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Strategies for reducing childhood obesity

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Childhood obesity is a medical condition that impacts one-third of all children in the United States — a condition that has more than tripled in the last 40 years.

Children with obesity are predisposed to it as adults. Later on in life, the condition may lead to a host of weight-related medical complications.

Some parents rely on puberty to help correct an overweight child; however, it is crucial to promote a healthy weight before the age of 12 as the number of fat cells in the body continues to be made up until that age. The more fat cells in the body, the more the hunger hormones are produced and weight gain occurs.

The most common and well-known reason for weight gain comes down to a simple dynamic: eating too much and moving too little. If your child consumes high amounts of calories, particularly in the form of fats and sugars, and doesn’t burn off the energy through exercise and physical activity, much of the surplus energy will be stored by the body as fat. But weight can pile on for other reasons as well. Obesity has a strong genetic component. Children of obese parents are much more likely to become obese than children of lean parents. In rare instances, genetics and hormonal factors can also play a role in excess weight gain.

Where does your child’s weight rank?

As part of regular well-child care, the doctor calculates your child's Body Mass Index (or BMI) and determines where it falls on the BMI-for-age growth chart. The BMI helps indicate if your child is overweight for his or her age and height.

Using the growth chart, your doctor determines your child's percentile, meaning how your child compares with other children of the same sex and age. For example, if your child is in the 80th percentile, it means that compared with other children of the same sex and age, 80 percent have a lower weight or BMI.

Cutoff points on these growth charts, established by the Centers for Disease Control and Prevention, help identify children who are overweight and obese: a BMI between the 85th and 94th percentiles signifies overweight; a BMI in the 95th percentile or above signifies obesity.

Left untreated, childhood obesity can lead to a host of potential medical complications including Type 2 diabetes, high cholesterol and/or high triglycerides, and high blood pressure. In addition, the social stigma attached to being overweight can be as damaging to a child as the physical factors, possibly leading to psychological disorders such as depression and anxiety.  

Reversing the trend

The good news is that childhood obesity can be reversed through early intervention. Parents can help ensure their child achieves a healthy weight by adopting some — or all — of these strategies:

  1. Eliminate sugar-sweetened beverages and fast foods. These include soda, sports, and fruit drinks, which are loaded with sugar, and high-calorie, nutrient poor foods such as fried and fast foods that do nothing but pack on the pounds.
  2. Balance the plate correctly. The USDA MyPlate program recommends making half of your child’s plate comprised of fruits and vegetables and the other half protein and grains. Other important recommendations include serving fat-free or low-fat (1 percent) milk to children older than 2, and choosing lower-sodium foods.
  3. Create eating routines. Establish daily meal and snack times, and eat together as a family as frequently as possible.
  4. Exercise portion control. An easy way to cut down on unhealthy eating is to use a smaller plate. Portion sizes are now two to five times larger than in years past, and studies have shown that the bigger the serving dish, the bigger the serving is likely to be.
  5. Promote activity. Pediatricians recommend children ages 1 to 3 get 60 to 90 minutes of physical activity every day, while preschoolers need 90 to 120 minutes. Older children and teens should get at least 60 minutes of exercise each day. Regular activity helps children grow to a healthy weight, build and maintain healthy bones, muscles and joints, and strengthen their hearts.
  6. Create bedtime routines and help your child obtain age-appropriate sleep patterns. Insufficient sleep raises the stress hormone in the blood, increasing appetite.
  7. Swap screen time for playtime. Young children thrive and learn best through interacting with others and playing with real objects in their environment, so make independent play an alternative to TV. Limit TV and screen time to fewer than one or two hours daily.

When is surgery an option?

If diet and lifestyle are not effective in maintaining proper weight, and obesity is extreme, or causing other medical problems, adolescents may receive medical or surgical therapy. Surgery is only considered when an adolescent has severe obesity accompanied by severe health complications and is unable to lose sufficient weight to reverse these complications. Surgery is not a quick fix; it is a tool for weight loss, but is only effective long-term when accompanied by healthy eating and physical activity behaviors.

To learn more about pediatric weight management program at NewYork-Presbyterian, visit nyp.org/pediatrics. To find a pediatric specialist, call 1-800-245-KIDS(5437).

Dan Levinsohn

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