Childhood Obesity

The examination of lifestyle on health has long been examined.  Healthful diet and physical activity have been shown to decrease risk of all cause mortality.  Even among those aged 70-90, the use of a Mediterranean diet and healthful lifestyle has been show to have a 50% decrease in the rate of all causes and cause specific mortality.  Diet and physical activity affect health at all stages of life.  This crisis is now more pronounced due to the affects of poor diet and lack of physical activity that characterizes much of our youth.  According to the Centers for Disease Control and Prevention, childhood obesity has more than tripled in the last 30 years.  Overweight and obesity is a definition that receives much criticism.  Advising a parent on the status of their child’s weight is a difficult situation for many providers.  Labeling a child may result in a real or perceived stigma associated with such a diagnosis. 

So what is the intervention?  I would make the same recommendation to the parent’s of an overweight/obese child that I would make to a parent seeking health information for long term disease prevention.

1)      Parent/Adult is responsible for what meals/snacks will be available as options

2)      Child is responsible for making food choices and activity choices based on the options made available.

3)      Parent is responsible for role modeling positive health behaviors such as healthful diet and physical activity.

In its simplest form unintentional weight gain is a result of an energy imbalance.  Not all calories are created equal but at the core of weight management - overall calories is a major focus.  High sugar, high salt, high fat foods result in larger food portions as well as more calorie intake.  Energy balance is attained by reducing calories consumed in the form of food/drink as well as increasing calories utilized thru increased physical activity. 

If this sounds like work and a troublesome endeavor, then you are right.  Healthful changes do take work.  They require time, planning and commitment.  Most children are not concerned with the long term health risks of poor diet and inadequate physical activity.  Issues such as diabetes, high blood pressure and/or other chronic illnesses are not a part of the young child or adolescent’s sense of mortality.  Energy levels, the fit of clothes, keeping up with their peers have a further reaching impact.  Children and adolescents will often clearly indicate when they are ready to open the discussion of developing their own specific plan for addressing desired weight loss.  Motivation for change on the part of the child and/or adolescent may take longer than what might be desired on the part of the health care provider.  The adults – as the individuals responsible for food purchasing, food preparation – have a larger responsibility when it comes to the day to day interventions that promote healthful lifestyle changes.  A helpful site on how to role model healthful lifestyle choices can be found at www.myplate.gov under their 10 tips series.