Leading by Example
The percentage of overweight children in the United States is
growing at an alarming rate, with 1 out of 3 kids now
considered overweight or obese.
Many kids are spending less time exercising and more time in
front of the TV, computer, or video-game console. And today's
busy families have fewer free moments to prepare nutritious,
home-cooked meals. From fast food to electronics, quick and easy is
the reality for many people in the new millennium.
Preventing kids from becoming overweight means adapting the way
your family eats and exercises, and how you spend time together.
Helping kids lead healthy lifestyles begins with parents who lead
by example.
Is Your Child Overweight?
Body mass index (BMI) uses height and
weight
measurements to estimate how much body fat a person has. To
calculate BMI, divide weight in kg by height in meters squared; for
pounds and inches, divide weight by height squared and multiply the
result by the conversion factor 703.
An easier way to measure BMI is to use a
BMI calculator
. Once you know your child's BMI, it can be plotted on a
standard BMI chart. Kids fall into one of four categories:
- underweight:
BMI below the 5th percentile
- normal weight:
BMI at the 5th and less than the 85th percentile
- overweight:
BMI at the 85th and below 95th percentiles
- obese:
BMI at or above 95th percentile
BMI is not a perfect measure of body fat and can be misleading
in some situations. For example, a muscular person may have a
high BMI without being overweight (because extra muscle adds to a
body weight - but not fatness). In addition, BMI may be difficult
to interpret during puberty when kids are experiencing periods of
rapid growth. It's important to remember that BMI is usually a
good indicator - but is
not
a direct measurement - of body fat.
If you're worried that your child or teen may be overweight,
make an appointment with your doctor, who can assess eating and
activity habits and make suggestions on how to make positive
changes. The doctor may also decide to screen for some of the
medical conditions that can be associated with obesity.
Depending on your child's BMI, age, and health, the doctor
may refer you to a registered dietitian for additional advice and,
possibly, may recommend a comprehensive weight management
program.
The Effects of Obesity
Obesity increases the risk for serious health conditions like
type 2 diabetes, high blood pressure, and high cholesterol - all
once considered exclusively adult diseases. Obese kids also may be
prone to low self-esteem that stems from being teased, bullied, or
rejected by peers.
Kids who are unhappy with their weight may be more likely than
average-weight kids to:
- develop unhealthy dieting habits and eating disorders, such
as anorexia nervosa and bulimia
- be more prone to depression
- be at risk for substance abuse
Overweight and obese kids are at risk for developing medical
problems that affect their present and future health and quality of
life, including:
- high blood pressure, high cholesterol and abnormal blood
lipid levels, insulin resistance, and type 2 diabetes
- bone and joint problems
- shortness of breath that makes exercise, sports, or any
physical activity more difficult and may aggravate the symptoms
or increase the chances of developing asthma
- restless or disordered sleep patterns, such as obstructive
sleep apnea
- tendency to mature earlier (overweight kids may be taller and
more sexually mature than their peers, raising expectations that
they should act as old as they look, not as old as they are;
overweight girls may have irregular menstrual cycles and
fertility problems in adulthood)
- liver and gall bladder disease
- depression
Cardiovascular risk factors present in childhood (including high
blood pressure, high cholesterol, and diabetes) can lead to serious
medical problems like heart disease, heart failure, and stroke as
adults. Preventing or treating overweight and obesity in kids may
reduce the risk of developing cardiovascular disease as they get
older.
Causes of Overweight
A number of factors contribute to becoming overweight. Genetics,
lifestyle habits, or a combination of both may be involved. In some
instances, endocrine problems, genetic syndromes, and medications
can be associated with excessive weight gain.
Much of what we eat is quick and easy - from fat-laden fast food
to microwave and prepackaged meals. Daily schedules are so
jam-packed that there's little time to prepare healthier meals
or to squeeze in some exercise. Portion sizes, in the home and out,
have grown greatly.
Plus, now more than ever life is sedentary - kids spend more
time playing with electronic devices, from computers to handheld
video game systems, than actively playing outside. Television is a
major culprit.
Kids younger than 6 spend an average of 2 hours a day in front
of a screen, mostly watching TV, DVDs, or videos. Older kids
and teens spend almost 4 hours a day watching TV, DVDs, or
videos. When computer use and video games are included, time spent
in front of a screen increases to over 51/2 hours a day! Kids who
watch more than 4 hours a day are more likely to be overweight
compared with kids who watch 2 hours or less.
Not surprisingly, TV in the bedroom is also linked to increased
likelihood of being overweight. In other words, for many kids, once
they get home from school, virtually all of their free time is
spent in front of one screen or another.
The American Academy of Pediatrics (AAP) currently recommends
limiting the time kids over 2 years of age spend in front of a
screen to no more than 1-2 hours. The AAP also discourages any
screen time for children younger than 2 years.
Many kids don't get enough physical activity. Although
physical education (PE) in schools can help kids get up and moving,
more and more schools are eliminating PE programs or cutting down
the time spent on fitness-building activities. One study showed
that gym classes offered third-graders just 25 minutes of vigorous
activity each week.
Current guidelines recommend that kids over 2 years of age get
at least 60 minutes of moderate to vigorous physical activity on
most, preferably all, days of the week.
Genetics also play a role - genes help determine body type and
how your body stores and burns fat just like they help determine
other traits. Genes alone, however, cannot explain the current
obesity crisis. Because both genes and habits can be passed down
from one generation to the next, multiple members of a family may
struggle with weight.
People in the same family tend to have similar eating patterns,
maintain the same levels of physical activity, and adopt the same
attitudes toward being overweight. Studies have shown that a
child's risk of obesity greatly increases if one or more parent
is overweight or obese.
Preventing Overweight and Obesity
The key to keeping kids of all ages at a healthy weight is
taking a whole-family approach. It's the "practice what
you preach" mentality. Make healthy eating and exercise a
family affair. Get your kids involved by letting them help you plan
and prepare healthy meals, and take them along when you go grocery
shopping so they can learn how to make good food choices.
And avoid falling into these common food/eating behavior
traps:
- Don't reward kids for good behavior or try to stop
bad behavior with sweets or treats.
Come up with other solutions to modify their behavior.
- Don't maintain a clean-plate policy.
Be aware of kids' hunger cues. Even babies who turn away from
the bottle or breast send signals that they're full. If kids
are satisfied, don't force them to continue eating. Reinforce
the idea that they should only eat when they're hungry.
- Don't talk about "bad foods" or completely
eliminate all sweets and favorite snacks from kids'
diets.
Kids may rebel and overeat these forbidden foods outside the home
or sneak them in on their own.
Recommendations by Age
Additional recommendations for kids of all ages:
- Birth to age 1:
In addition to its many health benefits, breastfeeding may help
prevent excessive weight gain. Though the exact mechanism is not
known, breastfed babies may be more able to control their own
intake and follow their own internal hunger cues.
- Ages 2 to 6:
Start good habits early. Help shape food preferences by offering
a variety of healthy foods. Encourage kids' natural tendency
to be active and help them build on developing skills.
- Ages 7 to 12:
Encourage kids to be physically active every day, whether through
an organized sports team or a pick-up game of soccer during
recess. Keep your kids active at home, too, through everyday
activities like walking and playing in the yard. Let them be more
involved in making good food choices, such as packing lunch.
- Ages 13 to 17:
Teens like fast food, but try to steer them toward healthier
choices like grilled chicken sandwiches, salads, and smaller
sizes. Teach them how to prepare healthy meals and snacks at
home. Encourage teens to be active every day.
- All ages:
Cut down on TV, computer, and video game time and discourage
eating while watching the tube. Serve a variety of healthy foods
and eat meals together as often as possible. Encourage kids to
have at least five servings of fruits and vegetables a day,
limit sugar-sweetened beverages, and eat breakfast every
day.
If you eat well, exercise regularly, and incorporate healthy
habits into your family's daily life, you're modeling a
healthy lifestyle for your kids that will last. Talk to them about
the importance of eating well and being active, but make it a
family affair that will become second nature for everyone.
Most of all, let your kids know you love them - no matter what
their weight - and that you want to help them be happy and
healthy.
Reviewed by:
Mary L. Gavin, MD
Date reviewed: February 2009
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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