Spotlight: Jens Christian Holm

Jens-ChristianEASO has the pleasure this month of turning the spotlight on Jens-Christian Holm, pioneering child obesity clinician, research scientist, professor and advocate.

MD Jens-Christian Holm, PhD is a Consultant in Paediatrics, Clinical and Research Associate Professor, and Head of The Childrens’ Obesity Clinic, Department of Paediatrics, University Hospital Holbæk, Denmark.

In 2007, Jens-Christian Holm established The Childrens’ Obesity Clinic (TCOCT) – a multidisciplinary childhood obesity chronic-care treatment facility. TCOCT is unique, and offers families a paradigmatic shift in approach by understanding child obesity as a chronic disease. We understand that the fat mass is endocrinologically regulated and offer a unique and successful treatment protocol.

TCOCT offers an innovative pedagogy providing empathy, self-identification and authenticity. This treatment approach has reduced obesity among 70-75% of participating children and adolescents enrolled in both hospital and primary municipality clinics. It also improves family health.

Professor Holm and his group have published extensively, providing evidence that the TCOCT protocol also reduces prevalence of dyslipedimia, hypertension, ectopic fat in the liver and viscera. Treatment also shows significant impact on parental overweight and obesity. Treatment results are based upon 5.4 hours of health professional time per obese child per treatment year.

Alongside this endeavour, Jens-Christian Holm established The Danish Childhood Obesity Biobank, which includes data from 2586 normal weight and 2200 obese children. This rich database includes deep phenotype description – DEXA, NMR, blood samples and metabolomics, genetics, and microbiota data for selected subgroups.

In conjunction with national and internationally recognised collaborators, these data sets have built a solid foundation and have been published widely, including in high impact journals. Recent studies include research around the influence of familial predisposition on childhood obesity treatment, changes in liver and muscle fat during treatment; research, includes information on changes in blood pressure during treatment.

The Danish Childhood Obesity Biobank has contributed to GWAS studies which have identified a new focal point associated with susceptibility to acute lymphoblastic leukaemia in children, as well as three new genetic loci exclusively associated with childhood BMI.

Jens-Christian Holm’s research activities are multi-faceted and include numerous PhD-projects involving early detection, body composition, pre-diabetes, ectopic fat, genetics, microbiota, and pharmacological analyses of medicamina in the obese vs the lean child.

In 2011 Jens-Christian Holm joined the EASO Childhood Obesity Task Force (COTF) and, along with Jennifer Baker, was elected co-chair in 2015. Through his clinical work and considerable media and public-facing contributions, Jens-Christian Holm has continuously fought the medical and psychological case for obese children, who are often neglected and stigmatised and denied professional medical service in most health care systems around the world.

The COTF recently published a position statement recommending that childhood obesity Europe should be considered a chronic disease. This development was inspired by The American Medical Association which declared obesity as a disease in 2013 and the Canadian Medical Association, which did likewise in October 2015. The COTF statement generated substantial media coverage and inspired debate, as obesity is not accepted as a disease among those in the medical profession.

It has been argued that only obese patients with metabolic deterioration should be considered ill and thus eligible for treatment; we believe this argument is flawed. The Childrens’ Obesity Clinic has published that up to 50% of our young people exhibit pre- or overt hypertension, 35% exhibit steatosis, 28% exhibit dyslipedemia, and 18% exhibit pre-diabetes. This shows that many if not most obese children are, at an average age of 11.5, already burdened by the metabolic consequences of their obesity. We know that there are an additional 16 well described complications, involving orthopaedic, endocrinological, neurological, gastroenterological, psychological and psychosocial components to obesity, which in many ways impede the obese child’s development potential during childhood. We have no advance knowledge of who among these children will face one of 20 established cancers as a consequence of their obesity during their adulthood. Based on these observations, it is imperative for us as medical professionals, to act and honour the Hippocratic Oath and endeavour to alleviate the disease and suffering among obese patients, child and adult alike.