When our first patient walks through the doors of the Helen DeVos Children's Hospital Healthy Weight Center, it will symbolize the beginning of a new era of pediatric care in Michigan. The patient will be obese, possibly sick from carrying too much weight around for anywhere from 5-17 year, but will have made one of the best decisions of their young life. The patient, along with the parent or guardian, will have decided that the time is now to change unhealthy lifestyle choices. The time is now to step up and get help from the Helen DeVos Children's Hospital Healthy Weight Center. The decision for the patient may come with a significant amount of fear but also a huge amount of hope.

The poor choices made in the past may have been eating too much, too often, at the wrong times and of the wrong foods. Or perhaps the patient will have been far too inactive, either without the motivation to run and play, no safe place to be active, exposure to too many distractions like television, gaming, phone or computer screens or maybe not in the state of mental health that allowed for enough movement that burns sufficient calories. Future posts here on the Double Duty blog will address specifics about how you can keep your family healthy and active.

The critics have and will say again "Just eat less! You don't need a center for that." Well, for what is probably the most common example of "it's easier said than done," this problem we have of childhood obesity is far more complicated than that. Our society, and growingly societies around the world, is set up to fail many children and lead them to becoming obese at a very young age. The accessibility and acceptability of food that promotes the consumption of far too many calories and parents who are in a situation of needing to provide for their kids but not necessarily aware or able to control their children's consumption of these foods are some of the issues. A lack of safe places to run around, a perceived lack of time in the day, competing activities at home or in school that de-prioritize healthy play time and activity in place of sitting and looking at a screen and not allowing sufficient physical education in place of classroom education in school are others. There are real concerns about the poor quality and unhealthy content of foods that are routinely marketed or made available to kids and which parents and schools buy for children to eat or drink without possibly knowing the consequences.

The staff members at the Helen DeVos Children's Hospital Healthy Weight Center plan to help turn the lives of these patients and families around. We will work as a cohesive team providing assessments for diseases that come with obesity like diabetes and fatty liver. We will assess food diaries and calorie expenditure. We will check for hurdles that slow the ability to change but don't prohibit it like lack of transportation or treatable depression. We will maintain an active and educational Web site,  where families, schools and medical offices can find the information they need and to connect with resources and events throughout our community.

For patients who enter our doors it will be unlike any other doctor's office visit. It will be much more. It will look a lot like what the future of health care holds for all patients as our team provides coordinated, multidisciplinary care. Our secretary will have already "met" them over the phone and our social worker will have already worked through many barriers to making it to our center. The time spent with the doctor will be de-emphasized and visits with our dietician and exercise physiologist will be just as important. These team members will individualize a prescription for leading a healthier life at a healthier weight for each child and family.

The patient who comes today will join a team of medical professionals whose members all have the same goal: finding ways for that patient to lead a healthy life with a healthier weight. Staff members at the Healthy Weight Center have loftier goals. Our hope is that:

• What we do will catch on with what other pediatric clinicians and medical office staff do in our area of the country
• One person or many people who work in medical offices, schools, daycares or restaurants in our region will step up and make changes
• When a child comes to the doctor their weight is assessed - every time - and a discussion is held with the family - every time - about healthy choices they can and should be making
• Schools will build more curricula about healthy eating and activity, and that they will allow kids to play and learn ways to be active when they are not at school
• Restaurants will offer healthier food choices for kids making it easy for parents to pick healthy food by serving kids' meals with a fruit and vegetable - every time - just like what is suggested to happen at home
• Cities will decide that we can find a way to build bike paths on streets or add support to making parks even more enjoyable
• Parents will start buying healthier foods such as calorie-free drinks and cook more at home, have family meal time more often, limit screen time, provide  a chance for kids to play hard and sleep well at night and not be alarmed when their child's medical office or school wants to bring up the subject of healthy weight

There are many strategies and recommendations for advice to give families about making choices that will lead their children, and themselves, to live with a healthy weight and one without the many risk factors that promote diseases that can happen at such young ages and require expensive and time-consuming medical care. Our hope is that these messages get out to those who need them. We don't, however, have all of the answers which is why we plan a robust research program in collaboration with experts from Michigan State University to study the causes of obesity and the strategies employed to lead families to make changes.

We hope today is the start of a reversal of the epidemic of childhood obesity in our area of the world. We know we will not do this alone and can't do this without committed patients and families. We can't do this without a committed community of schools, restaurants, policy makers and philanthropists. Our team is committed. Helen DeVos Children's Hospital is committed. In fact, Spectrum Health's annual gala will support our center this year. We hope things will be different in our region and that the efforts of our communities will make a difference for the children who live here. The patient who walks through our door today has taken the first step.

What steps are you taking or will you take within your family, school, workplace or community? What steps do you think others in our community can and should take? Please share your thoughts.