The Nutrition and Fitness for Life program in the Boston Medical Center (BMC) Department of Pediatrics, Division of Pediatric Nutrition, is an innovative clinical and community-centered obesity prevention and treatment program. Through unique interventions, initiatives and collaborations, Nutrition and Fitness for Life seeks to support children to age 18 and their families in leading healthier lives. ## Our Work The Nutrition and Fitness for Life program serves approximately 400 families through its two arms, provides education and training to primary and specialty health providers, community leaders, undergraduate students and medical students. - **In the community.** The Nutrition and Fitness for Life program’s community branch aims to build the capacity of communities to support Boston youth and families in developing healthier lifestyles by developing and implementing nutrition education and fitness programming for children and families. - **In the healthcare field.** Nutrition and Fitness for Life develops and hosts workshops, conferences, and seminars for health professionals and area youth workers. The program also serves as a consultant group for new pediatric weight management programs. - **For the environment.** The program also advocates for positive environmental changes and health policies and is involved in public health research and educational activities. ## Our History Nutrition and Fitness for Life was founded in 2002 by [Caroline M. Apovian, MD](https://www.bumc.bu.edu/camed/profile/caroline-apovian/ "Caroline M. Apovian, MD | Boston University Chobanian & Avedisian School of Medicine (bumc.bu.edu)"), who at the time directed BMC’s Center for Weight Management and Nutrition, and [Barry Zuckerman, MD](/about-us/directory/doctor/barry-s-zuckerman-md "Barry S. Zuckerman, MD | Boston Medical Center (bmc.org)"), then chair of the Department of Pediatrics, as a clinical pilot project to identify the feasibility and success of an adolescent weight management clinic. The pilot clinic offered medical, nutritional, and physical activity counseling with adjunct initiatives. The program was expanded under the leadership of Carine Lenders, MD, and clinical dietician Vivien Morris, who focused on the pediatric weight management clinic and community-based interventions. **Hi-5 Way** In 2009, the clinic began a secondary prevention program called “Hi-5 Way” that focuses on children from 6 months to 6 years of age who are overweight or rapidly gaining weight to an extent that they may face increased risk. For more information about Hi-5 Way, please see our [program brochure (PDF)](/sites/default/files/Programs___Services/Programs_for_Children/Pediatrics___Nutrition___Fitness_for_Life/field_Attachments/bmc-NFL_Hi-5-PatientBroch.pdf "BMC Department of Pediatrics: Nutrition and Fitness for Life Program: Hi-5 Way Brochure (PDF, English)") and the eligibility criteria below. ### Nutrition and Fitness for Life (Pediatrics) - [Contact Us](#contact-us) - [Related Departments and Programs](#related-departments-and-programs) - [Treatments and Services](#treatments-and-services) - [Our Team](#our-team) - [For Medical Professionals](#for-medical-professionals) - [Acknowledgments](#acknowledgments) - [Education and Training](#education-and-training) ## Contact Us ##### Department of Pediatrics [ 801 Massachusetts Ave., Boston, MA 02119 7th Floor BMC, Crosstown Center ](https://maps.app.goo.gl/xHWq2RQhAjbdbTFd8) [617.414.4841](tel:617.414.4841) Fax: 617.414.3644 [ ![](https://assets.bmc.org/transform/52184c85-c2c6-4047-b33d-aa7bf996c852/20140821ecBMC_1309?io=transform:fill,width:300,height:200&format=jpg) ](/visiting-us/crosstown-building) ## Related Departments and Programs [### Pediatric Primary Care A program within the Department of Pediatrics providing children’s primary care from infancy to young adulthood, including check-ups, sick visits, vaccines, teen care, behavioral health, and support for chronic conditions. ](/departments/pediatric-primary-care) [### Pediatric Specialty Care Children’s specialty care that includes programs like developmental and behavioral pediatrics, gastroenterology, emergency care, and more. Families receive expert pediatric care tailored to each child’s unique needs at every stage of growth. ](/departments/pediatric-specialty-care) [### Adolescent Medicine A pediatric primary care program specializing in pediatric and adolescent medicine, providing comprehensive, age-appropriate care for teens and young adults. ](/departments/pediatric-primary-care/adolescent-medicine) [### Family Medicine A department where family practice physicians provide primary care to support individuals and families at every stage of life, including adult and pediatric care, women’s health, behavioral health, addiction treatment, and nursing services. ](/departments/family-medicine) [### Cardiology (Pediatrics) A pediatric heart clinic within the Department of Pediatrics where pediatric cardiologists provide care, including evaluation and treatment for congenital heart defects, murmurs, arrhythmias, chest pain, and high blood pressure. ](/departments/cardiology-pediatrics) [### Ear, Nose & Throat (Pediatrics) A program within Pediatric Specialty Care providing ear, nose, and throat care for children, including diagnosis and treatment for hearing loss, ear infections, sinus conditions, airway disorders, and voice or swallowing issues. ](/departments/pediatric-specialty-care/ear-nose-throat-pediatrics) [### Endocrinology (Pediatrics) A program within the Department of Pediatrics where pediatric endocrinologists provide care and long-term management for pediatric diabetes and hormone-related conditions, including growth, adrenal, thyroid, metabolic, and pubertal disorders. ](/departments/endocrinology-pediatrics) [### Nutrition (Pediatrics) A program within the Department of Pediatrics providing pediatric nutrition care, including evaluation and guidance to support healthy growth, manage medical conditions, and promote balanced nutrition for children and families. ](/departments/pediatric-specialty-care/nutrition-pediatrics) [### Psychiatry (Pediatrics) Pediatric mental health care from pediatric psychiatrists offering assessment and personalized treatment for depression, anxiety, ADHD, and other emotional or behavioral concerns. ](/departments/pediatric-specialty-care/psychiatry-pediatrics) [### Pulmonary & Allergy Clinic (Pediatrics) Respiratory care for children and young adults, where pediatric pulmonologists diagnose and treat a wide range of lung conditions, including complex or rare pulmonary issues. ](/departments/pediatric-specialty-care/pulmonary-allergy-clinic-pediatrics) ## Treatments and Services The Nutrition and Fitness for Life program’s specialty weight management clinic provides a comprehensive family and behavioral approach, as this is the sole evidence-based approach in pediatrics that has proven successful in treating obesity in children. However, many families are not ready for behavior management and need counseling sessions on roles and responsibilities, communication, and motivation. The core program focuses on motivation and readiness to change. The initial visit includes a physician and dietitian visit for in-depth medical, nutritional, and physical activity assessment of the patient, as well as a psychological screening. At the end of the visit, an action plan is developed for the family. A typical patient receives the following services each year: - Assessment and evaluation by physician and dietitian - A lifestyle change intervention (action plan) with intensive treatment during 6 clinic visits within 3 to 6 months, followed by maintenance visits up to 1 year - Psychologist treatment plan based on initial screening - Maintenance and relapse prevention visits with the clinical team ### Complex Medical Issues The Nutrition and Fitness for Life clinical team follows children with more complex medical issues more frequently. Care plans are developed in conjunction with primary care and other subspecialties, such as cardiology, endocrinology, otolaryngology (ear, nose, and throat or ENT), psychology/psychiatry, and sleep medicine. Approximately 13 percent of Nutrition and Fitness for Life patients require ongoing mental health counseling because stigmatization, depression, and diminished quality of life from teasing and social marginalization are part of the profound psychological impact of being overweight. ### Duration Nutrition and Fitness for Life is designed as a 12-month clinical program that includes 3 to 6 months of intensive treatment followed by maintenance sessions. The program tailors care to each family’s needs. ### Eligibility A referral from a primary care physician (PCP) is required for evaluation and treatment in the Nutrition and Fitness for Life clinic. **Hi-5 Way (Secondary Prevention)** 6 months to age 2**Hi-5 Way (Secondary Prevention)** 2 to 6 years**Nutrition and Fitness for Life Clinic** 6 to 18 years or older**Child Size or Rapidity of Weight Gain****Weight-for-Length** greater than or equal to 95th percentile — and/or — **Crossing Weight-for-Age Percentiles** - From 50th to greater than 75th - From 75th to greater than 90th - From 90th to greater than 95th **BMI-for-Age** greater than or equal to 95th percentile — or — **BMI** greater than 22 kg/m2 **BMI-for-Age** greater than 95th percentile**Prior Attempts to Manage Weight**Not applicableNot applicableAt least 3 to 6 months trial with their primary care physician (PCP) and then 3 to 6 months of work with an outpatient registered dietitian/nutritionist**Readiness to Change**Parent/guardian is in preparation for actionParent/guardian is in preparation for action**For a Child ≤ 12 Years** Parent/guardian is in preparation for action **For a Teenager (13–18)** They are in preparation for action ## Our Team - **Aimée Lim-Miller, MSW, LICSW** Social Worker - **Kathy Ireland, MS, RD, LDN** Clinical Dietician and Program Coordinator - **Eunice Santos** Administrative and Scheduling Coordinator ## For Medical Professionals ### Refer a Patient We are committed to providing a high level of assistance to our physician colleagues both within BMC and outside of the BMC system. Whether for diagnostics, treatment, a single consultation, second opinion, or ongoing follow-up, our physicians will keep the consulting physician fully informed of the patient’s treatment plan and coordinate long-term management. - **For BMC PCPs:** Please complete the referral form in MyHealth. - **For Non-BMC PCPs:** Please complete [referral form](/sites/default/files/Programs___Services/Programs_for_Children/Pediatrics___Nutrition___Fitness_for_Life/field_Attachments/bmc-NFL_Hi-5WayReferral.pdf "BMC Department of Pediatrics: Nutrition and Fitness for Life Program Referral Form (PDF, English)"), attach the patient’s growth charts and relevant recent lab work, and return the form via fax. ### Admit or Transfer a Patient To transfer or admit a patient, please call our on-call patient admitting service, accessible 24/7. Pager: [617.638.5795](tel:617.638.5795), #1111. ## Acknowledgments The Nutrition and Fitness for Life clinic has received funding for patients and clinical operations from the BMC Department of Pediatrics; BMC Kids Fund; American Heart Association; Bank of America; Boston Red Sox Foundation; Fleet Perpetual Trust for Charitable Giving; Loomis, Sayles & Company, LP; Massachusetts Vitamin Litigation Settlement; and the Carl and Ruth Shapiro Family Foundation. Nutrition and Fitness for Life thanks the following individuals for their service to the program: **Former Program Staff and Consultants** - Tara Agrawal, MPH - Caroline Apovian, MD, FACN - Lee Banh, MS, RD - Melanie Bradford, MS, RD - Angela Brown - Emily Burritt, MS, RD, CNSD - Shirley Cole - Diana Cullum-Dugan, RD, LD - Emily Cummings, MS, RD - Seth Eberlin - Judith Fallows, MEd - Julia Hincman - Cheryl Jesuit, MS, RD - Tanya Jones - Lakshmi Kolagotla, MD, MPH - Preeta Kuty, MD - Shaheen Lakhani, PsyD. - Jason Langheier - Kayoung Lee, MD, PhD - Margaret Marino, PhD - Holly Oh, MD - Lauren Oliver, MS, RD - Renea Page - Hope Parsons, RD, LDN - Judy Philips, MS, RD, LDN - Gita Rao - Amaru Sanchez - Esther Shamir - Rishi Shukla - Vijay Srinivasan MD, MPH - Pooja Tandon, MD - Laura Vinci - Robert Vinci, MD - Laura Wroblewski, RD, LDN **Former Community Volunteers/Interns and Consultants** - Affiliate Media, LLC - Sarah Bartellman - Jessica Blom-Hoffman, PhD - Analyn Brondyke - Wil Bullock - Seth Coburn - Kerri Connelly - Ashley Decker - Rachel DeGarmo - Neville DePass - Nativita D’Haitii, RD - Judith Fallows, MEd - Deborah Fogel - Pamela Griffin - Doreen Guay - Kelly Horton - Abby Isaacson - Carline Jean-Baptiste, PhD - Eva Joseph - Ellen Kaspik - Amanda Kirpitch - Liana Larkisova - Phoebe Lott - Michele Lye - Julianne Marvin - Samara Mbugua - Carolyn Murphy - Lucilda Dassardo-Cooper - Koren Melfi - Hannah Milch - Kathleen Minihan - Darrick Mitchell - Elizabeth Palazzo - Maria Pontes Ferriera - Lindsay Rayfield-ElShazly - Amy Richmond - Tamara Rudich - Alina Schmidt - Esther Shamir - Khalia Smith - Barbara Tanenbaum - Michael Tang - Scott Tropy, MPH - Ruth Weinstein - Marcianne Wittwer - Cindy Xi ## Education and Training Nutrition and Fitness for Life participates in various education and training programs for medical professionals, including: - Advanced pediatric nutrition elective for fourth-year [Boston University Chobanian & Avedisian School of Medicine](https://www.bumc.bu.edu/camed/ "Boston University Chobanian & Avedisian School of Medicine (bumc.bu.edu)") students - Vertical integration of nutrition and weight management in the medical school curriculum - Yearly CMEs and CEUs for health professionals with interests in pediatric ambulatory weight management - Nutrition education for families and community leaders - More than 200 regional and national presentations