Obesity in Childhoodthe Basics of Treatment

Obesity in Childhood: How To Stop the Epidemic?

http://doc.guandang.net/children/obesity-in-childhood-how-to-stop-the-epidemic/

Richard Saint Cyr MD

It’s no secret that children all over the world are putting

on too much weight; in the US, an astonishing 1/3 of

children are overweight or obese. Even in China, the

obesity rates for children are dramatically rising. Being

overweight as a child can lead to many diseases as an

adult, including heart disease, diabetes, arthritis, high

blood pressure, and some cancers. Also, overweight kids

have lower self-esteem and higher risks for depression.

So what can parents, or society really do to stop this

epidemic? And how can family doctors and pediatricians

help?

The first step parents should take is to find out where your child fits on a Body Mass Index (BMI) chart.Your doctor should be doing this at the well-child exams, but you can easily find childhood BMI calculatorsonline (such as this one) and find out yourself. A child above 85% is considered overweight, and above95% is obese. Many parents are surprised at finding their child is officially overweight or obese, which iswhy these objective BMI standards are important for tracking, as well as assessing progress.

There are quite a few weight loss approaches that most doctors can agree on; one major agreement isthat diets almost never help, at any age. Any diet plan designed for quick weight loss is almost guaranteedto long-term failure, and many people frequently end up even heavier than before. The healthiest option isalways slow and steady weight loss. One pound a week of weight loss for many children, from veryconscious changes in diet and exercise routines, is appropriate.

Another major approach involves cutting back on TV time. The American Academy of Pediatrics just

published a major policy statement stating that “the evidence linking excessive TV viewing and obesity ispersuasive”. They specifically recommend a ban on junk- and fast-food advertising in all children’s TV

programs, and they set specific limits of TV time for age groups. They also detail multiple studies showinghow having a TV in the bedroom is another independent risk factor for obesity, both as a child and later asadults. They also recommended that “pediatricians need to ask 2 questions about media use at every visit:

1. How much screen time is being spent per day? and 2. Is there a TV set or Internet connection in thechild’s bedroom?”

One approach I mentioned before was to have a good breakfast. Many studies have shown that eating anutritious breakfast is crucial for a child’s physical growth and school performance, and that breakfast-skippers actually end up more overweight, both in childhood and later as adults.

Of course, the main treatments for obesity are the obvious: more exercise and eating proper foods inmoderate amounts. It’s important that there be a family effort to help your overweight child lose weight.Parents also need to lead by example; it’s much harder for a child to lose weight if their parents are alsooverweight and don’t exercise. As for diet recommendations, the most obvious choices to eliminate aresodas and fruit drinks. Sodas truly have almost no redeeming value, especially for children. Any childdrinking a daily soda is adding extra pounds of fat each year, and they are also increasing their risk fordiabetes as well as teeth problems. Most fruit juices are also quite poor substitutes for natural fruits andshould be used at a minimum. For exercise, most kids should be getting 60 minutes a day, but this can bebroken up into multiple sessions. The key is finding something they love to do. And don’t forget that anyexercise is better than nothing!

Another effort involves reviewing the foods at school. I recently heard the great news that milk producers inAmerica this fall are all reformulating their flavoredmilk to have 1/3 less sugars and calories. Many (but notall) nutritionists consider this a positive step, as schools that totally eliminated flavored milk encountered alarge drop in milk drinking, which raises the risk of kids not getting enough nutrients such as calcium. Whatdoes your school do?

Parents who want to learn more about childhood obesity and how to fight it can find excellent resources atthe website http://doc.guandang.net, which is officially run by the American Academy of Pediatrics. And http://doc.guandang.net, the American Academy of Family Medicine also offers many tips on weight loss for allages.

(This article was originally printed in Beijing Kids magazine, where I am a contributing editor. You can clickhere to read the rest of my BeijingKids “The Doc Is In” columns.)