Obesity in Children

• If you or the school personnel think your child is overweight
• If your child has expressed concerns about his or her weight
• If your child has problems keeping up with peers in physical fitness or sports

Self-Care at Home

The cornerstones of a weight control plan are physical activity and diet  management. Old habits and attitudes—yours and your children's—need to change. The sooner a plan is put in place, the better; it is much easier to change habits in children than in adults.

Physical activity

• The single best thing you can do is restrict the amount of time your child spends watching TV, sitting at the computer, or playing video games. These activities burn few calories and encourage snacking. The U.S. Surgeon General recommends moderate physical activity for children every day for at least 60 minutes.
• Encourage children to enjoy physical activity that burns calories and uses different muscle groups: running games, swimming, skating, riding a bicycle. The most effective activities raise the hear rate moderately and cause mild sweating; the child should not become exhausted, overheated, or severely short of breath.
• Allow each child to try different activities to find those that he or she enjoys.
• The goal is to participate in continuous, moderately strenuous activity for at least 30 minutes every day.
• Be a role model for your children. If they see you being active and having fun, they are more likely to be active and stay active into adulthood.
• Plan family activities so that everyone can get some exercise and have fun. Walk, dance, or bike together.
• Encourage your children to get involved in sports at school or in the community
• Don't force children to take part in activities they find uncomfortable or embarrassing
• Whatever activities your children become involved in should be appropriate for their ages and development. Make sure children understand basic safety rules. Make sure they have plenty of water to drink to replace fluid lost by sweating.

Diet management

• First, educate yourself about your children's nutritional needs. Use what you learn to help your children learn a healthy attitude about eating.
• If you are unsure about selecting and preparing foods for a healthy diet, tell your healthcare provider. He or she can make recommendations or refer you to a nutritionist.
• Involve your children in food shopping and meal preparation.
• Don't dictate exactly what your children eat. Children should help choose what they eat and how much.
• Offer your children a variety of foods, including sweets and snack foods. All foods have a place in a healthy diet, even foods high in fat and calories—as long as they are eaten occasionally and in moderation. Familiarize yourself with appropriate serving sizes.
• Encourage your children to eat slowly. This helps them recognize the feeling of fullness and stop eating when they are full.
• The family should eat together whenever possible. Make meals a pleasant time for conversation and sharing the events of the day.
• Don't forbid snacks. While continuous snacking contributes to weight gain, planned snacks are part of a healthy diet for children. A nutritious and tasty snack after school will give children the energy they need for homework, sports, and play until supper.
• Identify high-risk situations such as having too many high-calorie foods in the house or watching television during meal times. With the distraction of television, many people overeat.
• Don't deprive your child of occasional treats like chips, cake, and ice cream, especially at parties and other social events.

Meal and snack suggestions

Most of your diet should be whole grains, fruits, and vegetables. Serve a variety of green, red, yellow, brown, and orange vegetables, fresh fruits, and whole-grain bread, pasta, and rice.

Eat two or three servings of low-fat (1% milk) or nonfat dairy products every day.

A healthy diet also includes two to three servings of foods from the meat and beans group. This includes lean meat, poultry, fish, cooked dry beans, eggs, and nuts.

Limit fats to no more than 25%-30% of total calories.

• Switch to low-fat (1% milk) or nonfat dairy products if you now use whole-fat dairy foods.
• Trim all fat off meat and remove skin from poultry.
• Choose low-fat or fat-free breads and cereals.
• Avoid fried foods.

Choose low-fat and tasty snack foods

• Fruit, fresh or dried
• Low-fat or nonfat yogurt or cheese
• Nuts or sunflower or pumpkin seeds
• Whole-grain breads, crackers, or rice cakes spread with a fruit spread or peanut butter
• Frozen desserts such as frozen yogurt, fruit sorbet, popsicles, and fruit juice bars

Do not limit fat in children younger than two years of age.

Select snacks for young children carefully to avoid choking hazards.

Follow-up

Parents need to develop good habits of their own to help their children maintain a healthy weight.

• Don't make your child eat when he or she isn't hungry.
• Don't insist that your child finish a meal.
• Don't rush meal time. In general, you eat more when you eat quickly.
• Don't use food to comfort or reward.
• Don't offer dessert as a reward for finishing a meal.
• Offer your child a healthy, balanced diet that includes a variety of foods. No more than 30% of calories should come from fats. The American Heart Association guidelines (see below) are appropriate for most children.
• Switch your child from whole milk to 2% milk at age two years. If she or he is overweight, switch to 1% milk. In early childhood, skim milk should only be substituted following a doctor's recommendation.
• Don't eat at fast-food restaurants more than once a week.
• Make sure meals outside the home, such as school lunches, are balanced.
• Offer your child water to quench thirst. Avoid away from soda and other sugary drinks.
• Limit your child's time watching television and playing computer and video games.
• Encourage your child to do something active, like riding a bicycle, jumping rope, or playing ball. Better yet, bicycle or play ball with your child.
• Teach your child good eating and exercise habits now.

American Heart Association Dietary Guidelines for Healthy Children and Families

• Achieve adequate nutrition by eating a wide variety of foods.
• Eat adequate energy (calories) to support growth and development and reach a healthy body weight.
• Recommended average daily fat intake
• Saturated fat - 7%-10% of total calories
• Total fat - Limit to 25%-30% of total calories
• Cholesterol - Less than 300 mg per day

These guidelines apply to adults and children older than two years of age.

These measures should be applied to everyone in the family, not just children who are already overweight or obese.

Parents should focus on building self-esteem and coping with emotional distress.

Outlook

Some health problems are much more likely to affect obese children than non-obese children.

• Asthma, especially severe asthma
• Diabetes, type 2
• High blood pressure
• High cholesterol
• Heart failure
• Liver problems ("fatty liver")
• Bone and joint problems in the lower body
• Growth abnormalities
• Emotional and social problems
• Breathing  problems such as sleep apnea
• Rashes or fungal infections of the skin, acne

Obese children also are much more likely to have these and other obesity-related health problems in adulthood:

• Heart disease
• Stroke
• Certain types of cancer
• Osteoarthritis
• Gout
• Gallbladder disease