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There's Nothing He Won't Try

Nine-year-old Joshua Goblowsky will probably never be able to run, ride a bike, skate or play baseball like other kids his age. But that doesn't mean he won't try.

When Joshua was just three and a half years old, he was involved in a car accident and suffered a serious brain injury that has affected his motor skills, balance and intellectual development. Performing physical activities is now a constant challenge for Joshua, but that hasn't stopped him.

One of his favorite activities is to accompany his father to his martial arts studio where he pretends to be martial arts fighter Bruce Lee. He plays on an adaptive soccer team and baseball team for kids with disabilities. But what Joshua loves to do most of all, is roughhouse with his dad.

"Joshua is a gregarious boy who tries to do everything the rest of us do," says his father Mark Goblowsky. "He's a pretty happy, easy-going kid."

As a result of his disabilities, Joshua has another problem. He is battling obesity. His endocrinologist Jean-Claude Desmangles, MD, diagnosed Joshua with a condition called precocious puberty, which causes puberty to occur at an unusually young age and can result in advanced bone aging. Dr. Desmangles was concerned that Joshua's extra weight could be contributing to the problem and referred the Goblowskys to Children's Hospital & Medical Center's Healthy Eating with Resources, Options and Everyday Strategies (HEROES) program.

The HEROES program is a medically-directed, multi-disciplinary program designed to address childhood obesity in children ranging in ages from 5 to 18-years-old. It is the only obesity treatment program in the region designed specifically for the pediatric population. The six-month program combines medical management, nutrition, behavior modification, fitness and behavioral health therapy to provide immediate and long-term management of a child's obesity problem to help prevent a lifetime of health complications. To qualify, patients must be referred by their physician and must meet certain medical requirements.

In January, Goblowsky enrolled Joshua in HEROES, hoping it would help him get a handle on Joshua's rising weight and physical fitness. At that time, Joshua was 4-foot, 7 inches and weighed 123 pounds.

During the pre-clinic evaluation, the HEROES staff also discovered that Joshua had vitamin D deficiency and acanthosis nigricans, a condition frequently seen in the obese identified by darkening and thickening of skin in areas such as the back of the neck, arm pits and groin. It is an indicator of insulin resistance, which increases an individual's risk for diabetes and heart disease.

"Our goal with Joshua was to help his parents get him on a healthier diet and to increase his physical fitness through our exercise classes," says Mary Hawkins, RN, BSN, CPN, a clinic nurse for the HEROES program. "Joshua has pretty much stabilized since starting the program and he has also grown one and a half inches. Oftentimes, with these younger children, if we can just stop them from gaining weight, they will eventually grow into their weight."

Goblowsky says Joshua has made many improvements to his health and physical abilities. His blood pressure has dropped, his stamina, strength, balance and agility have improved, his clothes are fitting better and his confidence has soared. "The program is tremendous," he says. "There's just enough fun mixed in with the exercise to make it enjoyable for Joshua. It has also been a great time for parents and kids to bond."

Nutrition and behavior modification classes, which are held once a week for the first three months and attended by parents, are an important part of the program's success "They were very enlightening," says Goblowsky. "The classes address everything from diet and exercise to behavioral and psychological issues. They have helped me and his mother understand how to make better food choices and have showed us lots of little tricks to help Joshua develop good eating habits. I feel like we are all on the same page now in developing better lifestyle habits for Joshua's long-term health and fitness."

"Across the board, the program has been excellent," adds Goblowsky. "I would recommend it to any parent who is challenged by their child's weight and is looking for solutions because they will find them here."