The problem:
About one out of three American children can be considered overweight and that rate is growing very rapidly. Additionally, according to the CDC, in the years 2015-16, approximately 14-20% of our kids were considered obese. The causes are multiple and are most likely societal in nature and not caused by a health condition. Most parents who realize that their child is overweight come to the Doctor to have “their glands checked”. It seems just about everyone knows someone who has a thyroid or other glandular condition that has been blamed for that person being overweight. In fact, a medical problem in kids is one of the least likely causes for obesity.
If one takes time to carefully dissect our current society one would easily be able to notice the low rates of exercise in children and the high rates of sedentary activities. The television and the computer now rank among the chief contributors to the increase in overweight children. In addition, local budget cuts have resulted in elimination of some physical education and intramural sports. And yet another reason for obesity in our kids may be the result of the busy lifestyle of some dual working parents who have very little time to prepare healthy foods- so it‘s fast foods for the night, and it is easy to find the root causes for obesity in this country. As easy as it is to pinpoint some of the reasons for obesity, it is extremely difficult to do something positive about it.
Not only is it time consuming to prepare healthy meals but it is more expensive to buy than a typical American diet and in this economic slump it might not be the first place people wish to spend their money.
On top of these reasons there are certain environmental and familial factors that will contribute to overweight children. If the familial body type is not thin and wiry, this trend will tend to continue through generations and it becomes easy to “blame” the overweight problem on “genetics”. In fact most overweight kids have overweight parents who just do not recognize the “problem” in their children.
What to do
Again, the first thing to do if you think your child is overweight is to take him or her to the primary care provider for an evaluation, looking for the rare and very unlikely medical cause. The diplomatic nature of the approach your Doctor may take to this problem might belie the serious nature of the issue. Beware, it is very serious! The use, by your health care provider, of graphs and charts in the office at the time of the discussion can be very helpful to you, pay attention.
Your Doctor may discuss in front of your child and in a very frank manner, all the medical repercussions of becoming an overweight adult: high blood pressure, increased rates of diabetes, heart disease and strokes just to mention a few. Your child will probably be asked to help resolve this problem. That is very important because without his/her help any attempts will probably fail. After all, you can only control what your child eats when he/she is in the house: once out of the house for the day, it’s all on him or her- that’s tough!
The following are some ideas I believe can help when approaching your overweight child.
Diet related issues
Before you begin to count calories there are some simple mechanisms to put into place.
- Feed your child on a smaller plate than usual but fill the plate- the visuals help to keep the total intake down.
- Do not allow “seconds” and desserts should consist of such dishes as fruits and low fat products.
- Watch out for the “innocence of toppings”. These may carry the majority of calories in the dish you are preparing: low fat or no fat substitutes can now be found in your supermarket for salad dressings etc. You can probably eat a pound of potatoes and gain somewhere near a pound, but if you add the butter, cream and bacon that usually accompany those dishes all bets are off as to the accumulated weight gain.
- Begin to become aware of the information on the labels of just about all foods.
- This is not a bad time to institute low fat and low cholesterol “diets” in hopes of altering adult behavior in the future as this is a major contributor to poor cardiac health in this country. In particular, stay away from foods containing, transfats, unsaturated and polyunsaturated fats as these can contribute to plaque buildup in arteries beginning at a young age; concentrate instead on fruits, vegetables and fiber.
- Rid your house of all snack foods, whole milk and carbonated drinks as this must become an entire family affair.
- While I approve of skim milk after the age of 2 years old I do not approve of artificial sweeteners for children, as many of the past artificial sweeteners have fallen into disrepute at one time or another, and carbonated drinks and juices are generally “empty calories” devoid of anything nutritionally useful except for sugar which he/she does not need.
- Remember, the object of a “diet” is not necessarily to lose weight initially but to begin to alter life styles as your child grows into adult hood. Weight loss is a bi product or “collateral damage”, if you wish, of the particular “diet” you chose.
- When you begin to concentrate on weight loss you should aim for no more than 1 – 2 pounds per week as anything faster has a high likelihood of failing.
- Let your child enjoy an occasional birthday party filled with cake, ice cream, candy etc. Total abstinence will breed discontent.
Don’t forget exercise
The flip side of the coin is, of course, exercise: a reasonable diet without exercise or, vice versa, is like one hand clapping. Family endeavors will be most likely to generate the best results. Encourage sports of all kinds as this not only yields some of the exercise component but builds a sense of belonging and responsibility.
Build in “rewards” to recognize your child’s effort in trying to adhere to this new life style. You might very well encounter resistance at your initial efforts to begin this program but stick with it as it will greatly improve the quality of life for the entire family.
Good info, Dr. Joe! I cringe whenever I see a child with a bottle of Gatorade or soda!! My son actually did have a thyroid condition but his lifestyle habits were also a big factor. He’s on the road to a healthier future!