Since the 1970s, the percentage of U.S. children with obesity has more than tripled. Today, about one in five school-aged American children (ages 6 to 19) is obese, according to the U.S. Centers for Disease Control and Prevention — and that figure doesn’t include children who are “just” overweight and not obese.
Children with obesity face physical, social and emotional hurdles while growing up. They are more likely than their classmates to be teased or bullied and to suffer from low self-esteem, social isolation and depression. They are at higher risk for other chronic health problems, including asthma, sleep apnea, bone and joint problems and Type 2 diabetes. They also are more likely to be obese as adults, resulting in increased risk of heart disease and other serious medical conditions.
Preventing or treating childhood obesity is vital for lifelong health, but it requires a team effort among a child’s parents and medical providers.
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A child’s risk of becoming obese depends on several factors:
Diet: Consuming too many high-calorie, low-nutrient foods and beverages, such as potato chips and soda, leads to excess weight gain.
Physical activity: A sedentary lifestyle means a child can’t burn off those excess calories.
Genetics: A family’s genetic background can influence a tendency toward obesity.
Emotions: Children may overeat due to stress or simply because they are bored.
Of these risk factors, genetics is the only one that can’t be changed. Parents and physicians can work together to help a child make positive changes to their diet, physical activity and reaction to emotions.
Monitoring growth — including weight — is part of every well-child medical visit, beginning in infancy. Even if an older child is not scheduled for immunizations in a particular year, it’s important to keep that appointment for an annual checkup so any minor problems can be addressed before they become serious.
The physician will compare the child’s height and weight against World Health Organization charts to see how his or her body mass index compares with averages for other children the same age, height and sex. In addition, the physician will chat with the parents or child, if the child is old enough, looking for red flags that could point toward future obesity or partially explain a current problem. Through this casual conversation, for example, the physician could learn that the child is spending too much time watching TV and not enough time in active play.
Small steps = big changes
Just as a child does not become obese overnight, achieving a healthy weight also takes time. Parents and physician can work together to set small goals for the child, such as swapping 30 minutes of TV time after dinner for 30 minutes of walking with the rest of the family. Activity- and diet-oriented goals are better than goals of losing a certain number of pounds; weight-focused goals for children can lead to anorexia or other eating disorders.
Parents can help most effectively by making good choices the easiest choices for their children:
▪ Buy healthy snacks, such as raw carrots. Slice and peel the carrots and put them in a highly visible bowl in the refrigerator so that it’s easy for kids to grab some.
▪ Sit down together for as many meals as possible, away from the television. Children who see their parents eating nutritious foods are more likely to make similar choices.
▪ Serve meals with appropriate portions already on each plate. Family members who are still hungry can serve themselves more from bowls of nutritious vegetables and fruits.
▪ Help children discover activities they enjoy so that physical activity is fun, rather than a chore. A child who loves to read might enjoy walking to the library, while another child might like the social aspects of a team sport.
Be patient as the child gradually learns to make better food and activity choices. By taking it slowly, parents can help children move toward a healthy weight — now and throughout life.
Alka Sood, M.D., is chief resident in the Penn State Health Family and Community Medicine Residency Program at Mount Nittany Medical Center. Franklin Berkey, D.O., is a family medicine physician with Penn State Medical Group.