Determining if a child or adolescent has a weight problem can be challenging. How do you know if the excess weight your child has is part of the natural growth process, and will your child just "grow out of?" How do you know if your child's weight may be negatively affecting his or her health?
Along with the rise in childhood obesity, there has been an increase in the incidence and prevalence of medical conditions in children and adolescents that had been rare in the past. Pediatricians and childhood obesity researchers are reporting more frequent cases of obesity-related diseases such as type 2 diabetes, asthma and hypertension that once were considered adult conditions.
There are some signs that may help you determine if your child has or is at risk for childhood obesity, such as:
- Family history of obesity.
- Family history of obesity-related health risks such as early cardiovascular disease, high cholesterol, high blood pressure levels, type 2 diabetes.
- Family history of cigarette smoking and sedentary behaviors.
- Signs in the child of obesity-related health risks from a pediatrician's evaluation including:
- Cardiac Risk Factors. Studies of children with obesity show higher than average blood pressure, heart rate and cardiac output when compared to children without obesity.
- Type 2 Diabetes Risk Factors. This involves glucose intolerance and insulin levels that are higher than average.
- Orthopedic Problems. Some symptoms include weight stress in the joints of the lower limbs, tibial torsion and bowed legs, and slipped capital femoral epiphysis (especially in boys).
- Skin disorders. Some are heat rash, intertrigo, monilial dermatitis and acanthosis nigricans.
- Psychological / Psychiatric Issues. Poor self-esteem, negative self-image, depression, and withdrawal from peers have been associated with obesity.
- Patterns of sedentary behavior (such as too much television viewing) and low physical activity levels.
- Taller height - children with obesity are often above the 50th percentile in height.
- Smoking initiation. Research studies show that youngsters use smoking as a method of weight control. Parents, pediatricians and schools should work together to discourage smoking as a weight control behavior for three main reasons: a) smoking is not likely to be successful in controlling weight, b) smoking is itself harmful, and c) smoking is associated with a decrease in sound nutrition and physical activity patterns.
An important part of treating obesity among children and adolescents is for parents and healthcare professionals to be sensitive to the youngsters and focus on the positive. Small and achievable weight loss goals should be set to avoid discouragement and to allow for the normal growth process.
Involvement of the entire family is also a motivating factor. Weight control programs that involve both parents and the child have shown improvement in long-term effectiveness compared to directing the program only to the child.
There are some structured weight loss programs such as Weight Watchers and Jenny Craig that allow older children and adolescents to participate with parental and medical permission.
Once the need for obesity treatment has been identified, your medical professional may suggest one or more options.
1. Dietary Therapy
According to the U.S. Department of Agriculture (USDA), there is a steady decline in the diet quality of children and adolescents as they get older.
Consultation with a dietitian / nutritionist that specializes in children's needs is often a valuable part of obesity treatment. Nutrition consultants can outline specific and appropriate nutritional needs for healthy growth.
As with adults, a nutrition consultant may or may not recommend reducing the number of calories the child eats and implementing strategies like learning to read nutrition labels and the food guide pyramid, selecting proper portion sizes, and prepared foods. Some eating behaviors that nutrition consultants typically encourage include taking smaller bites, chewing food longer, and to avoid eating too quickly by putting the utensil down between bites.
2. Physical Activity
The U.S. Surgeon General recommends moderate physical activity for children every day for at least 60 minutes. If a child is unable to meet that goal, than an individualized program should be designed according to fitness level, using the general guideline as an ultimate goal.
3. Behavior Therapy
Behavior therapy involves changes in diet and physical activity habits to one that promote a healthy weight. Some behavioral therapy strategies for children and adolescents should include parent and family involvement.
Some behavioral therapy strategies for children are to: