Weight problems in childhood

overweight; weight; fat; obesity; child; obese; nutrition; diet; exercise; soft; drinks; feelings; bullying; ;

Many more children are overweight today than in the past. There is a greater variety of food available and advertised to children, some of which is more likely to cause too much weight gain.

Many children also have fewer opportunities for being active and get less exercise as, for example, they are driven to school rather than walking (to keep them safe).

Being overweight can cause problems for children both in health and in how they feel about themselves.

The aim in managing weight is to be healthy. This means having a healthy lifestyle which includes exercise not just a focus on weight loss.

Normal development

Many children look plump in babyhood and early childhood. This is partly due to body shape at this age. As they grow their legs get longer compared with their bodies and they run around more so they naturally lose this look.

It is important not to be too worried about children's weight at an early age.

At the same time any child who is very overweight compared with others of the same age should have a medical check to see that there are no underlying problems and then get some help with healthy eating and exercise.

Weight problems

The following are some of the problems that can be caused by being very overweight:

• There can be problems with getting on with other children. Many children who are very overweight are teased or bullied by others and so their childhood can be unhappy.

• In the primary school years children's self esteem is partly related to how they get on with others so sometimes being overweight can cause children to feel badly about themselves.

• Often being overweight can continue into adulthood and cause other health problems.

• Some obese children are developing health problems in childhood that used to be very rare such as diabetes or high blood pressure.

• Many overweight older children and young people can develop eating problems (including inappropriate dieting and occasionally eating disorders) as they try to control their weight.

Causes

The causes of being overweight in childhood are mixed.

• Part of the cause is due to what the child inherits. The way the body controls energy, uses up fats and feels hungry is different for different people. Some different cultural groups are more likely to be overweight.

• There is very easy access to 'energy dense' foods; foods that are high in fats and sugars.

• Part of the cause is also in the way children live and what they do. They are more likely to be overweight if they do not get much exercise and if they eat a lot of foods that are high in fats.

• Dietary habits that contribute to obesity include

  • often having fast food and large volumes of sweetened beverages such as soft drinks -eating salty foods leads to a child being more thirsty and drinking more, especially more sugar containing soft drinks

  • eating large portions

  • skipping breakfast

  • eating high-fat snacks or other foods high in energy density

  • low intake of fruits and vegetables

  • irregular meal frequency and snacking patterns

• Television watching or using a computer is related to overweight problems because

  • children don't use much body energy when they are watching

  • they often watch instead of more active play

  • they are likely to have snacks while watching

  • on top of this they see a lot of food advertisements leading them to want foods that are not good for their health and weight.

So being overweight or obese comes both because of the way the child's body works and the way the child lives.

Increasing overweight and obesity is happening world wide. People who are obese are more likely to have health problems. Helping young children to develop good eating patterns and enjoyment from sport and exercise may help them avoid later health problems.

Soft drinks and fruit juice 

• Drinks that are sweetened with sugar, such as soft drinks and fruit juices, can help to cause children's weight problems.

• Children drink many more soft drinks and fruit juices now than in the past.

• Soft drinks often contain more sugar than is healthy for children's food needs. They also "fill children up" so they don't feel like eating healthy foods.

What parents can do

Even though it is partly due to the child's body type there is much that parents can do to help their children to manage their weight and the problems it causes.

You need to look at all the different things that might affect your child's weight, such as what he is eating, how much he eats, how much exercise he gets, what food there is about the house and family eating patterns.

It is very important to avoid 'diets' to lose weight as they do not work and even if people lose weight, they are very likely to gain weight again when they stop the diet.

Try to help the child to change what he is doing, not to always be thinking about what he should or should not eat. You might think about changing the amount of activities he does, or when and where you eat in your family, eg not in front of the television.

Exercise

• Exercise rather than limiting food intake is the best and safest way to become more healthy.

• People who only cut back on food lose some weight, but often this is due to muscle loss as well as fat loss, and the weight is put back on quickly.

• Regular exercise such as brisk walks daily, regular physical education classes or sport can lead to weight loss without muscle loss and improved health. Even if no weight is lost, this exercise makes the person fitter and healthier.

• Find out what exercise your child most enjoys and support him in doing that. This often works really well if you exercise with your child.

• Encourage your child to be involved in clubs and sports if he is old enough.

• Think of ways that your child can get more exercise in ordinary living, eg helping at home could be to take the dog for a walk instead of drying the dishes. Find ways of increasing energy use, such as using the stairs in shops instead of the escalators.

• If television watching or use of a computer is a problem you could have a diary with a certain number of watching hours a week that your child could choose to use up when he wanted to (within reason). Perhaps some extra time could be earned by active chores such as running errands or sweeping paths.

Nutrition

• It is a good idea to get some advice from a dietitian about how to manage weight and the best foods to provide for healthy eating.

• Teach children about healthy nutrition and suitable food choices.

• Remember that children are growing, so losing weight may not be best for them, it may be better to try to slow down their weight gain so it matches their growing.

• Set some small goals that your child can do well at and feel he is getting somewhere.

• Get help about healthy eating and living as a family. Long term weight loss may be possible when the whole family is involved and everybody changes the way they eat - and that is good for everybody.

• Change the way you shop and cook, eg don't have a lot of fatty type snacks such as sweet biscuits and cake in the house.

• Children should not drink more than 1 serving per day of sweetened beverages, such as fruit juice, fruit drinks, regular-calorie soft drinks, sports drinks, energy drinks, sweetened or flavoured milk, or sweetened iced tea.

• Limit children's fast-food consumption to no more than once per week.

• Eat meals together as often as possible, on most, and preferably all, days of the week.

Try to help the child to aim for being healthier rather than counting calories (or kilojoules).

Take care of yourself

If you also have a weight problem it helps children if they see you taking good care of yourself.

Television

Cut down on the amount of commercial TV your children watch. A study of 13 developed countries showed that Australia had the highest number of television food advertisements per hour (higher than the USA and the UK). (See Young Media Australia below.) Most food ads push foods that are high in fat, sugar or salt and are of low nutritional value.

• Don't let preschoolers watch any commercial TV at all.

• Wean older children away from commercial TV. Watch the ABC.

• If children want to watch a program on commercial TV, teach them to hit the mute button when the commercials come on.

• Record favorite programs and 'fast forward' through the commercials.

• Encourage children to do other things during the peak times of food commercials (eg late afternoon and early evening), such as outside play, walks to playgrounds. Go with them and have more family time.

Children's feelings

It is most important to keep up your child's self esteem and not to let anyone tease him about his weight. Everyone is different and it is not only thin people who are attractive.

• Being overweight can expose children to being teased (see 'Bullying' for ideas to deal with this).

• It is important not to label a child as fat, chubby, plump etc.

• Work on building the child's self esteem - encourage the child in what she does well, let her know that you love and value and approve of her.

• Make sure the child has attractive and fashionable clothes.

• Try to ensure that the child is not made to feel bad by being in sports where she will always come last. Look for ways to exercise which are individual and where the child can succeed. Encourage her to play sports that she likes and does well at. Walking and bike riding as a family can be excellent exercise.