Best Tips for Fighting—and Reversing—Childhood Obesity

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Every week at Westchester Health Pediatrics, we see patients who are overweight and obese, and parents who are anxious and worried. And they’re not alone. In the past 30 years, the number of overweight children in the US has tripled, and it is now estimated that one in five children is overweight (18.5%).

Lauren Adler, MD, FAAP

Given these numbers, it’s no surprise that childhood obesity is one of the most common health problems seen by pediatricians. Yet, all is not lost. Although childhood obesity is alarmingly and persistently on the rise in America, change can take place and overweight children can take real steps toward a healthier lifestyle. It takes a concerted effort from many people involved in a child’s life, but yes, childhood obesity can be avoided, and in many cases, reversed.

Many reasons why the US has so many overweight and obese children

Like their adult counterparts, most children in the United States are not eating enough nutritious foods or getting sufficient physical activity. Family and environmental factors are key. For example:

  1. 91% of American children have poor diets and less than half get the recommended 60 minutes of daily physical activity.
  2. Almost two-thirds of American youth consume a sugary beverage on any given day.
  3. 25% of American high school students watch 3 or more hours of TV on an average school day.
  4. Schools have reduced recess time in favor of academic instruction, particularly among older children.

As with adults, environmental factors also play a role in childhood obesity. Some children have limited access to safe places to play, while others live in “food deserts” where there are few neighborhood places nearby for their parents to buy affordable, healthy food. One study found that the odds of a child being obese or overweight increases by 20-60% if he or she lives in a neighborhood with unfavorable conditions such as poor housing, unsafe surroundings and/or limited access to sidewalks, parks and recreation centers.

In addition, unhealthy foods are heavily and disproportionately marketed to children, with African-American youth exposed to a greater amount of unhealthy food marketing than Caucasian youth.

How childhood obesity is measured

Because kids are still growing, obesity is measured differently among children than adults. Instead of a simple BMI (body mass index) measurement, a child’s BMI is compared to others of the same age and sex. Children with BMIs at the 95th percentile or above are considered obese, and those with a BMI between the 85th and 95th percentiles are considered overweight.

A wide range of factors contribute to childhood obesity

  1. Food choices: Diets high in calories (including fats and simple sugars) and lower in fruits and vegetables
  2. Little physical activity: Lack of physical exercise, more time spent in sedentary activities such as watching TV and video games
  3. Parental obesity: Children of obese parents are more likely to be overweight themselves. Parental obesity may also reflect a family environment that promotes excess, unhealthy eating and insufficient activity.
  4. Eating patterns: Skipping meals or failure to maintain a regular eating schedule can result in eating too much at one time.
  5. Parenting style: Some researchers believe that excess parental control over children’s eating can cause those children to have poor self-regulation regarding food.
  6. Diabetes during pregnancy: Overweight and type 2 diabetes occur with greater frequency in the offspring of diabetic mothers (who are also more likely to be obese).
  7. Low birth weight: Low birth weight is a risk factor for being overweight in several studies.
  8. Excessive weight gain during pregnancy: Several studies have shown that excessive maternal weight gain during pregnancy is associated with increased birth weight and overweight later in life.
  9. Formula feeding: Breastfeeding is generally recommended over formula feeding, and studies suggest that it may also prevent excess weight gain as children grow.
  10. Parental eating and physical activity habits: Parents with poor nutritional habits and sedentary lifestyles model these unhealthy behaviors for their children, who often copy them in their own choices.
  11. Demographic factors: Certain demographic factors are associated with an increased risk of being overweight in childhood. For example, there is evidence that African-American, Hispanic, Asian and Pacific Islander children are more likely to be overweight.

Negative consequences of childhood obesity

As well as causing a child to be several pounds overweight, childhood obesity has both immediate and long-term effects on a child’s health and psychological well-being.

  1. Psychological consequences:

  • Depression
  • Poor body image
  • Low self-esteem
  • High risk of eating disorders
  • Behavior and learning problems
  1. Physical consequences:

  • Insulin resistance
  • Type 2 diabetes
  • Asthma
  • Hypertension
  • High Total and LDL cholesterol and triglyceride levels in the blood
  • Low HDL cholesterol levels in the blood
  • Sleep apnea
  • Early puberty
  • Orthopedic problems such as Blount’s disease and slipped capital femoral epiphysis
  • Non-alcoholic steatohepatitis (fatty infiltration and inflammation of the liver)
  1. Obese children are more likely to be obese as adults, and therefore are at increased risk for a number of diseases, including:

  • Stroke
  • Cardiovascular disease
  • Hypertension
  • Diabetes
  • Some cancers

Good news: Obesity can be reversed with healthy eating and exercise patterns

Just because a child is obese when young does not mean that he/she has to remain that way throughout life. Healthy lifestyle habits, including healthy eating and physical activity, can be taught—and when put into practice, can change a child’s life, both physically and mentally.

  • Schools play a critical role in influencing a child’s weight by establishing a safe and supportive environment that supports healthy behaviors. They also provide opportunities for students to learn about and practice healthy eating and physical activity (the dreaded gym class!).
  • Your child’s pediatrician also plays a vital role in helping your child reach and maintain a healthy weight. He/she can explain the health risks and benefits of a healthy and physically active lifestyle, create a customized diet and exercise plan, and encourage your child when he/she is struggling. Also, with regular checkups, your child’s doctor is more likely to notice changes in your child’s weight, both positive and negative, and can respond quickly to issues.
  • Parents probably have the most influence on a child’s eating and exercise habits. They can make sure there are healthy foods available at home, consult a nutritionist for meal guidelines, take their child to the gym with them, and be a cheerleader or a drill sergeant, whichever is needed.

Our pediatricians’ tips for fighting childhood obesity

From our years of experience here at Westchester Health Pediatrics helping our patients lose weight and become healthier and more active, here are the tips that have proven to be most effective:

  1. Serve and eat a variety of foods from each food group.
  2. Serve small portions. Compared to adult portions, child portions should be very small. More food can always be added if needed.
  3. Bake, broil, roast or grill meats instead of frying them.
  4. Limit use of high calorie, high fat and high sugar sauces and spreads.
  5. Use low-fat or nonfat dairy products for milk, yogurt and ice cream.
  6. Encourage participation in sports and other physical activity at school, church or community leagues.
  7. Be active as a family: go on walks, bike rides or hikes together.
  8. Limit TV time.
  9. Avoid eating while watching TV. TV viewers typically eat too much, too fast, and are influenced by the foods and drinks that are advertised.
  10. Replace sugary drinks, especially sodas, with water and/or low fat milk.
  11. Limit fruit juice intake to two servings or less per day (one serving = ¾ cup). Many parents allow their children unlimited intake of fruit juice because of the vitamins and minerals it contains. However, children who drink too much fruit juice may be consuming excess calories.
  12. Encourage physical play in young children and provide environments that allow children to play indoors and outdoors.
  13. Model healthy dietary practices, nutritional snacks and lifestyle activities.
  14. Avoid using food as a reward for good behavior or good grades.

If you’re concerned that your child is overweight or obese, please come see us

If you are worried about your child’s weight and the effect it is having on his/her health, please make an appointment with Westchester Health Pediatrics to come in and talk to one of our pediatricians. We will meet with you and your child, assess their weight and overall health, and together with you, decide on the best course of action to steer him/her toward a healthier lifestyle and healthier weight. Whenever, wherever you need us, we’re here for you.Make an appt

By Lauren Adler, MD, FAAP, pediatrician with Westchester Health Pediatrics, member of Northwell Health Physician Partners

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About the Author: ML Ball