Feature Archive

Heavy Duty: Parenting & Obesity

More and more children are becoming overweight -- even obese. How do you know if your child is overweight? When should you be alarmed? And what can you do? We have some answers.

By Gina Shaw
WebMD Feature

Reviewed By Charlotte Grayson

Remember "adult-onset diabetes?" That's what doctors used to call type 2 diabetes, because it tended to develop later in life.

"Adult-onset diabetes" doesn't exist anymore -- at least, not by that name. Now there's only type 2 diabetes, because as a generation of American children get heavier and heavier, they're developing diseases that doctors used to see only in adults: diabetes, high cholesterol, and high blood pressure, gallstones, and a host of other medical problems.

America's children are gaining weight at an alarming rate. According to the Centers for Disease Control and Prevention, 15% of children and teens ages 6-19 are overweight. That's nine million kids, three times as many as in 1980.

But their parents don't seem to see it. Pediatrician Jennifer Bass, MD, has interviewed hundreds of parents in her clinic at Albert Einstein College of Medicine's Jacoby Medical Center and in her private practice. "In the municipal hospital clinic, over 100 of the 400 children were clinically obese, but 50% of the parents didn't recognize it," she says. "In the private practice, fewer children were obese, but again, half of their parents didn't think their children had a problem. People say 'Oh, they'll outgrow it,' but they don't. Overweight children become overweight adults."

What's An Overweight Child, Anyway?

So how do you know if your child is just holding onto a little baby fat, or flirting with a dangerous weight problem? The CDC defines an overweight child as one whose body mass index (BMI) falls into the 95thpercentile or more for their age. If a child is between the 85thand 95thpercentiles, he's at risk for becoming overweight; another 15% of kids fall into this category.

To see which percentile your child falls under, first calculate BMI with WebMD's BMI calculator. Then match that number with your child's age in these CDC charts -- click girls or boys (AdobeAcrobat is required to view these documents. Download it for free here.). It's a good idea to consult with your pediatrician, as the charts can be complex.

But don't expect your pediatrician to just come out and tell you that your child is overweight. "A lot of physicians aren't comfortable discussing obesity," says Bass. "They let it go for awhile hoping the child will grow into his weight and become more active, but that doesn't happen."

In addition to the BMI-for-age measurement, there are other signs that a child has a weight problem, says Mary Savoye, RD, CDE, a research dietitian and director of the "Bright Bodies" program at Yale University School of Medicine. Some red flags:

  • Sedentary behavior. Has your child become less active, sitting around instead of going out to play?
  • Difficulty with physical tasks -- for example, becoming short of breath while climbing stairs.
  • Puffiness in the face and neck.
  • Darkened areas of skin, especially the neck and under the arms. Called acanthosis nigricans, it's caused by overproduction of insulin (a precursor of diabetes), and is a sign that your child's health is already impaired.

Causes of the explosion in childhood obesity include many of the same trends that are making parents fat as well: more hours in front of the television and the computer, fewer hours outdoors, and the birth of the "super size." Meanwhile, schools are cutting down on physical education and loading cafeterias with vending machines that sell chips, candy bars, and soft drinks. What's a parent to do?

Healthy Weight: All in the Family

Combating the rising tide of childhood obesity isn't easy. "You're walking a fine line. You don't want your child to have this dieting mentality at 8 years old," says Savoye. "Diets haven't worked for adults, so how will they work for kids?" Instead, parents need to change not only their children's lifestyles, but also their own -- with a focus on health, not "dieting."

  • "Stand in your kitchen and look around!" says Kristi Houser, RD, a dietitian at the Columbus Children's Hospital in Columbus, Ohio. "Are you feeding your child Pop-Tarts for breakfast every morning?" Giving your child free access to healthy foods can be done at a very young age. Offer them fresh and dried fruits, crackers, pretzels, and other healthy snacks to choose from instead of chips and candy.

  • Watch what your child drinks. Those ever-popular juice boxes are deceptive: high in sugar and low in nutrition. "Kids drink juice instead of milk now, and it's often just these sugary drinks. Eight ounces of juice a day is plenty for a child," says Bass. "And the American Academy of Pediatrics recommends switching to 1% or skim milk at the age of two." If your ten-year-old can't live without her soda, try switching to diet instead of the sugar-packed regular kind.

  • Pack your child's lunch. School lunches can be high in fat, says Savoye. Instead, send them to school with a turkey sandwich on whole wheat, an orange, and some pretzels. But if you resort to prepackaged, high-calorie meals, your child might be better off with a school lunch, Houser notes. "That is the worst lunch you could send your child to school with."

  • Get your family active. Involving your child in a healthy form of exercise, like karate or soccer, is great, but sending the children out to play while Mom and Dad sit on the couch sends the wrong message. "Parents think their children's activity levels and theirs are a separate issue," says Savoye. "They don't realize that if they get on the rollerblades on or get on the bike, they're showing their child what to do."

  • Make changes gradually, not drastically. "Cold turkey's hard on everyone," says Houser. "Say fast food is one of your problems, and you're eating burgers and fries three nights a week. Instead of cutting it out completely, pare it down to once a week and let the kids pick the day they want it." If the children are used to three-cookie snacks, try switching to an apple or an orange followed by one small chocolate chip cookie. "You don't want to go completely restrictive."

Published Jan. 29, 2003.


SOURCES: Jennifer Bass, MD, assistant professor of pediatrics, Albert Einstein College of Medicine Jacoby Medical Center, New York • Mary Savoye, RD, CDE, research dietitian and director of the "Bright Bodies" program, Yale University School of Medicine, New Haven, Conn. • Kristi Houser, RD, Columbus Children's Hospital, Columbus, Ohio • CDC: "Prevalence of Overweight Among Children and Adolescents: United States, 1999-2000."

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