Childhood Obesity

Childhood obesity is becoming a major health concern here in the United States.  One of my roles when I provided consultations at a pediatric clinic was to be part of their multidisciplinary team that worked with their children who were overweight.  The goal of this team was to provide education to the children and their families regarding healthy eating and exercise habits.  An important message we stressed to our families was that the goal was never to have the child lose weight.  Rather than recommend that a child lose weight, we encouraged a child to maintain their current weight, knowing that they would continue growing and their body mass index (BMI) would normalize.  I have serious concerns about some of the other programs that do recommend children lose weight.  Some of these programs even encourage a child to “diet”.  This shocks me because we know that diets don’t work even for adults and can lead to the development of serious eating disorders.  I have worked with many children and adolescents who have felt ashamed about their bodies after being told by their doctor that they were overweight.  I do not think it is helpful to inform a child that they are overweight or obese.  Nor do I think it is useful for a doctor to focus on a child’s weight.       

How do we address this growing health issue in a way that does more good than harm to our children?  How can we help these children and their families to live healthier?  I believe it has to start with education.  Many of us were not given information about how to determine a serving size, how many fruits/vegetables a child needs a day, or how much exercise is appropriate.  Educating every family member about nutrition allows the entire family to make healthy changes together and to reinforce new healthy habits. 

I think being able to provide education and training to families is the first step we can take.  Next, we need to reinforce the positive changes that a family is making.  Are they eating more fruits/vegetables, spending more time outside, or recognizing serving sizes?  Encouraging the family to make changes together is important to help the child be successful in making life long healthy changes.  Parents need to find ways to support their kids in doing activities that do not involve electronics.  Sometimes this means parents needing to set limits about how much “screen time” a child is allowed.  Other times this may mean parents need to sign their children up for after school activities or sports.  I also recommend being able to find small things that the family can do together.  Even if it’s something simple, such as everyone taking the dog for a walk after dinner or going on a bike ride together.  Not only are these family activities helpful physically, they can also provide a stronger emotional bond and trust between family members.

I think every primary care physicians’ office should have a dietician/nutritionist who can provide the education and training to families about nutrition.  Providing guidance for parents on how to set limits with their children (which could be in relation to choosing healthy foods, limiting screen time, etc) is also an important piece.  Encouraging families to not focus on weight, not go on “diets”, and to instead begin making a few small healthy changes in their daily lives; could be some of the first steps to address this increasing health concern.  Children and adolescents are already trying to adjust to their changing bodies and we don’t need more adolescents feeling insecure about whom they are as a person.