A Weight Reduction Program For Overweight Older Children And Adolescents

The Problem

Your child is overweight if he/she meets any of the following criteria:

  • His/her weight is more than 20% over the ideal weight for height.
  • He/she appears overweight to an objective person.
  • The skinfold thickness (fat layer) of his/her upper arm is more than one inch, as measured with a special instrument.

More than 25% of American children are overweight. 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.

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 underexercising. Some overeating is normal in our society, but only those who have the inherited tendency to overweight will gain significant weight when they overeat. Therefore, it is not reasonable to blame your child for being overweight.

Less than 1% of obesity has an underlying medical cause. Your physician can easily determine this by a simple physical examination.

Losing weight is very difficult. Keeping weight off is also a chore. The best time for young people to lose weight is when they are over 15 years of age. That is when they become very concerned about their appearance. The self-motivated teenager can follow a diet and lose weight, regardless of what the family eats.

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.

The Solution

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. If your child is overweight, he/she is probably already disappointed in himself/herself. 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:

  • Don't tell your child he/she is fat. Don't discuss his/her weight unless he/she brings it up.
  • Never try to put your child on a strict diet. Diets are unpleasant and should be self-imposed.
  • Never deprive your child of food if he/she says he/she is hungry. Withholding food eventually leads to overeating.
  • Don't nag your child about his/her weight or eating habits.

Help your child develop readiness and motivation to lose weight

Teenagers can increase their motivation by joining a weight-loss club such as TOPS (Take Off Pounds Sensibly) or Weight Watchers. Sometimes schools have classes to help children lose weight. A child's motivation can often be improved if diet and exercise programs are undertaken by the entire family. 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

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. Have your child weigh himself/herself no more than once a week; daily weighings generate too much false hope or disappointment. Keeping a weekly record may provide added motivation. When losing weight becomes a strain, have your child take a few weeks off from the weight-loss program. During this time, try to help him/her 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. While your child is reducing, he/she must leave the table a bit hungry. He/she cannot lose weight if he/she eats until full.

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).

Calorie counting is helpful for some people, but it is usually too time-consuming. Instead, consider some general guidelines on what to eat and drink:

1. Fluids: Because milk has lots of calories, your child should drink no more than 16 ounces of skim, 1%, or 2% milk each day. He/she can also drink up to eight ounces of fruit juice and fruit drinks a day; they have about 15 calories per ounce, similar to the calories in 2% milk. All other drinks should be either water or diet drinks. Encourage your child to drink six glasses of water each day.

2. 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.

3. Desserts: Encourage smaller-than-average portions of dessert. Do not serve seconds. Encourage more Jello and fresh fruits after meals; avoid serving rich desserts.

4. 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.

5. Vitamins: Give your child one multivitamin with iron tablet daily during the weight-loss program.

Help your child develop good eating habits

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:

  • Discourage skipping any of the three basic meals.
  • Encourage your child to drink a glass of water before meals.
  • Serve smaller portions.
  • Suggest that your child chew food slowly.
  • Offer seconds only if your child has waited for ten minutes after finishing the first serving.
  • Don't buy high-calorie snack foods such as potato chips, candy, or non-diet soda.
  • Do buy diet soft drinks and fresh fruits and vegetables.
  • Leave only low-calorie snacks, such as fruit, out on the counter. Put away the cookie jar.
  • Store food only in the kitchen. Keep it out of other rooms.
  • Discourage your child from continual snacking ("grazing") throughout the day.
  • Allow eating in your home only at the kitchen or dining room table. Discourage your child from eating while watching TV, studying, riding in a car, or shopping. Once eating becomes associated with these activities, the body learns to expect it.
  • Discourage eating alone.
  • Encourage your child to reward himself/herself for hard work or studying with a movie, TV, music, or a book rather than food.

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. Encourage your child to try the following forms of exercise:

  • Walking or bicycling instead of riding in a car whenever it's feasible.
  • Using stairs instead of elevators.
  • Learning new sports. Swimming and jogging are the sports that burn the most calories. Your child's school may have an aerobics class.
  • Taking the dog for a long walk.
  • Spending 30 minutes a day exercising or dancing to records or music on TV.
  • Using an exercise bike or Hula Hoop while watching TV (Limit time spent sitting in front of the TV set to two hours or less each day.)

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

  • Blot the grease on the top of pizza with a napkin. You'll eliminate at least a teaspoon-or 4.5 grams-of fat per slice.
  • Make sandwiches with an thin sliced bread (40 cal/slice) and use reduced fat meat and cheese.
  • Leave the last half-inch of take-out Chinese food, and fatty sauce, in the container. By eating only the top of the tub, you get a light taste of the sauce and all the crisp vegetables, and you leave the fat behind.
  • Dip your chicken nuggets or chicken wings in barbecue or sweet and-sour sauces. Avoid creamy dip at all costs-Burger King's ranch sauce, for example, adds 17 grams of fat.
  • Use 1 cup of egg substitute or two egg whites in place of an egg in any recipe.
  • At McDonald's, order two small regular hamburgers instead of one quarter-pound cheeseburger. They're just as filling, and you'll save 10 grams of fat.
  • Prepare packaged macaroni-and-cheese or scalloped potatoes by cutting the added butter or margarine by half, or skipping it entirely. You'll hardly notice the difference.
  • Wipe half of the special sauce off your fast-food sandwich. You'll cut up to 6.5 grams of fat and still enjoy the creamy taste.
  • Make mashed potatoes with buttermilk (2 fat grams per cup) instead of butter and whole milk, or use skim milk and butter buds. You'll taste the butter flavor without the fat.
  • Saute meat or vegetables in water, chicken broth, fruit juice or Worcestershire sauce instead of oil.
  • Use small-curd low-fat cottage cheese instead of high-fat ricotta in lasagna, manicotti and other Italian dishes.
  • Mix one-fourth to one-third of the margarine, butter or oil in most recipes. It won't affect the flavor of the food.
  • Use a nonstick vegetable cooking spray for frying. A two-second squirt of Pam aerosol, enough to stir-fry chicken and vegetables, is just nine calories.
  • Slim down tuna- or chicken-salad sandwiches by replacing the mayonnaise with plain nonfat yogurt.
  • When ordering a side for eggs, remember that ham is leaner than bacon, which in turn is leaner than sausage.
  • When buying ground turkey at the meat counter, make sure it's ground turkey breast. Regular ground turkey can include fattier dark meat and even some skin, which gives it almost as much fat as lean ground beef.
  • Heat the oil in your skillet before you cook. That way, meat will absorb less fat.
  • Choose mustard over mayonnaise for sandwiches.
  • Make your own nonfat chip dip with one part nonfat sour cream and one part medium or hot salsa.

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