Overweight Children

Overweight children

by T. Berry Brazelton, M.D., author of Feeding: The Brazelton Way

Americans are facing an epidemic of overweight children today—an estimated 20 percent of all children are obese. A child is considered obese if she is 20 percent above her normal weight for height and age. Obesity can also be defined as weight levels that put well-being and health at risk.

Overweight children suffer from being teased and from the resulting poor self-esteem. They may also avoid or have trouble succeeding in sports. This condition can also lead to medical problems in childhood (high blood pressure and cholesterol, sleep apnea, and joint problems, among others). It also can increase the risk of these and other disorders in adulthood (for example, cancer, diabetes, and heart disease). Childhood obesity is a major risk factor for obesity in adulthood.

Genetics plays a role in obesity, so any child with overweight parents is at risk. But in our country, children are also put at risk by fast foods and processed foods, full of unhealthy fats, sugars, and salt in oversized portions, nutritionally "empty" calories that don't supply a balance of necessary nutrients. Healthier foods, with more fiber and protein, are not the ones being pushed in television advertisements and fast food joints, and they may be more expensive. Sadly, our country's poorest children are most at risk.

Added to our unhealthy diet is our couch potato culture. Television, video and computer games, and the Internet take time away from physical activity. As fields and forests are taken over by malls and unsafe housing developments, and child-safe sidewalks are replaced by freeways, more children are kept indoors, in front of the TV.

For some children, there may be additional factors in weight gain. Some children may turn to food for comfort and soothing, particularly if they never learned other ways of comforting themselves. Some children may never have learned to pay attention to hunger and fullness cues. We'd expect this to be more common in children who never learn to enjoy sitting down for relaxed mealtimes with their families, but instead have meals in front of the TV and snack and graze all day. Children are more likely to learn to handle their appetites when mealtimes (and snacks) occur at regular, predictable times that have a beginning, middle, and end—such as salad to start with, then the main course, and finally dessert. If you are concerned about your child's weight, let your pediatrician know—early. In any case, your pediatrician should be monitoring your child's growth (weight and height) at each routine preventive visit. Overweight children under 2 years of age are likely to be obese later, as older children. Uncommon medical causes of weight gain, including hormone abnormalities, need to be considered. Depression can also lead to excess weight gain.

Many children gain a little weight just before entering puberty. Unless the gain is excessive, it should not be cause for concern. Children this age are often very sensitive about their appearance, and a parent's reaction to bodily changes can be very upsetting. Don't comment on it. If you are concerned, discretely ask for your pediatrician's advice at your child's routine visit. If your child is concerned, listen to her, let her know that you understand that it bothers her, but let her know that this is a normal change and that you are not worried.

More on: Learning Good Nutrition