Obesity in children becoming more common-Ask Dr. Paul Library

DEAR DR.PAUL: My nine-year-old niece weighs more than 150 lbs. and I am worried about her. She says she wants to lose weight, but cannot seem to stay on a diet. How can I help?

PEDIATRICIAN DR.PAUL Answers: Your question brings up several important points. First, recent studies have shown that school-aged children on average have more body fat and weight than children had 20 years ago. This is also the case in younger, pre-school children where studies have shown that they too have higher levels of body fat than normal.

Why is this occurring? I think it has to do with our whole society. In general, people (adults) tend to be less active and more obese. Fast food and sedentary lifestyles seem to have accompanied our present technological revolution. One of the important things I tell parents all the time is that children are very impressionable and will follow the example set by their parents. So, it's no wonder that as adult obesity increases, childhood obesity levels rise as well. The major causes of obesity are: lack of physical activity, as well as eating excessively and eating food with too much fat content.

Let me talk about physical activity. It is estimated that children two to five years of age watch an average of 25 hours of TV per week. I'm sure that in older children, the time spent in front of the TV, the computer or the video game station is quite high. These habits obviously cut into the time a child can spend being active either exercising or participating in sports. What I talked about is really important from the preventative point of view. Limiting a child's time in front of the TV or computer and encouraging and supporting an active lifestyle is an important key to maintaining good health and preventing obesity.

Now, in your situation, the issue is how to approach your niece to help her lose weight and prevent further weight gain and the complications that often come with it.

As well as the social effects of being an overweight child, there are a few potential medical complications of childhood obesity including: sleep disorders, bone or orthopedic problems, diabetes and high blood pressure.

A full medical assessment is needed to make sure there are no complications present and that there is no hormonal or other identifiable cause of the obesity. In most cases, a medical or hormonal cause is not found. Importantly, there needs to be an assessment of the child and family in terms of them accepting or being able to start on a weight management program which includes a diet and increasing physical activities. This is often easier said than done, and in many cases support will be needed from other professionals including nurses, psychologists, dieticians and social workers.

Obviously, the plan should involve all members of the family. As well as exhibiting good eating and exercise habits, parents need to learn to use praise and positive reinforcement in order to maintain a child's behavior change. The only way to maintain permanent change is to do this gradually, aiming to instill "life-long" lifestyle changes in the child. Being supportive, patient understanding as well as persistent, is the key.

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