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to: Nutrition
Central > Weight Control |
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Weight
Control
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Help
for an Overweight Child
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In
the United States at least one child in five is overweight and
the number of overweight children continues to grow. Over the
last 2 decades, this number has increased by more than 50 percent,
and the number of "extremely" overweight children
has nearly doubled (Arch Pediatr Adolesc Med. 1995: 149:
1085-91). A doctor determines if children are overweight
by measuring their height and weight. Although children have
fewer weight-related health problems than adults, overweight
children are at high risk of becoming overweight adolescents
and adults. Overweight adults are at risk for a number of health
problems including heart disease, diabetes, high blood pressure
stroke, and some forms of cancer.
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Children
become overweight for a variety of reasons. The most common
causes are genetic factors, lack of physical activity, unhealthy
eating patterns, or a combination of these factors. In rare
cases, a medical problem, such as an endocrine disorder, may
cause a child to become overweight. Your physician can perform
a careful physical exam and some blood tests, if necessary,
to rule out this type of problem.
Genetic
Factors
Children whose parents or brothers or sisters are overweight
may be at an increased risk of becoming overweight themselves.
Although weight problems run in families, not all children
with a family history of obesity will be overweight. Genetic
factors play a role in increasing the likelihood that a child
will be overweight, but shared family behaviors such as eating
and activity habits also influence body weight.
Lifestyle
A child's total diet and his or her activity level both play
an important role in determining a child's weight. The increasing
popularity of television and computer and video games contributes
to children's inactive lifestyles. The average American child
spends approximately 24 hours each week watching television-time
that could be spent in some sort of physical activity.
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If
you think that your child is overweight, it is important to
talk with your child's doctor. A doctor is the best person to
determine whether your child has a weight problem. Physicians
will measure your child's weight and height to determine if
your child's weight is within a healthy range. A physician will
also consider your child's age and growth patterns to determine
whether your child is overweight. Assessing overweight in children
is difficult because children grow in unpredictable spurts.
For
example, it is normal for boys to have a growth spurt in weight
and catch up in height later. It is best to let your
child's doctor determine whether your child will "grow
into" a normal weight. If your doctor finds that your
child is overweight, he or she may ask you to make some changes
in your family's eating and activity habits.
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Be
Supportive.
One of the most important things you can do to help overweight
children is to let them know that they are okay whatever their
weight. Children's feelings about themselves often are based
on their parents' feelings about them. If you accept your children
at any weight, they will be more likely to accept and feel good
about themselves. It is also important to talk to your children
about weight, allowing them to share their concerns with you.
Your child probably knows better than anyone else that he or
she has a weight problem. For this reason, overweight children
need support, acceptance, and encouragement from their parents.
Focus
on the family.
Parents should try not to set children apart because of their
weight, but focus on gradually changing their family's physical
activity and eating habits. Family involvement helps to teach
everyone healthful habits and does not single out the overweight
child.
Increase
your family's physical activity.
Regular physical activity, combined with healthy eating habits,
is the most efficient and healthful way to control your weight.
It is also an important part of a healthy lifestyle. Some
simple ways to increase your family's physical activity include
the following:
- Be
a role model for your children. If your children see that
you are physically active and have fun, they are more likely
to be active and stay active for the rest of their lives.
- Plan
family activities that provide everyone with exercise and
enjoyment, like walking, dancing, biking, or swimming. For
example, schedule a walk with your family after dinner instead
of watching TV. Make sure that you plan activities that
can be done in a safe environment.
- Be
sensitive to your child's needs. Overweight children may
feel uncomfortable about participating in certain activities.
It is important to help your child find physical activities
that they enjoy and that aren't embarrassing or too difficult.
- Reduce
the amount of time you and your family spend in sedentary
activities, such as watching TV or playing video games.
- Become
more active throughout your day and encourage your family
to do so as well. For example, walk up the stairs instead
of taking the elevator, or do some activity during a work
or school break-get up and stretch or walk around.
The
point is not to make physical activity an unwelcome chore,
but to make the most of the opportunities you and your family
have to be active.
Teach
your family healthy eating habits.
Teaching healthy eating practices early will help children
approach eating with the right attitude-that food should be
enjoyed and is necessary for growth, development, and for
energy to keep the body running. The best way to begin is
to learn more about children's nutritional needs by reading
or talking with a health professional and then to offer them
some healthy options, allowing your children to choose what
and how much they eat. The pamphlet "Dietary Guidelines
for Americans" is a good source of dietary advice for
healthy Americans ages 2 years and older. This pamphlet is
available from WIN.
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Don't
place your child on a restrictive diet.
Children
should never be placed on a restrictive diet to lose weight,
unless a doctor supervises one for medical reasons. Limiting
what children eat may be harmful to their health and interfere
with their growth and development.
To
promote proper growth and development and prevent overweight,
parents should offer the whole family a wide variety of foods
from each of the basic food groups. A healthy diet should
consist of a balance among food groups in a daily eating pattern.
- Most
of the foods in your diet should come from the grain products
group (6-11 servings), the vegetable group (3-5 servings),
and the fruit group (2-4 servings). (See chart for suggested
serving sizes.)
- Your
diet should include moderate amounts of foods from the milk
group (2-3 servings) and the meat and beans group (2-3 servings).
- Foods
that provide few nutrients and are high in fat and sugars
should be used sparingly. Fat should not be restricted
in the diets of children younger than 2 years of age.
| One
Serving* Equals |
BREAD,
CEREAL, RICE & PASTA GROUP
- 1
slice of bread
- 1
ounce of ready to eat cereal
- 1/2
cup of cooked cereal, rice, or pasta
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MILK,
YOGURT, & CHEESE GROUP
- 1
cup of milk or yogurt
- 1
1/2 ounces of natural cheese
- 2
ounces of processed cheese
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VEGETABLE
GROUP
- 1
cup of raw vegetables or 1/2 cup of frozen leafy leafy
vegetables (cooked)
- 1/2
cup of other vegetables - cooked or chopped raw
- 3/4
cup of vegetable juice
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MEAT,
POULTRY, FISH, DRY BEANS, & NUTS GROUP
- 2-3
ounces of cooked lean meat, poultry, or fish
- 1/2
cup of cooked dry beans or 1 egg counts as 1 ounce
of lean meat
- 2
tablespoons of peanut butter or 1/3 cup of nuts count
as 1 ounce of meat
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FRUIT
GROUP
- 1
medium apple, banana, or orange
- 1/2
cup of chopped, cooked, or canned fruit
- 3/4
cup of fruit juice
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*NOTE:
Serving sizes are for children and adults ages 2 years
and older. A range of servings is given for each food
group. The smaller number is for children who consume
about 1,300 calories a day, such as 2-4 years of age.
The larger number is for those who consume about 3,000
calories a day, such as boys 15-18 years of age.
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If you are unsure about how to select and prepare a variety
of foods for your family, consult a physician or registered
dietitian for nutrition counseling. You may also want
to refer to the readings and organizations listed at the end
of this fact sheet for more information on healthy eating.
Carefully
cut down on the amount of fat in your family's diet.
Reducing
fat is a good way to cut calories without depriving your child
of nutrients. Simple ways to cut the fat in your family's
diet include eating lowfat or nonfat dairy products, poultry
without skin and lean meats, and lowfat or fat-free breads
and cereals. Making small changes to the amount of fat in
your family's diet is a good way to prevent excess weight
gain in children: however, major efforts to change your child's
diet should be supervised by a health professional. In addition,
fat should not be restricted in the diets of children younger
than 2 years of age. After that age, children should gradually
adopt a diet that contains no more than 30 percent of calories
from fat by the time the child is about 5 years old.
Don't
overly restrict sweets or treats.
While
it is important to be aware of the fat, salt, and sugar content
of the foods you serve, all foods-even those that are high
in fat or sugar-have a place in the diet, in moderation.
Guide
your family's choices rather than dictate foods.
Make
a wide variety of healthful foods available in the house.
This practice will help your children learn how to make healthy
food choices.
Encourage
your child to eat slowly.
A
child can detect hunger and fullness better when eating slowly.
Eat
meals together as a family as often as possible.
Try
to make mealtimes pleasant with conversation and sharing,
not a time for scolding or arguing. If mealtimes are unpleasant,
children may try to eat faster to leave the table as soon
as possible. They then may learn to associate eating with
stress.
Involve
children in food shopping and preparing meals.
These
activities offer parents hints about children's food preferences,
teach children about nutrition, and provide children with
a feeling of accomplishment. In addition, children may be
more willing to eat or try foods that they help prepare.
Plan
for snacks.
Continuous
snacking may lead to overeating, but snacks that are planned
at specific times during the day can be part of a nutritious
diet, without spoiling a child's appetite at mealtimes. You
should make snacks as nutritious as possible, without depriving
your child of occasional chips or cookies, especially at parties
or other social events. Below are some ideas for healthy snacks.
| Healthy Snacks |
Fresh, frozen, or canned vegetables and fruit
served either plain or with lowfat or fat-free cheese
or yogurt
Dried fruit, served with nuts or sunflower or pumpkin
seeds
Breads and crackers made with enriched flour and
whole grains, served with fruit spread or fat-free
cheese
Frozen desserts, such as nonfat or lowfat ice cream,
frozen yogurt, fruit sorbet, popsicles, water ice,
and fruit juice bars |
| *Children of preschool age can
easily choke on foods that are hard to chew, small
and round, or sticky, such as hard vegetables, whole
grapes, hard chunks of cheese, rasins, nuts, and
seeds, and popcorn. Its important to carefully select
snacks for children in this age group. |
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Discourage eating meals or snacks while watching TV.
Try to eat only in designated areas of your home, such as
the dining room or kitchen. Eating in front of the TV may
make it difficult to pay attention to feelings of fullness,
and may lead to overeating.
Try
not to use food to punish or reward your child.
Withholding food as a punishment may lead children to worry
that they will not get enough food. For example, sending children
to bed without any dinner may cause them to worry that they
will go hungry. As a result, children may try to eat whenever
they get a chance. Similarly, when foods, such as sweets,
are used as a reward, children may assume that these foods
are better or more valuable than other foods. For example,
telling children that they will get dessert if they eat all
of their vegetables sends the wrong message about vegetables.
Make
sure your child's meals outside the home are balanced.
Find out more about your school lunch program, or pack your
child's lunch to include a variety of foods. Also, select
healthier items when dining at restaurants.
Set
a good example.
Children are good learners, and they learn best by example.
Setting a good example for your kids by eating a variety of
foods and being physically active will teach your children
healthy lifestyle habits that they can follow for the rest
of their lives.
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If
you need to make changes to your family's eating and exercise
habits, but are finding it difficult, a registered dietitian
(RD) may be able to help. Your physician may be able to refer
you to an RD, or you can call the National Center for Nutrition
and Dietetics of The American Dietetic Association at 800-366-1655
and ask for the name of an RD in your area.
If
your efforts at home are unsuccessful in helping your child
reach a healthy weight and your physician determines that
your child's health is at risk unless he or she loses weight
steadily, you may want to consider a formal treatment program.
To locate a weight-control program for your child, you may
want to contact a local university-based medical center.
Look
for the following characteristics when choosing a weight-control
program for your child. The program should:
- Be
staffed with a variety of health professionals. The best
programs may include RDs, exercise physiologists, pediatricians
or family physicians, and psychiatrists or psychologists.
- Perform
a medical evaluation of the child. Before being enrolled
in a program, your child's weight, growth, and health should
be reviewed by a physician. During enrollment, your child's
weight, growth, and health should be monitored by a health
professional at regular intervals.
- Focus
on the whole family, not just the overweight child.
- Be
adapted to the specific age and capabilities of the child.
Programs for 4-year-olds are different from those developed
for children 8 or 12 years of age in terms of degree of
responsibility of the child and parents.
- Focus
on behavioral changes.
- Teach
the child how to select a variety of foods in appropriate
portions.
- Encourage
daily activity and limit sedentary activity, such as watching
TV.
- Include
a maintenance program and other support and referral resources
to reinforce the new behaviors and to deal with underlying
issues that contributed to overweight.
The
overall goal of a successful treatment program should be to
help the whole family focus on making healthy changes to their
eating and activity habits that they will be able to maintain
throughout life.
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The
American Academy of Pediatrics (Marketing Division)
Northwest Point Boulevard
Elk Grove Village, IL 60009
Phone: (708) 228-5005.
Food
and Nutrition Information Center
United States Department of Agriculture
Internet: http://www.nal.usda.gov/fnic.
The
National Center for Nutrition and Dietetics
The American Dietetic Association
216 West Jackson Boulevard
Chicago, IL 60606-6995
Consumer Nutrition Hotline: (800) 366-1655.
National
Heart, Lung, and Blood Institute Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
Phone: (301) 251-1222.
President's
Council on Physical Fitness and Sports
701 Pennsylvania Avenue, NW, Suite 250
Washington, DC 20004
Phone: (202) 272-3421.
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References:
Arch Pediatr Adolesc Med. 1995: 149: 1085-91 and from
the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK), part of the National Institutes of Health |
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