More than 25% of American children are overweight. Childhood obesity increases the risk of adult obesity. Children who are obese at age 6 have a 50% or greater chance of becoming obese adults. This can put them at risk for many medical problems, including diabetes, high blood pressure, high cholesterol, and sleep apnea. Obesity can also adversely affect self-esteem.
The tendency to be overweight is usually inherited. If both parents are overweight, most of their children will be overweight. If one parent is overweight, half of the children will be overweight. If neither parent is overweight, the children have a 10%chance of being overweight. Less than 1% of obesity has an underlying medical cause. Your physician can easily determine this by a simple physical examination.
Heredity alone (without overeating) accounts for most mild obesity, defined as less than 30 pounds overweight in an adult. Moderate obesity usually results from a combination of heredity, overeating, and under exercising.
Children normally need a certain number of calories each day (energy allowance) that their bodies use as energy for normal daily activities (walking, breathing, etc.). This ranges for boys from 2000 calories for a 7-10 year old, 2500 calories for an 11-14 year old, and 3000 calories for a 15-18 year old. For girls the ranges are from 2000 calories for a 7-10 year old, to 2200 calories for an 11-18 year old. These are only estimates and some children need more (fast metabolism) or less (slow metabolism) of an energy allowance for daily activities.
If a child consumes more food and calories than is required by their energy allowance, than those excess calories are converted to fat for storage. Conversely, if a child consumes less food and calories than is required by their energy allowance, than their body fat is converted to energy for the needed calories.
Your child can lose weight by either dieting (eating fewer calories each day) or by exercising, so that their body needs more energy and uses up more calories. Either way, body fat will be burned and converted to energy and weight will be lost.
Helping children between 5 and 15 years of age lose weight is very difficult because they have access to so many foods outside the home and are not easily motivated to lose weight. It is not quite as difficult to help a child under 5 years lose weight because the parents have better control of the foods the child eats.
To help get your child motivated to exercise and eat healthier, it is important that you provide your child with a healthy lifestyle. This includes having healthy eating habits and participating in a regular exercise program. Also limit how much time that the family watches television.
Pediatricians use growth charts that are used to plot a child’s height and weight to make sure their growth is normal. New growth charts have been developed which include a new growth parameter called Body Mass Index (BMI). Adding BMI makes the growth charts a much more useful and accurate tool. BMI can be used to identify children who run the risk of becoming overweight or obese in the future. BMI serves as an early warning signal for future obesity.
How Do I Know If My Child Is Overweight?
Your child is overweight if any of the following criteria are present:
What are the advantages of using BMI-for-age with children from 2 to 20 years?
Sixty percent of children and teens with a BMI-for-age above the 95th percentile have at least one risk factor while 20 percent have two or more risk factors for cardiovascular disease. Overweight children are likely to become overweight adults.
If You Know Your Child's Weight And Height In Pounds And Inches
Follow these steps to calculate your child's BMI. Fractions and ounces must be entered as decimal values. See the table below for conversions to decimals.
BMI = weight in pounds / height in inches x height in inches x 703
Conversion of height fractions and weight ounces to decimals
BMI can be used to determine if your child is underweight or overweight:
Below the 5th percentile (for their age) are considered underweight.
Equal to or above the 85th percentile (for their age) are at risk for being overweight.
Equal to or above the 95th percentile (for their age) are considered overweight.
Suggestions For Helping Your Child Lose Weight
To help your older child or teenager lose weight without losing self-esteem, try the following:
Protect Your Child's Self-Esteem
Self-esteem is more important than an ideal body weight. Overweight children are aware of the weight problem and are already upset. They need their family to support them and accept them as they are. Parents who become overly concerned about their child's weight can reduce or destroy self-esteem. Avoid these pitfalls:
Help Your Child Develop Readiness And Motivation To Lose Weight
It is easier for your child to lose weight if motivated to do so. But even without motivation you can still help your child to lose weight by making healthy choices for his meals at home and encouraging regular exercise and physical activity.
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You can help your child become more motivated by getting actively involved in the process of eating healthier and exercising regularly. It may also help to use lots of praise and simple rewards for when your child is eating well and is being physically active.
Teenagers can increase their motivation by joining a weight-loss club such as Weight Watchers. Sometimes schools have classes to help children lose weight. A child's motivation can often be improved if the entire family undertakes diet and exercise programs. A cooperative parent-child weight-loss program with individual goals for each family member is usually more helpful than a competitive program focused on who can lose weight faster.
Set Weight-Loss Goals
The first goal of weight management in kids should be to lessen weight gain and maintain normal growth in height. This way they can ‘grow into' their weight. Begin doing this by having your child eat healthier (about 500 fewer calories each day) and begin a program of regular exercise and physical activity.
Once your child has stopped gaining weight and is on a regular program of dieting and exercising, you can set further goals of slow weight loss (about a 10% reduction at a time).
Help your child pick a realistic target weight, depending on his/her bone structure and degree of obesity. The loss of one pound a week is an attainable goal, but your child will have to work quite hard to maintain this rate for several weeks. Daily weighing generates too much false hope or disappointment. Keeping a weekly record may provide added motivation.
If losing weight becomes a strain, have your child take a few weeks off from the weight-loss program. During this time, try to help your child stay at a constant weight through exercise and moderation in eating.
Once your child has reached the target weight, the long-range goal is to stay within five pounds of that weight. Maintaining a particular weight is possible only through permanent moderation in eating and a reasonable exercise program. Your child will probably always tend to gain weight easily, and it is important that he understand this.
Help Your Child Consume Fewer Calories
Your child should eat three well-balanced meals a day of average-sized portions. There are no forbidden foods; your child can have a serving of anything family or friends are eating. There are forbidden portions, however. If your child eats until full, no weight will be lost. Your child has to be hungry when leaving the table.
Encourage average portions, and discourage seconds. Shortcuts such as fasting, crash diets, or diet pills rarely work and may be dangerous. Liquid diet preparations are only safe if used according to directions (consult a dietitian if you have any questions).
Help your child keep a weekly journal of food and beverage intake and also of the amount of time that is spent watching television, playing videogames and exercising. You can also record your child's weight each week (but do not weigh your child every day).
Fluids: Encourage your child to drink 4-6 glasses of water each day, especially before meals. Water has no calories and it will help make your child feel full. Other drinks can include diet sodas and skim milk. Avoid letting your child drink regular soft drinks or fruit juices, as they are high in calories (150-170 calories per serving).
24 ounces of skim milk and/or orange juice with calcium will provide your child with most of their daily calcium requirements.
Meals: Serve fewer fatty foods (eggs, bacon, sausage, butter). Fat has twice as many calories as the same amount of protein and carbohydrate. Trim the fat off meats. Serve more baked, broiled, boiled, or steamed foods and fewer fried foods. Serve more fruits, vegetables, salads, and grains.
Desserts: Encourage smaller-than-average portions of dessert. Do not serve seconds. Encourage more Jello and fresh fruits after meals; avoid serving rich desserts.
Snacks: Serve only low-calorie foods such as raw vegetables (carrot sticks, celery sticks, pickles), fresh fruits (apples, oranges, cantaloupe), popcorn, or diet soft drinks. Limit snacks to two a day.
Vitamins: Give your child one multivitamin with iron tablet daily during the weight-loss program.
Help Your Child Develop Good Eating Habits
It is not necessary to count calories, but you and your child should become more educated about the foods you eat and how many calories they contain. You should begin to routinely check the nutrition label of the foods that your family is eating. You want to try and eat foods low in calories and fat. Many “low fat” or “diet foods,” may be lower in fat, but may still contain too many calories as sugars.
Begin checking the serving size of prepared meals and snacks. A bag of chips might have 200 calories, but you may be surprised when the serving size is only 10 chips. Eating the whole bag can easily get you over 1000 calories.
To counteract the tendency to gain weight, your youngster must be taught good eating habits that will last a lifetime. You can help your child keep off unwanted pounds by doing the following:
Your child should eat three well-balanced meals of average size each day. Serve fewer fatty foods. It is healthy to prepare foods that are baked, broiled or steamed, rather than fried. Buy diet soft drinks and fresh fruits and vegetables.
In addition to a small serving of lean meat, provide large servings of vegetable
Suggest that your child chew food slowly.
Allow eating in your home only at the kitchen or dining room table. Store food only in the kitchen. Keep it out of other rooms.
Encourage Your Child To Increase Calorie Expenditure Through Exercise
Daily exercise can increase the rate of weight loss and promote a sense of physical well-being. The combination of diet and exercise is the most effective way to lose weight. An essential part of any weight loss or weight management program is regular fitness. Encourage your child to participate in a physical education class in school and extracurricular sports at school or in the community. Try and find physical activities that your child enjoys doing.
Some suggestions to help increase your child's and family's physical activities:
Encourage Your Child To Keep His/Her Mind Off Food By Participating In Social Activities
The more outside activities your child participates in, the easier it will be for him/her to lose weight. Spare time fosters nibbling. Most snacking occurs between 3 p.m. and 6 p.m. Help your child fill time after school with activities such as music, drama, sports, or scouts. A part-time job after school may help too. If nothing else, encourage your child to call or visit friends. An active social life almost always leads to weight reduction.
Ways To Trim Fat
Body Mass Index, or BMI (wt/ht2), provides a guideline based on weight and height to determine underweight and overweight. As children grow, their body fatness changes over the years. The interpretation of BMI depends on the child’s age. Additionally, girls and boys differ in their body fatness as they mature. Therefore, we plot the BMI-for-age according to sex-specific charts.
Each of the CDC BMI-for-age charts contains a series of curved lines indicating specific percentiles. BMI decreases during the preschool years, and then increases into adulthood. The percentile curves show this pattern of growth.
Look at BMI for a boy as he grows, yet remains at the 95th percentile BMI-for-age.
In the United States, BMI declines and reaches a minimum around 4 to 6 years of age before beginning a gradual increase through adolescence and most of adulthood. The upward trend after the low point or dip in BMI percentile curves reflects what has been described as the "adiposity rebound." Children whose adiposity rebound begins at younger ages are more likely to have an increased BMI as an adult.1
Plot the BMI-for-age as a girl grows from age 3 years to 9.5 years.
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