Managing the overweight child

Overweight children

The overweight child is now becoming an epidemic in western cultures. 22% of Australian children are overweight and 11% are obese. Managing this problem is very difficult. There are few studies that have shown any one diet or strategy has been successful. Understanding the factors surrounding this problem may well lead to family lifestyle changes. The factors are complex but surround a very simple equation. This is related to  laws of physics. The following applies universally.

·         Energy in  >  Energy out =  gain weight

·         Energy in < Energy out = weight loss

·         Energy in = Energy out = stable weight

Increased intake - energy in

This is the food intake. Not only in solids but also in sugar soft drinks. The sugar is converted to carbohydrates and fats when not utilised very efficiently. Some of the factors important here include:

• Families consume higher levels of fat rich fast food then in the past - particularly when both parents work - evening meals need to be quick and easy - this often means takeaway.
• Parents expectations regarding how much their child is eating. This translates to making a child eat a meal or rewarding eating a main meal by giving high calorie desserts afterwards. The child is then forcing food down so he can access the 'fun food'.
• Using food as a tool in behaviour management. Food should not be used as a reward for behaving well. More effective rewards and cheaper include stickers, stamps etc. (There is one theory that children who were rewarded with food as a toddler later in life used food as a comforting source during challenging times. This led to weight gain. )

Decreased activity - energy out

Times have changed a great deal. Nowadays home is often filled with entertainment media and this discourages outside play. Other factors include:

• Diminished activity due to parents concerns about safety
• Limited levels of physical activity at schools
• Parents themselves not exercising

What about genetics ?

Genetics plays a factor on both sides of the above equation. Some children have larger appetites and some children are more sedentary. The same equation rules apply but genetics relates to the food personality of the child. This makes it hard in some families where two children appear to eat the same amount of food but one is larger than the other.

How can I check if my child is overweight ?

Most GPs who have an interest in children will have percentile charts. These charts plot the height and weight on a graph of Australian standards.  If the height and weight have a large positional discrepancy there could well be a problem.

So what if my child is overweight ?

• Increased incidence of diabetes mellitus leading to kidney failure and blindness
• Increased incidence of high blood pressure leading to stroke and heart disease
• Increased incidence of musculoskeletal problems such as hip back and knee problems.
• Increased incidence of depression and suicide associated with the psychosocial problems
• Increased incidence of heart disease