthcare Network is now incorporating a nutritionist into our pediatric primary care appointments.

This means that during their regular visits, patients will have the opportunity to meet with a nutritionist, who will provide the necessary interventions to help treat obesity—something that many families cannot afford otherwise. Health insurance, including Medicaid, often does not cover nutrition counseling or interventions for obesity until it leads to a chronic disease. By integrating this service into our appointments, we aim to offer proactive support to our young patients.

The local obesity epidemic isn’t confined to Immokalee. Golden Gate, a community that accounts for only 7% of Collier County’s total population, accounted for nearly 25% of children referred to the Children’s Health Insurance Program (CHIP) Child Obesity Program in a year.

Healthcare Network addressed the lack of health care in Golden Gate by opening the Nichols Community Health Center in 2020. We are also raising money to build another center in the once-rural Orangetree region to serve another “health care desert” that lacks health clinics and medical centers.

I know that building a healthy community takes a village. Our goal is to enhance and expand our integrated, collaborative practice for the future. In doing so, we hope to create a model that other communities can emulate, providing a pathway to wellness and breaking the cycle of childhood obesity.

About the Author
Dr. Salvatore Anzalone is Healthcare Network’s medical director of pediatrics and vice president of clinical business development. For his ongoing efforts to combat childhood obesity in Southwest Florida, he was recognized by the University of Florida as Doctor Gator.