Childhood obesity is a serious problem in the United States. According to the U.S. Centers for Disease Control and Prevention (CDC), obesity affects nearly one in five children and young adults ages 6-19. As obesity can lead to serious health problems beginning in childhood and continuing throughout adulthood, it’s a condition that must be taken seriously.
When it comes to childhood obesity, the trendline is worsening, not improving. Despite advances in medicine and better information about how to keep children healthy, the childhood obesity rate is getting worse, not better. In fact, the percentage of children and adolescents who are considered obese has tripled since the 1970s.
“The increase in childhood obesity rates is a troubling health trend that must be addressed in a comprehensive manner by medical professionals, parents, schools and other partners,” says Dr. Amy Burton, a pediatric endocrinologist. “Childhood obesity can lead to serious chronic health problems such as type 2 diabetes, high cholesterol and hypertension. For many young people, it can also lead low self-esteem and an increased likelihood to be bullied.”
Obesity is generally defined as a weight that is 20 percent higher than the average for the child’s age and height. Both the CDC and the American Academy of Pediatrics recommend children be screened for obesity and overweightness utilizing the Body Mass Index (BMI). The BMI is a simple equation – the person’s weight divided by the height, squared: weight ÷ (height x height). For adults age 20 and over, the BMI score indicates if someone is underweight, normal weight, overweight or obese.
For children, teens and young adults, the BMI calculation is more nuanced. The age and gender of the child is factored in to help determine the BMI and then the result is evaluated in the context of BMI results across the entire population of children the same age and gender.
There are a variety of BMI calculators for both adults and children online, but for children, it’s best to let the pediatrician calculate the BMI and interpret the results, as there are a number of variables that help determine what range the child falls in. Even if a BMI score appears high for a child’s age and gender, it does not necessarily indicate obesity or overweightness. A pediatrician may perform additional evaluation and take into account other physical and environmental factors, such as diet and physical activity.
Don’t Blame Your Child – or Yourself
“It’s not uncommon at all for young people who are overweight to suffer from low self-esteem and to blame themselves for weighing too much,” observes Dr. Chris M. McGonnell, a pediatrician. “I have also known a lot of parents to be hard on themselves – they think it must be their fault that their child is overweight, when that is not necessarily the case. It’s usually more complicated than that.”
“There are several organic health traits that can contribute to obesity in childhood. For example, obesity can be hereditary. The role our metabolism plays in how quickly we burn calories is one of the most important factors that determines if someone is normal weight or overweight,” explains Dr. Damien Mitchell. “Metabolic tempo can vary as much as 20 percent in people – that means two kids could eat the same amount of food and then get the same amount of exercise and one could burn a few hundred calories less than the other.”
“Another condition that can contribute to obesity is insulin resistance, which some children are born with. Insulin resistance leads to the body storing extra sugar, instead of burning it,” says Dr. David Samara. “Low leptin levels are another contributing factor. Cells produce leptin to signal the brain when we are full; a leptin deficiency can lead to a person overeating. All of these conditions are outside a child’s control or that of their parents. But the good news is that we can identify these conditions and develop a strategy to treat or manage them.”
There are numerous environmental factors that contribute to children being overweight, as well. But even these aren’t necessarily the fault of the child or the parents.
“No doubt, eating too much and frequently eating junk food – foods high in sugar, fat and refined carbohydrates – contribute to weight gain,” says Dr. Samara. “But for many families, access to fresh fruits and vegetables and lean meats is difficult for a variety of reasons, including location, cost and time.”
For example, some families live in what is commonly referred to as a “food desert” – an area in which there is not a grocery store or supermarket nearby. There are numerous neighborhoods in North Texas that fall within this definition. Compounding this problem is that people in these areas may not have access to a vehicle or transportation services to get them to a grocery store that is miles away.
Time is another constraint facing many parents, regardless of where they live. “Most parents work full-time and from personal experience, I know that between work obligations and getting kids to and from school and extra-curricular activities, it can be difficult to find time to prepare dinner at home every night,” says Dr. Burton, who has two young children. “Sometimes the convenience of driving through a fast-food restaurant for dinner or ordering pizza is hard to pass up. But as parents, we have to force ourselves to develop meal plans that ensure those fast-food days are an exception, not the norm.”
Of course, diet is only half the equation when it comes to weight management; burning calories through exercise and physical activity is also important. Just as some families may have difficulty accessing a grocery store conveniently, they may also live in an area where they don’t want their kids to play outside for safety reasons. Some communities lack playgrounds, parks, sidewalks and trails, which can make it challenging for young people to get enough exercise outdoors.
For children who are overweight or obese, the best thing a parent can do is to work with their child’s pediatrician to develop a plan to gradually lose weight. “Just as with adults, we don’t ever want to see a child embark on an unhealthy fad or ‘crash’ diet,” says Dr. Isha Mannering. “Instead, we want to look at what and how much the child is eating, what kind of exercise she or he is getting and make adjustments so that we begin to see gradual weight loss.”
Additionally, if the child is diagnosed with any underlying health conditions that may be contributing to an unhealthy weight, the physician will develop a treatment plan for those, as well.
Tips for Healthy Eating
Whether working to reduce your child’s weight or simply maintain a healthy weight and lifestyle, here are a few ideas that will benefit the entire family:
Pre-make as many meals as possible on Sunday, before the hectic school and work week gets underway. For example, grill or roast chicken and keep it in the fridge so it can be used for quick, healthy meals later in the week.
Double or triple a recipe over the weekend that can be used as leftovers throughout the week or put in the freezer for future meals.
Stock up on frozen vegetables. These are relatively inexpensive, don’t go bad and can be cooked in a matter of minutes on the stove or in the microwave. Frozen vegetables generally are just as healthy as fresh ones, and are a far superior choice to canned vegetables, which tend to be loaded with sodium and sugar.
For snacks, grab enough fresh fruit that will keep for several days – apples, unripe bananas and oranges are good choices. Steer clear of canned fruits, which are high in sugar and calories.
Provided they aren’t loaded with sugar, granola bars can be a good choice. So is microwave popcorn that is light on butter and salt.
Maybe you find out your child hates cooked carrots but likes them raw. Experiment with serving healthy foods different ways – you may be surprised what your child embraces.
Be mindful of portion sizes. Use measuring cups and kitchen scales to measure foods in proper quantities.
Reserve desserts such as ice cream, candy and cookies for special occasions. They should not be an everyday expectation.
Some breakfast cereals are great for kids, but others have way too much sugar or limited fiber in them to be healthy. Look for cereals lower in sugar and higher in fiber and top with some fresh or previously frozen fruit.
It’s not just food you have to watch – it’s drinks, also. Low-fat milk (2 percent or less) and water are always good options. Don’t allow chocolate milk, soft drinks, artificial juices, fruit punch and sports drinks – all are high in sugar and have little to no nutritional value. And while natural fruit juices may be high in some vitamins, they also have lots of sugar and are not recommended. Eating fruit is great, but fruit juice is a common contributor to obesity in children.
Lead by example: children mimic their parents. If your child sees you eating – and enjoying – healthy foods, they will learn from your example and imitate your behavior over time.
“All parents struggle at times finding the foods their children enjoy enough to eat that are also relatively healthy,” says Dr. R. Adrian Clarke, a pediatrician. “Experiment with different healthy foods and resist the temptation to give up and let your kids have whatever they want.”
One of the biggest barriers to children getting enough exercise is the many distractions they face today. Television, video games, tablets, phones – all of these electronic devices can provide hours of entertainment and can quickly become addictive to young people. If your child is staring at a screen for hours on end, chances are he or she is also not moving. That type of sedentary lifestyle can contribute to obesity.
“It’s so important that kids get outside and move around,” says Dr. Christopher Straughn. “When we were kids, we didn’t have as many electronic distractions that kept us indoors and on a sofa. Today, parents must be intentional about making sure kids get outside to play. It doesn’t even have to be an organized sport; riding a bike or throwing a football around helps to burn calories and keep kids healthy.”
The goal is to get at least one hour of physical activity per day and to limit screen time to no more than two hours per day. One way to ensure your children get enough exercise is to build in regular family activities – this could be a hike, a bike ride, swimming, etc. In addition, children who join an organized activity such as a sports team or scouts are sure to get more time moving around.
“The most important thing parents can do for their children is to be supportive,” says Dr. Diana Dickschat. “Just as this is true in school and in sports, it’s true when a child is dealing with weight issues. Every child is special and as parents, we must remind them of that. We have to tell our kids we love them, no matter what. We’re there to help them be safe and healthy, and that means we will help them lose weight if they need to – but we’ll also protect them from a world that can be cruel at times.”
Bullying is a real issue for many kids, and those who are overweight often experience bullying disproportionately. It’s important to talk with your children about how to handle bullies – and for them to know that they should tell you if and when they experience bullying.
Keeping an open dialogue with your children’s teachers is important. If your child complains of bullying at school, the faculty should be made aware so they can address it.
“Above all, have open lines of communication with your kids,” adds Dr. Mitchell. “This is important at every age, but especially in the adolescent and teen years, when some kids have a natural inclination to not share as much with their parents. Respect their privacy, but make sure they know they can always come to you with what they are feeling and experiencing.”
Healthy Childhood Leads to Healthy Adulthood
Given the increased risk an obese child faces for developing a variety of health problems such as type 2 diabetes, high cholesterol and high blood pressure, working to achieve and maintain a healthy weight in childhood will pay off throughout life. “Chronic health conditions associated with obesity are some of the most common problems facing many adults today,” explains Dr. Burton. “By laying the groundwork in childhood to reduce the risk of those conditions, we’ll improve quality of life in adulthood and life expectancy.”
For children who are overweight, losing weight will do a lot to help their self-esteem and confidence. These positive effects will spill over into academic and extra-curricular activities, as well as help with friendships and relationships with others.
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