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Fitbits: A Pharmacy-Free Solution to Childhood Concerns

Juan Espinoza, MD, FAAP

In my practice at Children’s Hospital of Los Angeles (CHLA), I work with kids of all ages who are sick and scared. I talk to their equally worried and frightened families about how to engage with their son or daughter, calm them, support their recovery. The last thing either these children or their parents want to see is a needle or a laundry list of medications to manage their illness, disease, stress. It’s up to me as their physician, that person to whom they trust their children’s lives and well-being, to find a way to alleviate those concerns by offering options to treatment that are non-invasive and comforting.

Technologies, not pharmacies 

I’m a big believer in the benefits of the new technologies out there as a way to research, of course, but also to heal. For the last few years, I have been incorporating Fitbits as a part of clinical trials into managing and diffusing childhood obesity. Not so much to track activity, but because the team with whom I work believes wearables enhance our structured multidisciplinary eight-week program meant to stave the disease — we provided wearables to different groups and requested they join us to record progress over the course of eight-weeks. Our focus groups were children between the ages of 7 to 18 who would wear the Fitbits, provided by us, to monitor activity to alleviate the need for self-monitoring and due to our belief that it is a more accurate record of PA (physical activity). In one group, the control group, our youth patients wore nothing and engaged with monitoring and managing their weight on the honor system — this was our control. In the other group, our intervention group, we provided Fitbits to both the kids and the parents to engage them in the process more intimately and actively. Our hypothesis was that not only would wearables encourage and reinforce better weight management through exercise and eating, but that when parents and the family as a whole are  involved in the process, the results would be  more successful due to the support provided.


Yes, I know it sounds like a lot, but as we watched, we discovered the latter to be true. If you’ve ever attempted a diet or training schedule, you’ve discovered how beneficial it is to have a support system who  knows what your goals are and can encourage you towards them. The family structure and interaction is key to how our pediatric patients act and their routines. To change that behavior requires the backing of those who provide the opportunities for that change and when parents can see for themselves what is being recorded for their children as well as themselves, it prompts them to be more involved and work together toward the common goal of lowering BMI and raising energy and activity levels.


But that’s obesity and it’s obvious from what we all know about activity tracking wearables, the  goal of this technology is to be an asset in encouraging more PA. What I discovered in the midst of this were the added benefits of these wearables in supporting better sleep and rest.

Weight and sleep

Lack of sleep in children is revealed differently than in adults. You know the term, “slap happy?” That’s what happens to a kid who’s not sleeping. Tantrums, hyperactivity, spinning out — those are all signs a child is overtired and needs his or her rest. Severe weight gain is also a byproduct of lack of sleep and in using wearables to monitor activity and support a healthier lifestyle, I found that the Fitbit is also a good companion for tracking and modifying sleep patterns.


A 2014 study was conducted by MassGeneral Hospital for Children that looked into the effects of chronic sleep deprivation in kids. The results, published in Pediatrics, revealed that researchers learned that children most impacted by chronic sleep deprivation had the highest weight and body mass index across the board. It also showed that kids who were most consistently suffering from lack of sleep came from racial and ethnic minority backgrounds with less education and lower income. However, the relationship between lack of sleep and obesity doesn’t change. A child who is sleep deprived, no matter who they are or where they come from, is most at risk for obesity.

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