Dr. Gwenn Is In

Childhood Obesity
Don’t ignore it, talk to your child

Dr. Gwenn Schurgin O’Keeffe
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:

www.kidshealth.org  (Kids Health)
www.teengrowth.com (Teen Growth)
http://teamnutrition.usda.gov/ (Team Nutrition)
http://www.bam.gov/index.html (CDC Body and Mind)
http://www.thinfromwithinteens.com/index.html (free podcasts and advice from 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 point out that 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 moving more that day or eating a bit less that day. The food pyramid for kids can really help kids of all ages visualize what they should be eating and in what amounts. It's our body's gasoline guide for high octane vs. low octane body fuels!

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.

Gwenn Schurgin O'Keeffe, M.D., F.A.A.P., P&K Medical Advisor, a pediatrician and mother of two from Wayland. A graduate of Tufts University School of Medicine, Dr. O'Keeffe completed her residency training at New England Medical Center and practices in the Metrowest area.  She is a columnist with the Gatehouse family of publications and her column, Dr. Gwenn Is In (formerly Your Child's Health), runs monthly. Dr O'Keeffe is founder and CEO of Pediatrics Now: www.pediatricsnow.com and she is Editor-in-Chief for the American Academy of Pediatrics Council on Communication and Media: http://aap.org/councils/media . She can be reached at ideas@pediatricsnow.com