Set realistic goals. Help establish a steady routine.
Surprise (not really) — science has discovered that plump kids tend to stay that way! In a study of almost 4,000 public school students in three metropolitan areas, 65 percent of obese fifth-graders remained so as tenth-graders, and 23 percent were overweight. Nearly all obese tenth-graders had been obese or overweight in fifth grade.
This may seem obvious, but parents often underestimate the problem, assuming their children will outgrow their adorable “baby fat.” Others think their child’s weight is normal. Childhood obesity isn’t cute: it can lead to heart disease, diabetes, asthma, and sleep problems, and make kids vulnerable to bullying. These risks are run by the 17 percent of American kids and teens, ages 2 to 19, who are obese, according to reports from the Centers for Disease Control and Prevention (CDC). At 12 and up, the figure jumps to 20.5 percent. “It sneaks up on people, and you can start to feel hopeless,” says pediatrician Stephen Pont, medical director of the Texas Center for the Prevention and Treatment of Childhood Obesity in Austin, who struggled with his own weight as a child. “If physicians use guilt or blame, it just makes people feel worse. Everyone’s solution will be unique.”
We don’t need to look hard to understand the child obesity problem. Americans at all ages are getting too little exercise while sleeping too little, or badly, and are continually surrounded by foods engineered to make us want to eat more.
Americans are less likely to bike or walk to school than in the past, so exercise isn’t built into our routine. Kids ages eight to 18 spend an average of 7.5 hours a day wrapped up in TV, computers, video games, cell phones, and movies. While they’re staring at the screen, they tend to snack, especially after watching a catchy ad for an addictive food.
Parents can help by following the advice of the American Academy of Pediatrics to establish "screen-free" zones in children's bedrooms, turn off the TV during dinner, and limit children and teens to one or two hours a day of TV or video games. Instead, encourage kids to play outdoors or join sports teams. The CDC recommends that children and teens get at least an hour of physical activity a day, most of it aerobic, and engage in muscle and bone-strengthening activities like skipping rope, gymnastics, and push-ups at least three days a week. Encourage kids to walk or bike rather than drive them to school or after-school activities. Your kids also may be short on sleep, which can lead to weight gain.
It may help to minimize giving antibiotics to babies and toddlers: evidence with mice and children under two suggests that antibiotics at early ages can change the balance of bacteria in the gut and lead to obesity.
With overweight children who are still growing, aim to keep them at the current weight rather than drop pounds, unless you’re working with a doctor. You can check how your child fits the standards by age and height with this calculator. After the age of one, if a girl’s waist is more than 60 percent of her height, both measured in inches, she’s “at risk of having the metabolic complications of overweight,” says Frank Biro, MD, who studies and treats teenagers at Cincinnati’s Children’s Hospital Medical Center.
For children under seven or so, you make the menu. Be sure they eat breakfast, even if they prefer leftovers or sandwiches to traditional breakfast food. Track the number of servings of vegetables and fruits your child eats. Aim for at least five portions a day, as recommended by a 2007 expert committee report to the U.S. government.
Start each meal with a glass of water, and slowly cut back on sodas. Limit fruit juice to half a glass for younger kids.
At ages 7 to 9, children begin to snack on their own. Don’t set up a fight by stocking forbidden foods in the cabinet. Keep fruits in a bowl on the table and veggies with a healthy dip easily available in the refrigerator.
Eat dinner as a family at the table, rather than letting kids grab their own meal and eat it in front of the TV. They may enjoy cooking with you, and you can use that time to interest them in new healthy foods.
Limit meals in restaurants — at home you can control the fat and sugar. When you do eat out, explain that portion sizes in restaurants are much bigger than they used to be, and suggest an appetizer for dinner or sharing an entrée. Decline the bread basket, order a salad, choose lean meats, and avoid rich sauces. Share or skip deserts.
Don’t throw up your hands. In a study of 8,550 4-year olds led by Ohio State University epidemiologist Sarah Anderson, those who regularly ate dinner as a family, had limited screen time, and got enough sleep were 40 percent less likely to be obese. “Warm and responsive parenting during early childhood is also protective” against obesity, she says.
Overweight pre-teens or teenagers may already be a target for ridicule and bullying. Discuss a strategy that creates self-awareness, such as keeping a food or activity diary or tracking activity with an electronic device. Set realistic goals. Help them see that a steady routine with enough rest, exercise, and healthy food works better than binge dieting or drastic exercise. For kids prone to binge eating, strategies to boost self-control include removing temptations, distraction, and setting up “if/then” statements, such as “If I eat potato chips, I’ll eat more salad at dinner.” “Parents should be empathic and say that there’s no perfect shape or size. We try to empower the child to make small health changes,” says Pont.
Doctors are recommending bariatric surgery for the most obese teens, who seem to getting better results from it than adults do.
May 31, 2016
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Janet O’Dell, RN