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My Child Has:
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Weight Management
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Childhood Obesity
Safe Weight Gain and Loss for Young Athletes
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| Christopher Duggan, MD, MPH |
Watch gastroenterologist Christopher Duggan, MD, MPH, discuss the challenges of getting children to eat healthfully.
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Overweight and obesity together represent the second leading preventable cause of death in the United States. Obesity is a serious, chronic disease that can inflict substantial harm to a person's health. Overweight and obesity are not the same, rather, they are different points on a continuum of weight ranging from being underweight to being morbidly obese. The percentage of people who fit into these two categories, overweight and obese, is determined by Body Mass Index (BMI).
The US Surgeon General has declared that overweight and obesity have reached epidemic proportions in this country. Over 9 million children between the ages of six and 19 are overweight. Public health officials say physical inactivity and poor diet are catching up to tobacco as a significant threat to health. Currently, about 28 percent of women and 39 percent of men are considered seriously overweight.
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Obesity is defined as a generalized accumulation of body fat. Obesity is determined by measuring both the height and weight of the adolescent. An adolescent is considered obese if he/she is significantly over the ideal weight for his/her height. Overweight is defined as increased body size with increased lean body mass and without excess accumulation of body fat. A uniform standard to separate obesity from overweight has not been established. Research studies suggest that overweight adolescents may become overweight adults.
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The following are some of the factors that may contribute to overweight adolescents:
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- easy availability of food, especially high-calorie snack food
- parents' attitudes towards food
- an increase in the eating of fast-foods
- using food as a reward or to change behaviors
- lack of exercise
- television watching and snacking
- not knowing how to eat healthy
- heredity (the size of parents and other family members)
- socioeconomic factors
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The basis of treatment for obesity in children and adolescents involves diet changes and exercise. It is important for parents and the adolescent to be ready and willing to make the change. Generally, weight loss is not recommended for babies and young children who are still growing and developing. The goal of treatment for these children is to maintain their weight while they continue to grow taller. Weight reduction may be recommended for obese adolescents who have completed their growth. The following are some of the general guidelines that may be followed in treating your adolescent.
For children older than 7 years of age:
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- The goal is to maintain baseline weight initially, and then add slow changes in eating and exercise to achieve slow weight loss as recommended by your adolescent's physician.
- At this age, a child or adolescent should follow adult guidelines, and limit fat intake.
- Eat a variety of foods that are low in calories. Consider the following:
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- Your adolescent needs enough calories to maintain his/her energy level, but no more than he/she can burn off. This is called an energy balance.
- If he/she takes in more calories than he/she burns, he/she gains weight.
- If he/she takes in fewer calories than he/she burns, he/she loses weight.
- If he/she balances the two, he/she maintains his/her weight
- Even when dieting, however, calories should not be cut back so much that your adolescent's energy needs are not met. The number of calories your adolescent needs depends primarily on age, gender, and activity level.
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- Decrease consumption of high-fat foods.
- Eat more vegetables and fruits.
- Eat less sweets, candy, cookies, chips, and sodas.
- Change to skim milk.
- Refer to support groups.
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- Do not use food as a reward. Use other activities as a reward for good behavior.
- Have family meal time and snack times.
- Provide only healthy options for your adolescent to choose from. For example: stock in the refrigerator apples or yogurt, rather than cookies and pies.
- Have the entire family become involved on a healthy eating plan, not just the adolescent who is overweight.
- Encourage activities that promote exercise, such as riding a bike, walking, or skating.
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