Childhood obesity is on the rise.  It is estimated that somewhere between 15- 35 percent of children in the United States are obese.  This number is increasing rapidly, with obesity rates doubling over the past 30 years.  By the time an obese child reaches the age of ten, his or her chances of becoming an obese adult is 80 percent.  Obesity is defined as a BMI (Body Mass Index) of 30 or more.  This number looks at the relationship between an individual’s height and weight.  It is derived, by dividing a person’s weight, in kilograms, by their height, in meters squared.

The causes of obesity are multifactoral, and often involve more than one etiology.  These include such factors as a person’s genetic makeup, their behavioral or cultural practices, or less frequently a physical disorder.  By far the most common reason for persistent of progressive weight gain is a child’s eating habits and lifestyle.  Basically, weight gain occurs when an individual consumes more calories than they can burn.

If a child’s weight issues are not addressed and controlled, there may be physical and emotional health problems in their future.  These include such conditions as high blood pressure, heart disease, type 2 diabetes, and poor self- esteem and depression, sometimes leading to a lonely and debilitating lifestyle.

As part of the work up for an obese child or adolescent, a complete physical exam needs to be done by a licensed practitioner.  Physical causes, which account for less than 1 percent of overweight children, should be ruled out before management of that patient.

When I evaluate children in my practice that are overweight, my strategy is not to put them on “diets”.  Instead I counsel them on adopting a “healthy lifestyle”.  This includes changing the way they eat and getting involved in regular physical activity.

Parents need to be very involved and take responsibility in their children’s lifestyle change.  It is very difficult for one or two children in the family to adopt a new strategy for weight loss, when the remainder of their family continues to live, eat, and rely on old habits.  In my household I try to set the example for my children by eating healthy and exercising on a daily basis.  I don’t expect them to undergo changes unless I am also willing to make those changes myself.  This change will become very satisfying for those involved as they see the results of their efforts, and the probability of continuing it successfully becomes very high due to the positive rewards it brings the entire family.

The focus of change rests in two specific areas.  This includes dietary changes and exercise.  Parents, with the help of their doctor, should set healthy and realistic weight goals, and slowly change the way they eat.  Outlined below are some common recommendations for dietary changes.

• Start the day with a healthy breakfast, which could include meals such as cereal with low fat or fat free milk, yogurt, fruit, and whole grain bread.
• Pack your school lunch (i.e. Turkey/ ham / tuna sandwiches, fruit, pretzels, yogurt, water)
• Cut out or cut down on sugary drinks.  These include fruit juices, sodas, sports drinks, or sweetened coffee drinks.
• Drink more water and low fat or fat free milk
• Eat more meals at home and avoid fast food meals, which tend to have more saturated fat and are higher in calorie density.
• Increase fruits and vegetables, whole grain, and lean protein meals.
• Control portion size, and if you are still hungry after a meal, eat a fruit.
• Try not to eat too late in the evening prior to going to bed.

Finally, I would try to incorporate 30 to 60 minutes of some form of exercise 4-5 days per week.  This includes anything that increases and sustains your heart rate during your workout, and promotes sweating.  Various forms of exercise include fast walking, riding your bicycle, running or jogging, going to the gym and doing some form of aerobic exercise, or getting involved in organized group or individual sports. 
Other suggestions include limiting computer and television time to no more than 1 to 2 hours a day.  Sedentary video games should also be discouraged and limited to weekends or after physical activity has been completed.

In summary, dietary changes and exercise, when done with the help and motivation of your family, can lead to a healthy lifestyle change. This, in turn, prevents complications from obesity, which allows your children and yourself to live a healthy and more satisfying life. 

Dr. Kathy Sarantos, Pediatrician
Alliance Pediatrics
 

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