In our fat-phobic culture, all overweight people endure a certain amount of criticism and discrimination. Overweight children, however, suffer the cruelest treatment in school and on the playground.
An overview
The U.S. government estimates that in this country about six million young people are sufficiently overweight to endanger their health. Another five million are borderline, and the problem grows larger every year. Why? Lots of reasons.
Families no longer eat regular meals together. Home cooking is no longer the primary source of meals for many people. Greasy and sugar-laden fast food is cheap, tasty, and available everywhere. Time spent in front of a TV, video game, or computer steals time from sports and other activities that burn calories. Manufacturers of snack food and soft drinks advertise their empty calories directly to children. Faced with shrinking budgets, schools eliminate or cut back physical education classes. Because of concerns about community and neighborhood safety, parents keep their children from participating in informal, spontaneous playground activities, driving them to and from school and other activities.
What is the result of children taking in more calories and being less active than they were a decade ago? Dr. Naomi Neufeld, a pediatric endocrinologist says, "The children we see today are thirty percent heavier than the ones who were referred to us in 1990."
Obese children are at risk physically and emotionally. Many become obese teens and then obese adults. They suffer low self-esteem and are candidates for diabetes, heart disease, high blood pressure, elevated cholesterol, and many cancers. Diabetes alone can lead to damaged blood vessels, kidney failure, blindness, amputations, heart attacks, and strokes. The U.S. Secretary of Agriculture predicts that obesity will soon rival smoking as a cause of preventable death. (Newsweek, July 23, 2000; page 42)
What to do if your child is overweight or obese
- If your child is still a baby, don't panic. Baby fat is normal and healthy.
- If your child is still growing, don't panic. Weight gain precedes growth spurts. It is not unusual for a child to gain thirty or forty pounds and then shoot up ten or twelve inches.
- Limit couch potato time. A Stanford University pediatrician found that children who watched TV for one hour or less per day were measurably leaner than those who watched as much as they wanted to. Ditto for video games and time spent sitting in front of a computer.
- Don't nag about food or weight. Your child will resent you and withdraw, probably to a hidden stash of food. If you try to police what your child eats, you may inadvertently contribute to depression, shame, feelings of abandonment, anxiety, or even a life-threatening eating disorder.
- Be especially careful if your child is a preteen daughter. Our culture teaches young women to base their self-esteem on the shape and size of their bodies. If your daughter thinks you are criticizing her appearance, she may believe that you find her unacceptable too. She may deal with her crushed feelings by becoming anorexic in an heroic effort to please you, or she may rebel and become even fatter as an expression of anger and defiance.
- Instead of nagging, set a healthy example. Don't give one child a diet plate while everyone else dives into fried chicken and chocolate cake. Make family meals healthy for everyone. Instead of collapsing in front of the TV after dinner, go for a walk or bike ride with the kids. On weekends take them hiking or introduce them to your favorite sport -- but make sure you participate in it and don't just watch it on TV.
- Another thought about nagging: just don't do it -- ever. Nagging can reduce your child's self-esteem and leave him /her feeling a failure and a disappointment to you. Find some non-appearance-related trait, some behavior, some gift, talent or ability to praise, and do just that. Do everything you can to raise your child's self-esteem. By doing so you will empower, or at least begin to empower him/her to make healthy, responsible life choices, including choices about food.
- Practice portion control. Portion control and exercise are probably the two most important factors in a successful weight management program. Give your child, and the entire family, a wide range of healthy foods, but in reasonably sized portions. That way no one feels deprived, and thus vulnerable to overeating.
- In order to avoid rebellion and crushed feelings, when you talk to your children about food and weight management, focus on health, not appearance. Emphasize more activity, not less food. Diets create feelings of deprivation. For that reason they don't work for adults, and they won't work for kids either.
- Some children, girls in particular, may be so focused on losing weight that they resort to unhealthy behaviors to lose it (starving, vomiting, abusing laxatives, obsessive exercising, etc.) For this reason, it may make sense to involve the child's pediatrician who can stress the importance of healthy eating and healthy weight over mere physical appearance.
- Be realistic about your child's weight. Genes do make a difference. If a child is chubby but eats healthy foods in reasonable amounts, and if s/he is active and has self-control, s/he may be genetically predisposed to be heavier than average. Research suggests that this kind of extra weight is not as much of a health risk as the kind acquired via too many snack foods and too many hours on the Internet. Genetically pudgy children may be healthier chubby than if they are forced to diet to fit in with slim peers. Just make sure they understand that personal worth depends on character, not on appearance.
- Make sure your child gets enough sleep every night, at least eight to nine hours, plus daytime naps if appropriate for his/her age. Sleep deprivation can contribute to obesity. Bodies that aren't rested produce increased amounts of ghrelin, a hormone that triggers sensations of hunger. (Archives of Pediatrics & Adolescent Medicine, April 2008). Sleep deprivation also reduces the body's production of leptin, a hormone that regulates appetite, leading to increased cravings for candy, other sweets, and salty carbohydrates like chips and french fries. (Source: David Rapoport, MD, director of the sleep program at New York University School of Medicine. Reported in Health on Parade; August 28, 2005)
- Find out if emotional stress or unhappiness is contributing to your child's weight gain. Children may substitute food for friends if they are lonely. They also can overeat when they are bored, angry, depressed, anxious, or otherwise stressed. If you suspect your child is eating in an attempt to numb painful feelings or escape stress, talk to a qualified counselor about how to attack the underlying cause of the problem, not just the symptom of eating.
- If you find yourself frantic or at your wits end, work with your child's pediatrician and a counselor who is trained to work with young people to generate new ways of approaching the situation. Your child's present and future health are worth an investment of time and money that can pay significant dividends down the road.
Advice from a pediatrician
Two hours or less of screen time per day, total. (includes TV, video games and computer). Turn off the TV during meals. Remove TVs and computers from your child's bedroom.
Thirty to sixty minutes of physical activity each day
No super-sized portions. Especially no super-sized main dishes, soft drinks or desserts. Leave room for healthy fruits, vegetables and whole grains.
Milk, not soda pop. Milk is much healthier than pop for children. After about age two, low-fat milk is a healthier choice than whole milk.
Fruit, not juice. Whole fruits are healthier than juice, but juice is healthier than soda pop.
Disband the Clean Plate Club. Never force a child to eat. If s/he is hungry later, offer fruit and vegetable snacks, never candy, cookies or empty-calorie fatty and sugary snack foods.
Never say "Eat your vegetables and then you can have dessert." The child will hear "Veggies are horrible and sweets are wonderful." When you try to encourage healthy eating this way, you increase the chances that your child will grow up to hate vegetables and eat lots of sweets, especially in the rebellious teenage years.
Limit junk. With a few exceptions, fast food is junk food. Consider it a once-in-a-while treat. Once or twice a month is enough. Ditto soda pop.
Eat smart. In sit-down restaurants where large portions are common, practice two-for-one economy. Eat half and take the other half home for the next day. You get twice the meals for half the money.
Side issues. In restaurants ask for side orders of fruit or veggies instead of french fries.
Keep a regular schedule. At home, schedule meals at regular times. Children thrive on routine. Eat at a table and never in front of the TV where eating becomes automatic and no attention is paid to portion size. Anything that distracts from the meal experience can diminish feelings of satisfaction, which can lead to mindless overeating.
Involve your child in meal planning, shopping, and food preparation.
Learn more. If you never learned to prepare healthy meals, take classes. Ask your local Extension Service for opportunities. Learn to read labels, and collect healthy menus.
NEVER, EVER practice the "do as I say, not as I do" style of parenting, eating poorly and exercising rarely yourself, all the while telling your kids to eat right and get more active.
Todd Huffman, MD
Chief of Pediatrics
McKenzie-Willamette Medical Center
Eugene, Oregon
A note for expectant parents
It's never too early to begin laying a foundation for your child's healthy eating patterns. Babies learn about food even before they are born. Tastes of what mom eats find their way to the amniotic fluid that cushions the fetus, so if mom eats lots of vegetables and healthy grains while she is pregnant, the baby will become accustomed to them and be likely to enjoy them later. Ditto for hamburgers, junk food and sugary soft drinks, so if you want your baby to accept healthy foods, eat lots of them while you are pregnant and limit empty calories and high sugar, high fat foods. You both will benefit.
Breast feeding also seems to help prevent obesity. Flavors of foods that mom eats end up in her breast milk. If you accustom your child to the flavors of healthy foods, s/he will be more accepting of them when s/he is older.
Please Note: ANRED information is not a substitute for medical or psychological evaluation and treatment. For help with the physical and emotional problems associated with eating disorders, talk to your physician and a mental health professional.
Page updated April 21, 2008
ANRED
Anorexia Nervosa and Related Eating Disorders, Inc.
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