Small Steps Can Head off Child Obesity

Published by Contra Costa Times

Posted on Sat, Feb. 21, 2004

By Dr. Diane Dooley

"WELCOME BACK," beamed my 12-year-old patient, Alan, as I recently entered an exam room for his regular appointment. A very likable child, he and his mother had been seeing me for years with a number of issues. "I didn't like that other doctor," he volunteered, referring to a doctor he saw while I was on vacation. With tears in his eyes, he revealed, "He told me I'm fat."

What could I say? Children today are getting heavier at a rapid rate. Inactivity, too much TV, and high-fat, high-sugar foods are the problem.

In the eyes of this boy's family, my patient was just carrying a few extra pounds before his adolescent growth spurt helped him "grow out" of his chubby appearance. They were embarrassed to have a physician comment on his appearance. Yet according to the medical literature, my patient was overweight. He and his parents needed to know that he has a high risk of adult obesity and chronic health problems. It's my responsibility as a physician to alert him and his family to the risks of obesity, and to educate and encourage them to make healthy lifestyle changes.

Physicians across the nation have become alarmed by an epidemic of childhood obesity. A 2002 survey of Contra Costa children reported that 35 percent to 40 percent of children ages 2-19 were either at risk of being overweight or already overweight. It's difficult to tell when your child is too heavy, in part because we have all become used to seeing chubby children and begin to think it's normal.

Physicians are using a new tool, the Body Mass Index (BMI), to predict your child's risk of future obesity. Your doctor can calculate this using the height and weight and a standard growth chart. If your child is overweight, your physician will perform a screening history and physical to identify associated health problems, such as Type II diabetes, high blood pressure, high cholesterol, and hip and knee problems.

People who want to avoid having weight problems in their family need to adopt better eating habits and exercise every day - 30 minutes of even moderate activity can make a big difference.

Some tips to consider include:

Breast-feed your infants as much and as long as possible. Breast feeding has been shown to reduce the chances that your child will be overweight in childhood.
Do not offer your children soda or sweetened drinks, such as Kool Aid.
Limit juice to only 4 to 6 ounces a day.
Try to offer desserts and fast food only once a week.
Encourage regular physical activity. Children should be actively playing at least 60 minutes a day. Try to think of regular physical activities for the whole family that aren't a chore: walking, basketball, biking, dance.
Limit TV, video games and computer watching to one to two hours a day. This will improve both your child's health and school performance. Don't combine meals or snacks and TV.
Children should not have a TV in their bedroom.
Serve smaller food portions. Allow seconds if desired, but don't push your child to finish meals.

We all need to take responsibility for building a world where children live healthy, vigorous lives and avoid the health problems and stigma of obesity.

Dr. Dooley is a pediatrician who practices at the Concord Health Center. She is currently chairwoman of the Department of Pediatrics at the Contra Costa Regional Medical Center.