Comprehensive Obesity Treatment Programs for Adults and Children


Avichai Assouline

Two unique multidisciplinary programs at Columbia help children and adults who suffer from obesity, a chronic disease that often leads to other health issues, such as diabetes, cancer, liver disease, and kidney disease.

For adults there is COMMiT, the Comprehensive Obesity and Metabolism Management and Treatment program. Advice to patients about obesity management used to be simple, says the leader of COMMiT, Marc Bessler, MD, director of the Center for Metabolic and Weight Loss Surgery at Columbia and professor of surgery. “We told people how to lose weight, and they were able to or not. But now, with the focus on obesity as a chronic disease, we recognize that we have to keep working at finding better ways of managing the condition and its consequences. 

“There are almost as many reasons why people become overweight as there are people who are overweight,” says Dr. Bessler. “The COMMiT team understands the social, emotional, and behavioral factors in an individual’s life and environment that can affect their weight and their health.”

The COMMiT team brings together surgeons, internists, endocrinologists, gastroenterologists, nurses, and dieticians to provide a multifaceted approach to weight loss. This kind of multidisciplinary team can promote healthier lifestyle choices in various ways, from offering meal plans, delivering stress management and mindfulness therapy, and recommending the latest medications to offering nonsurgical procedures or minimally invasive surgery. 

For children, the Families Improving Health Together—FIT—program provides comprehensive care for obese children ages 2 to 9.

“Treatment and prevention of obesity are most effective when started early,” says FIT director Michael Rosenbaum, MD, a pediatric endocrinologist at the Naomi Berrie Diabetes Center and professor of pediatrics and of medicine. “Only about 15 percent of adults who lose weight keep it off, but children tend to sustain the loss of body fat better than adults.” 

Obesity affects multiple organs and systems, but care for children with obesity is usually fragmented, with few centers able to address the multiple issues that can arise from pediatric obesity. In the FIT program, children receive care from a multidisciplinary team of cardiologists, gastroenterologists, endocrinologists, and other specialists. The entire team reviews each child’s needs to develop a holistic plan, including healthy diet and exercise. The plan is tailored for each family, based on a detailed assessment of what the family likes to eat and the exercise options available where the family lives. As part of the treatment, the FIT team asks the child’s entire family to adopt new dietary and exercise interventions. 

“Approximately 75 percent of children seen in the FIT program have at least one adiposity-related comorbidity, such as low vitamin D or dyslipidemia,” says Dr. Rosenbaum, “but because of the diverse on-site expertise, we are able to address these problems without having to refer patients to another appointment in another clinic. The patients and their families seem to appreciate it. Over 90 percent of them have come back for their follow-up visits with their physician and nutritionist.”

Both the FIT and COMMiT programs—and their patients—benefit from bringing specialists from various disciplines onto one treatment team, allowing doctors to address obesity in a more holistic and convenient way for the patient. Through programming like this, Columbia recognizes and treats obesity as a chronic multisystem disease that persists across the entire lifespan.

COMMiT can be reached at 212-305-4000. 
FIT can be reached at 212-305-9237.