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Helping Overweight Children

Posted Aug 24 2008 1:49pm
SAMUEL KLEIN, MD: Obesity in children is a major public health problem that really forebodes serious issues for the future. And now the prevalence of obesity has doubled in children in the last 15 to 20 years; about 15 percent of children today are overweight.

ANNOUNCER: The problem is twofold. Poor eating habits. And lack of exercise.

BETH TAYLOR: If you think about our kids, they are more sedentary than they've been in a long time. They come home and play video games or get on the computer as opposed to going outside and playing baseball or soccer.

SAMUEL KLEIN, MD: I think fast food is a contributor to the problem. But certainly fast foods are usually very energy-dense, high-fat kinds of foods.

ANNOUNCER: The consequences of obesity in childhood are serious and multi-dimentional. Being overweight, for example, can interfere with emotional development.

SAMUEL KLEIN, MD: There are serious problems associated with childhood obesity. One is the problem of self-esteem and interacting with their peers and other children. Obese children are ostracized; there's tremendous prejudice against them, and this can have serious psychological effects that could affect them long term.

ANNOUNCER: Overweight kids also face serious medical problems.

SAMUEL KLEIN, MD: Diseases that we normally see in adults because of obesity are now being seen with increasing frequency in children, particularly type 2 diabetes, gall bladder disease and liver disease.

ANNOUNCER: Normal, but uneven growth patterns can complicate the question of whether a child is overweight. That's when the pediatrician can be helpful, tracking how a child compares to others.

SAMUEL KLEIN, MD: I would have the pediatrician who's involved in the child's care be a guide and look at the child's body weight in relationship to height or body mass index according to the growth charts that are distributed by the Center for Disease Control. And if the child hits a certain target in terms of the growth chart, that child might be a candidate for obesity therapy.

ANNOUNCER: When the charts show a child is overweight, treatment usually revolves around diet, exercise and patterns of behavior in the family.

BETH TAYLOR: I think the best starting point for intervention is looking at what's offered to the child at home by the parents, so it's educating the parents.

SAMUEL KLEIN, MD: I think treating children who are obese requires a family commitment and requires parents to be directly involved. It's not effective by just treating the child alone, and everyone who eats from the same refrigerator needs to be involved in the therapeutic process.

BETH TAYLOR: What parents can do at the table at home is offer choices of a variety of foods, as far as like fruits and vegetables and meats, lower-fat choices. And also watching the amounts of what they eat. And also by showing by example. A parent that sits down and eats a healthy meal himself, that child will see that and help learn by example.

ANNOUNCER: Encouraging physical activity must also be part of a successful strategy in helping children who are overweight.

SAMUEL KLEIN, MD: The first thing parents should do is really to decrease television viewing and sedentary activities at home. So watching TV, being on the computer should be limited. Parents should also establish increased physical activity behaviors with them and their children. So go out for walks on a regular basis after dinner, embark on family activities that increase physical action.

ANNOUNCER: When it comes to dieting, doctors offer similar advice for children as they do for adults.

SAMUEL KLEIN, MD: The dietary approach for anyone who is obese is really reducing calorie intake compared to energy expenditure, and doing it in a way where you eat healthy foods that provide you with all the nutrients that you need, but also foods that will increase your ability to adhere to that diet, as well. And the principles in an adult should not be too much different than the principles in a child, except the child cannot tolerate as well severe calorie restriction.

ANNOUNCER: Despite the prevalence of obesity among children, the solution is remarkably simple: cut calories and increase exercise.

If more families could devise strategies to accomplish those two goals, many more young people could look forward to healthy lives as adults.

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