As a pediatrician, I have had many conversations with parents, who are concerned about their child's weight, especially children who are overweight for their age. It is a well known fact that pediatric obesity is on the rise in the United States. In fact, 32 percent of America's children are estimated to be overweight. Obesity is particularly troubling because it sets children on a path to health problems previously unique to adults, such as diabetes and high blood pressure. Furthermore, it is a major cause of adolescent depression and poor self esteem.
Parents generally come to me concerned about their pre-teen (age 10 -12) who has all of a sudden become "chubby." It's not surprising because this is generally an age of weight gain in excess of linear growth, as children prepare for the onset of puberty. An average 11 year old can gain between three and seven pounds per year. This is normal. However, recently, the average weight gain for some children in this age range has been between 10 and 20 pounds. I believe this isoftentimes the "kick-start" on the obesity track in adolescence.
There are several risk factors usually working in combination that increase your child's risk of becoming overweight. Diet, exercise and other factors, including psychological development, family factors, and socioeconomic issues come into play as well. Let's explore these:
Diet: Regularly eating high calorie foods, such as fast foods, baked goods, and vending machine snacks, can easily cause your child to gain weight. Loading up on soft drinks, fruit juices, candy and desserts also cause weight gain.
Lack of exercise: Children who don't exercise much are more likely to gain weight because they don't burn calories through physical activity. Inactive leisure activities, such as watching television or playing video games have contributed greatly to this problem in recent years. The American Academy of Pediatrics recommends limiting computer activity to one hour a day, and removing the television set from the bedroom.
Family Factors: If many of the groceries you buy are convenience foods (and what working mother can avoid doing this once or twice a week?) this can contribute to your child's weight gain. If you can control your child's access to high calorie foods, you may be able to help your child avoid gaining an excessive amount of weight.
Socio-economic factors: Many households today are "dual income" households. This means mother and father are working. It takes both time and resources to make healthy eating and exercise a priority.
Psychological development: Children become increasingly independent during their course through middle school. This means wanting to make their own choices, and often those are not the healthiest. When faced with a salad or chicken nuggets on the lunch line, how many kids will choose the salad? What would your child choose?
Treatment: The Best Treatment is a Lifestyle Change
The methods for maintaining weight or losing weight are the same: Healthy diet and increased activity. Success depends largely on familial commitment to making these changes. Here are some helpful tips:
Choose fruits and vegetables over convenience foods, such as cookies, crackers, and prepared meals. Never use food as a reward or punishment.
Eliminate sweetened beverages, including fruit juices. These drinks provide little nutritional value.
Make an effort to sit down together for family meals at least four times per week. Limit recreational computer and TV time to no more than two hours a day
Emphasize activity, not exercise. Kids love group activities, free play such as hide and seek, tag, or jump rope can burn calories and provide fun at the same time.
Become active yourself: Park the car farther away from the entrance to the store, and walk, walk, walk!!!!
Finally, eliminate the words "fat" and "chubby" from your vocabulary. Instead, talk with your child about "healthy choices" and a "healthier lifestyle."
Childhood obesity is a prevalent, but preventable condition that when detected early is amenable to healthy intervention.
Editor's note: Dr. Toni Salvatore is a pediatrician at Greenwich Hospital. Her article is the first in a series of pieces about children's health that she will contribute to these pages.
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