Studies show that today’s youngsters tend to be heavier than their counterparts were a generation ago, and that over 30 percent of America’s school-age youngsters are now overweight. That can contribute to physical problems such as high blood pressure, limit a child’s athletic abilities and impair self-esteem. We live in a society that emphasizes thinness, and an overweight child is likely to be teased by peers.

What, then, is a reasonable approach to this problem? First, you need to determine if your child is overweight. Talk with your pediatrician, who will consult growth charts to determine the most appropriate target weight range for your youngster. This ideal range will depend on a number of factors, including your youngster’s sex, age, height and body build. Obesity is usually defined as more than 20 percent above ideal weight for a particular height and age. Youngsters who are greater than 40 percent overweight are generally recommended for a physician-guided weight-loss program.

Children tend to gain weight at a fairly steady rate through the middle years, with an increase in weight gain and growth during, and just prior to, puberty. Your youngster’s need for calories rises during times of rapid growth, gradually increasing as she moves through middle childhood into puberty. Parents and their children should not become alarmed by this increase in weight and initiate dieting at this time.


Causes for Obesity

Various factors can influence the likelihood of a child’s becoming overweight. A family history of obesity increases your youngster’s chances of weight problems later in life. A child who is physically inactive is more likely to have a weight problem. If your family’s meals tend to emphasize high-calorie foods, that can cause excess weight gains. Nutrition is important to normal growth processes, and thus you should make an effort to ensure that your child consumes a well-balanced diet. However, if the calories consumed exceed those expended, your child may develop a weight problem. Although certain metabolic and endocrine disorders may contribute to obesity, they are the culprits in only about five percent of obese children.

Stress can also play a role in some overweight problems. Adults change their lifestyles in response to feelings, both when they feel good and when they feel bad. They may work harder or less intensively, engage in active exercise and social activities or become more sedentary, indulge in the use of substances such as alcohol and tobacco or abstain from them. Adults use food in similar ways – some people eat more under stress or when they are happy or excited, while others lose their appetites. Children have less control over their lives and thus have fewer options with which to respond to emotional peaks and valleys. They may be prone to changing the way they eat as their moods and behavior change – for instance, when they are bored, anxious, depressed or even extremely pleased with things.


Treating Obesity

If your child is obese, do not ignore the problem. A lifetime of poor eating habits and obesity can increase your youngster’s chances of developing serious diseases that could shorten his lifespan. Also, don’t ignore the effect that obesity can have on a child’s self- concept. The most successful programs concentrate not only on dietary modifications and exercise, but also on boosting a youngster’s self-esteem.

Together, you and your child should set some realistic goals. In middle childhood actual weight loss may be an inappropriate objective for many overweight youngsters. Indeed, the goals you agree upon should not be principally about weight, but rather about healthy living – eating appropriate amounts and kinds of food, exercising, and dealing with personal and social factors that encourage poor lifestyle habits.

As part of a comprehensive program, your pediatrician may suggest the maintenance of current weight, keeping your child’s weight at its present level while he continues to grow in height, thus causing him to slim down. However, for children who are more than 40 percent overweight for their age, sex, and height, your doctor may recommend a comprehensive plan, including dietary changes aimed at small increments of weight loss. Obese youngsters should avoid fad diets and instead consume a variety of foods relatively low in calories but high in nutritional value. Foods like vegetables, fish and poultry fit this description. While you can limit portion sizes, do not severely restrict your youngster’s caloric intake or you may run the risk of impeding normal growth.


Helping Your Overweight Child

Support your child by your own good eating habits. Cook low-calorie meals for the entire family. You cannot expect your youngster to successfully change his eating and exercise habits on his own, particularly if others in the household are not setting good examples. Your goal should be to help him learn and adopt healthier lifetime eating habits that can keep his weight permanently under control.

Also, encourage your overweight child to become more physically active. Regular exercise can play an important role in the maintenance of a healthy weight over the long term. You can become a good role model for physical activity, even involving your child in your own exercise program, perhaps bicycling, swimming or brisk walking as a family. It is probably better to encourage your child to exercise as part of a fitness program, not as part of a diet. Diets are short-lived, but fitness is a lifelong goal. Encourage your child to exercise, knowing that as he becomes more physically fit, his overall sense of well-being and his feelings of self-worth are likely to improve.



(Adapted from “Caring for Your School-Age Child: Ages 5-12,” Bantam 1999, American Academy of Pediatrics)