How to Help an Overweight or Obese Child

Ask a parent to name the greatest health threat to children and you'll hear about drinking or drugs. Rarely will anyone cite obesity -- even though it can lead to heart disease, high blood pressure or diabetes.

"It's at least as great a risk as smoking, if not greater," says John Rowlett, M.D., a Georgia pediatrician and member of the American Academy of Pediatrics.

And it's rampant. One child in five is overweight, according to the National Institutes of Health. Kids are more than twice as likely to be overweight today than they were 30 years ago.

Researchers place much of the blame on fast food and a sedentary childhood. Kids today spend an increasing amount of time watching TV, playing video games or sitting at the computer. Schools have cut back or eliminated physical education classes in favor of more academic subjects. Busy families often let nutrition slide, as they rely on fast-food meals and junk food snacks.

Obesity largely stems from a combination of poor eating and exercise habits, so both must be addressed. "Foundations developed in the early years," says Dr. Rowlett, "determine whether you choose a healthy lifestyle later on."

The problem

• Set realistic goals. Talk to your pediatrician or family doctor about healthy ways for your child to lose weight.

• Offer healthy snack alternatives. Keep fresh fruit and raw vegetables on hand instead of chips.

• Teach moderation. One cookie is OK -- not eight. Don't order your child a super-sized fast-food meal.

• Get your child moving. Exercise as a family and encourage your child to be active every day. Build up to 60 minutes of vigorous activity every day as recommended by the 2005 guidelines for nutrition and exercise from the U.S. Department of Agriculture.

• Change habits. For example, just switching from whole to skim milk can help.  Serve unsweetened cereal and allow the child to sweeten with Equal or Splenda or other no-calorie sweetener. Sugared sodas and fruit drinks are a common unrecognized source of high caloric intake. Eliminating these drinks or switching to diet drinks will help. 

• Start early. About 40 percent of overweight children stay fat as adults. That rises to 75 percent for adolescents.

• Set an example. As a parent, are you eating right and exercising?

• In general, the goal for overweight children who are still growing is not to lose weight, but rather to slow down their weight gain and allow their growth to catch up.

• Research has shown time spent watching television, playing video games or in front of the computer correlates with the risk for obesity. Also, having a TV or computer in the child’s bedroom is an additional risk factor for obesity. Limit TV time to 30 minutes per day for young children and one hour a day for preadolescents and teens. Take the TV or computer out of the child’s bedroom.