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Q: My nine-year-old son is obese at under 5 feet tall and 115 lbs. I am trying to help him to reduce his weight. I can find nothing that gives caloric guidelines for a child this age. Experts are so afraid of limiting calories in a child this age, which I understand because he is growing, but I need some kind of guidelines about servings of the food groups, fat grams, and calories if I am going to help him. He is already feeling the social constraints and needs help.
A: You are right when you say that the usual advice is to not limit calories severely for a child who is still growing. The concern is that you would also end up limiting the important nutrients that the body needs for normal physical development and proper growth. The traditional wisdom has been to try to keep the weight stable, rather than actually lose weight, and allow the child to slowly "grow into" that weight.
Rather than focusing on calories and grams of fat, I think it is reasonable to focus instead on getting the appropriate servings of each particular food group. Your son needs to learn which foods he can eat as much of as he wants, and which foods he should avoid or eat rarely. This is a gradual process that takes time, and commitment from the family. The whole family has to adopt this healthful diet, not just your son. Additionally, if the whole family is doing this at home, it makes it a little easier for your son to continue a healthful pattern when he is away from home.
It would be helpful for you and your son to meet with a nutritionist who can go over basic dietary guidelines. The nutritionist can also give you an estimate of calories that your son should take, based on his level of activity and current rate of growth. There are also a number of children's groups available that specifically focus on children ages 8 to 15, and provide nutritional advice and counseling. You should speak to your doctor or a nutritionist.
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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.