Article - How to Help Your Overweight/Obese Child

Is your child truly overweight?
It is important to determine if your child's rate of growth is reflective of a problem. Ask your pediatrician to examine the pattern of your child's growth (height vs. weight). If your child's rate of weight gain is proportionally higher than her height increase, there may be an increased risk of obesity.

It is also possible that your child, while meeting criteria for "overweight", is not at risk for adult overweight or obesity. Sometimes children got through periods of having excess body fat (e.g., pre-menarche). The most important factor is your family lifestyle. Creating and maintaining an environment for your child that consists of mostly healthful food, physical activity every day, and very little sedentary behavior (TV, video games and computer time) is the most effective way to prevent obesity in adolescence and adulthood. These are the habits that your child will maintain for a lifetime.

My pediatrician has told me that my child is overweight. What do I do?
It is very important to redefine the problem of an overweight child as a family problem. Instead of trying to change your child's weight, try to change the family environment.

In what ways do we change the family environment?

• Realize that even if the rest of the family is slim, nobody benefits by eating "junk". Replace unhealthful foods with nutritious fare.
• Don't put your child on a diet. At best, diets produce short-term results, but over the long-term are not effective. It is far more beneficial to establish and maintain a lifestyle that supports good health.
• Practice what you preach. Research shows that our children imitate our behavior. "Model" healthy living.
• Don't express a desire for your children to be thin; instead, express the importance of being healthy. Praise health-oriented behavior (such as participation in physical activity), not weight loss. Teach children to feel good about what their bodies can do, not what they look like.

Practice "Conscious" Eating
Most people eat past the point of satiety. Satiety is the "just right" amount of food: the point at which your body is no longer hungry, but not "full". Satiety is a subtle, quiet signal. If you are eating in a distracted manner, you won't notice this signal.

Here are some ways to hear the "Quiet Message":

1. One room should be designated for eating. Don't allow eating in front of the tv, in bedrooms, etc.
2. Eat sitting down, with no distractions other than family interactions.
3. Eat as a family, with designated mealtimes.

Make Healthful Choices
One of the main reasons that obesity is on the rise in the US is that our diet is largely processed, calorie-dense and nutrient-poor food. Statistics show that the amount of time the average American household spends preparing meals has decreased drastically in the last 25 years. It is no longer the norm for meals to be prepared at home.

• Make fast-food meals (including frozen dinners) a rare occasion.
• If your schedule does not allow for cooking, consider hiring a personal chef. While this sounds expensive, it costs no more than (and sometimes less) living on pre-packaged and fast-food meals.
• Get the whole family involved in meal-preparation. Even very young children can help with kitchen duties (eg, tearing lettuce for salad. Again, this is a way to "model" healthy living.
• Eliminate sodas and juices. These have no nutritional value, and are extremely high in calories. Use water to quench thirst. After age 2, offer low fat and skim milk.
• "Low-fat" snacks and desserts are usually as calorie-dense as their "regular fat" counterparts. Keep "whole" food snacks on hand, such as nuts, seeds and fruit. Whole-fruit popsicles are a good dessert choice, and kids love them.
• Never use food as a reward or comfort. As much as possible, food should be treated as value-neutral.
• While keeping the above in mind, allow for the occasional treat. Don't exclude your child from households or people who don't practice your healthful habits. Aim to eat in a healthy manner 80% of the time.
• Finally, insist that your child's school provide healthful options. Luckily, public awareness about nutrition is increasing: the trend is shifting away from junk food in the schools.

Exercise
The second major contributor to the increase in obesity in industrialized nations is the decrease in physical activity. Research shows that while formal exercise is helpful to overall health and weight-maintenance, lifestyle activity is the most important protection against overweight/obesity. In the past 20 years, "drive-thru" living has taken hold: drive thru fast food, banking, dry-cleaning, prescription pick-up and drop-off to name a few. TV remote controls, automatic soap dispensers and hand dryers, microwave ovens, lawn services, ride-on mowers all make our lives easier, but make us fatter. The human body is not designed to be so sedentary. We are literally outsmarting ourselves by using our creative brains to design machines to do our physical work. The result of this is that we have created an environment that makes it very difficult to expend enough energy to balance out our food intake.

What do we do? Make our own bread again? Use a push mower? Ride a horse to work?

Well, those things would help, but may be a bit unrealistic.

1. Research has shown that without a doubt that there is a direct link between the number of hours spent in front of the TV or computer and overweight in children. In other words, the more sedentary, the fatter. What does this mean? Simply by turning off the TV/computer/video games, you significantly decrease the likelihood that your child will be overweight.
2. Set a TV "allowance" for your child. No more than one hour per day.
3. "Play" together. Ride bikes, go for walks, play kickball in the backyard.
4. Encourage your children to try a variety of activities (sports, games, dance). Children who participate in such activities have higher self-esteem and are at lower risk for self-destructive behavior.

Other considerations

1. Unless your child brings it up, don't discuss her weight. Concentrate on creating a healthy environment for the whole family.
2. Don't allow teasing of the overweight child.

The Boswell Center is headed by Dr. Kelly Boswell, a leading provider of psychology services in North Florida and an expert in the treatment and prevention of obesity and eating disorders. The Center offers personalized treatment and follow-up processes that are second to none, with a full spectrum of services, including registered dietitians.

For more information, (904) 332-9100.

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