Childhood obesity is a challenging problem. As difficult as it is for a parent to acknowledge that their child is overweight, it is even more daunting for that parent to figure out how to even being to talk to the child about loosing weight. Many parents wonder if they should have the discussion at all.

Some experts worry that discussing weight issues with kids may create body image problems, problems. But many experts, including me, feel the exact opposite. It is crucial to talk with your child because overweight kids know they have a problem and are in huge pain as a result.

Child obesity expert, Kim Hiatt, PhD, from www.thinfromwithinteens.com, agrees. “The parent should absolutely verbalize it so the child/teen stops suffering alone with it.”

According to Dr. Hiatt, “I’ve had some kids tell me that they didn’t want to let their parents know that they were unhappy, though. They wanted to protect their parents so they acted like their weight didn’t bother them. But it seems to me that they always already know, have heard comments at school, etc. and that when a parent finally says…that they are going to get help, that it is a huge relief for the child.”

The long-term issues of childhood obesity are well known: heart problems, high blood pressure, stroke, exercise intolerance, diabetes, back and leg problems, self-esteem issues. The life expectancy for obese kids may very well be lower as adults due to these issues and that is a major concern. We all should have a sense of urgency to help these kids turn their lives around and help them start safely shedding pounds.

Where should you start?
First, call your pediatrician to discuss any potential medial issues that need to be controlled either before weight loss begins or during weight loss. This will vary by child.

Second, one big talk won’t do the trick, studies have taught us that. But, small conversations over time will work and also will help you build a strong bridge of communication. That bridge will be your best tool to help your child through this journey.

Early conversations typically need to focus on why loosing weight is so important. Focus on good health and future life goals and don’t dwell on the past. It helps kids of all ages to learn that body weight is really a reflection of food intake and energy used through exercise. Put this way, a body with too much weight needs to move more and eat a lower amount of calories, or a different proportion of calories, for a while.

The Internet can be one of your best allies for reinforcing positive messages of health and fitness to your overweight child. Here’s a list of some of my favorite nutrition and fitness Web sites:

CDC Body and Mind
Thin from within teens: free podcasst by Dr. Kim

Once you are moving in the right direction
Once you have the motivation, you have to work on changing eating and fitness habits. For the best long-term results, expect a slow steady pace and don’t change too much too quickly. Make sure fitness is not only fun but is an activity your child is interested in. Keep in mind, your child may be a bit self-conscious. Sometimes more individual fitness plans work better than group programs.

For nutrition, first be realistic that your goal is to teach healthy eating for life as well has controlling intake short term while your child is loosing weight. The overriding messages should be: no food is bad, all foods can be enjoyed in moderation and some foods can be eaten more liberally than others.

When talking to your kids about food, it helps to reinforce food intake is always balanced by how much we move during the day. So, if we have a special event coming up, we can avoid weight gain by either  moving more or eating less that day. The food pyramid for kids is a great tool to help kids of all ages visualize how much food they should aim for each day in each food category. It helps to reinforce to them that these are just guidelines, not stead fast rules so they don’t feel guilty if they have too much of one category one day and more of another category the next. The goal is to have a balance over the entire week and aim for healthy choices as a general rule over all.

Finally, if your child has a great deal of weight to loose, eating a healthy diet and exercising alone may not be enough. You may have to explore a formal weight loss plan such as Weight Watchers or Jenny Craig, or programs offered at many children’s hospitals. The key is finding a program that has experience with tweens and teens, teaches portion control and emphasizes healthy habits for life.

Remember, don’t ever view the scale as your guide to success. The best indicator for a successful weight loss program in kids is the boost in self esteem.

(Original post May 2008; updated December 2009)

]]> http://www.pediatricsnow.com/2009/12/childhood-obesity-talking-listening-to-your-kids/feed/ 0 http://www.pediatricsnow.com/2009/08/picture-perfect-not-in-this-years-camp-pics/?utm_source=rss&utm_medium=rss&utm_campaign=picture-perfect-not-in-this-years-camp-pics http://www.pediatricsnow.com/2009/08/picture-perfect-not-in-this-years-camp-pics/#comments Mon, 17 Aug 2009 10:18:00 +0000 DrGwenn http://pediatricsnow.com/blog/2009/08/picture-perfect-not-in-this-year%e2%80%99s-camp-pics/

If you want proof that the kids and teens of our society have a weight problem, are obese, all you have to do is check out the online camp photos of any overnight camp this year compared with last year or the year before. Seeing is believing – and shocking. It’s time we realize our kids are collectively eating too much and not moving enough.

I hear from families that their kids are often but the waist lines of kids, and parents, would state otherwise. Strolling through the food court at any mall is testimony that today’s family has a problem. It’s fine for families to eat out once in a while and fast food on occasion need not be a calorie killer but these kids are not just eating a bit of calories, they are eating 2-3 times their daily calories in one sitting. It isn’t uncommon to see a small elementary school child or a middle school child downing a super sized fast food meal complete with a milk shake. Someone needs to shake these parents, look them in the eye and yell STOP!

At any age, being overweight is a combination of eating too much and not moving enough. There is no such thing as “baby fat” so we have to stop using that term and deluding ourselves that our overweight and obese kids will just shed those extra pounds because they are kids.

We also have to stop linking our kids’ bodies to our past histories. Many parents will say “he’s just like his dad” or “I was just like that as a kid”.  Just because one of us had a weight issue as a child doesn’t mean our kids will shed the pounds the same way or at all. And, you know what? For us to shed those pounds we all had to eat less and move more. There were no short cuts.

Let’s stop denying our kids have a problem. A new school year is approaching and this can be a great time to clean the slate and help our kids become more healthy. Here’s what I would suggest:

1. Make healthy eating the goal for all, not dieting. This helps put the focus on “health” and creates a life long plan.

2. Find ways to get your child move more – start slow and build and don’t compare your child to other kids or to you or your spouse. Family pressure with sports is one of the worst motivators.

3. Help your child dress appropriately. There is nothing worse than seeing an overweight child dress like they are thin. There are many clothing options out there for kids of all body types. Find some clothes that help your child look neat and feel confident. If your child doesn’t feel like a slop, at whatever weight your child is, that will help keep your child motivated while shedding pounds.

4. Don’t deny the issue! This is very important. It’s ok to admit that your child has a weight problem without placing blame. In many ways, we are all always working on our bodies. One way to frame this is to say “when our bodies gain weight it is a signal from our body that we have to eat more healthy and move more. We all should be doing that. If you do that with our help, since you are still growing, the pounds will come off fairly quickly and you’ll learn what many adults take until our age to learn!”

5. Don’t ban food. Even eating healthy and shedding pounds treats are ok. The key is balance and portion control. So, if a birthday party or holiday comes up, help your child have a small piece of cake or one piece of candy. Look for treats like the Weight Watchers desserts that are low in calories and a good, occasional dessert.

6. Involve your pediatrician to help follow blood pressure and cholesterol.

7. Consider a nutritionist if you feel overwhelmed or are unsure how to eat a balanced diet. Keep in mind what works for you as an adult may not work for your growing child.

8. Programs like weight watchers are fine for kids and teens! In fact, they help kids learn great habits. Many health clubs and YMCAs have similar healthy living/eating programs.

9. If you have a weight problem, don’t deny it and work on it with your child.

10. Have your child cook with you in the kitchen. The more home cooked meals you all have, the healthier you all will be – and at healthier weights.

The new school year can be the best time to clean the slate and set everyone in a new, healthier direction. Every family can do something better where healthy eating and exercise are concerned. Figure out what your family has to tackle and tackle it. This is the year of no more excuses.

It’s always a bit of a landmark when something like the Happy Meal reaches a big milestone in years. This week marks it’s 30th anniversary of being introduced into our lives. That’s a lot of years, a lot of meals and a lot of small cute toys!

A meal in a box…who would have thought! I do remember when they first came out and parents with little kids flocked to them like flies to sticky paper. However, coming in at 600 calories for an average meal, packed a huge punch on the typical child’s health and waist band. Indeed, as noted by ABC News, childhood obesity has increased by 4x over the last 3 decades moving from only 4% the child population to 17%!!

The McDonald’s rep interviewed by ABC News mentioned that the “most popular” Happy Meal, the chicken nuggets with apples, is now only 360 calories. That is a great decrease by just shy of 50%.

Let’s not celebrate yet. What we need to consider is what proportion of a daily calorie amount this mean eats up.

Calorie amounts vary by age and gender. Here’s how it breaks down with recent recommendations from the American Academy of Pediatrics:

• Toddlers: 1000 calories a day
• 4-8 yr old girls: 1200 calories a day
• 4-8 yr old boys:1400 calories a day
• 9-13 yr old girls: 1600 calories a day
• 9-13 yr old boys: 1800 calories a day
• 14-18 yr old girls: 1800 calories a day
• 14-18 yr old boys: 2000 calories a day

Now, let’s look at some of the most popular Happy Meal calorie counts:

• Chicken nugget meal with Apple dippers & Apple Juice: 380 cals
• Chicken nugget meal with fries, 1% chocolate milk: 580 cals
• Hamburger meal with apple dippers, white milk: 460 cals
• Hamburger meal with fries, chocolate milk: 650 cals
• Cheeseburger meal with apple dippers, white milk:500 cals
• Cheeseburger meal with fries, chocolate milk: 700 cals

Finally, what percentage of a child’s daily calorie count will each of these meals snatch up for a toddler at 1000 calories a day?

• Chicken nugget meal with Apple dippers & Apple Juice: 38% Chicken nugget meal with fries, 1% chocolate milk: 58%
• Hamburger meal with apple dippers, white milk: 46%
• Hamburger meal with fries, chocolate milk: 65%
• Cheeseburger meal with apple dippers, white milk:50%
• Cheeseburger meal with fries, chocolate milk: 70%

What about if the child is a 5 year old girl requiring only 1200 cals/day?

The kicker here is that if we run these numbers for the teens, the percentages wouldn’t be quite as bad but teens go for the bigger meals which put them right back into these ranges in the end! (A Quarter Pounder alone is 400 calories! Check this list out for more details.)

Fast food such as Happy Meals is one of the big players in obesity in general for all populations. There are times we all have to grab and go because of work, travel and circumstances beyond our control. The key to not have the loaded calories make too much of a long term dent is to have a fast food plan and to work on being more healthy over all. Here are my suggestions:

1. Pick small portions and healthy alternatives at fast food places, and teach our children to do so as well. When in doubt, down size and pass on the fries or split them.
2. Eat healthy in general so the fast food day is the exception, not the rule.
3. Be as active as possible daily so your body and your children’s bodies have a way to burn the added calories.

McDonald’s job is to sell food and lure you and your kids’ through the doors. Your job is to keep your kids healthy and teach them how to be healthy life long. Have a Happy Meal once in a while…but do so thoughtfully and don’t delude yourself that these meals are anything close to healthy. The new packaging and food choices are just new hype for the same old unhealthy song.

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