68A - Fit and Well Column for April 25th, 2004

68A - TITLE: "Children, Obesity, and Fitness"

Dear David and Trish,

I need your help. Or, I should say, WE do! We don’t know where to turn!

I have a twelve year old daughter that I am very concerned about. She is overweight, and I can’t seem to help her!

We’ve tried nagging, rewarding, punishing, and even psychotherapy! We can’t seem to find the solution. Based on your experience, are there any suggestions that you have that might help.

Sincerely,

Worried in Severna Park

Dear Worried,

This problem is serious, and tremendously complex. In 2001, the Office of the Surgeon General predicted that preventable chronic illness and premature death from complications associated with obesity might surpass even those health problems associated with cigarette smoking. Well, according to recent surveys, we are already there!!!

As you probably know, I grew up "chubby", and continued to "blossom" until I tipped the scales at a formidable 275 pounds (at age 32). My journey is chronicled in our website, and I am always ready and willing to share it. I believe that the patterns of my eventual obesity began when I was a child.

Today we will discuss the problem, and next week we will present some vital elements of the solution!

Is being overweight as a child less life-threatening than as an adult? Absolutely not! As a matter of fact, there is strong evidence that suggests that once excess fat cells are accumulated through adolescence, these cells stay readily available throughout our whole life! So just being overweight as a child will make it harder to maintain a healthy body fat ratio as an adult. And the social and psychological effects are overwhelming, not only to the child, but also to the parents! An overweight adolescent has a 70 percent chance of becoming an obese adult

Additionally, overweight children face the following problems:

BOX ONE:

• Orthopedic Problems
• Premature Puberty
• Respiratory Complications (children with asthma have much more severe problems than normal weight asthmatics)
• Hypertension
• Diabetes
• Heart Disease
• Older children and adolescents may develop hip problems.
• Suffer socially from obesity. At a time when body image and self-esteem are developing, growing up obese can have negative effects that can make a child miserable and haunt him for the rest of his life.

And there is significant negative effects on us parents. We often go from confusion, shock, distress, resentfulness, anger, guilt, shame, embarrassment, hopelessness, frustration, and more! And this makes matters even worse. And, as a result, we make bad decisions that actually make matters worse!

We have all known children who seem to be able to eat and eat, and STILL stay slim and trim (just as some adults do!). At the same time, there are youngsters who don’t appear to over-consume, but seem to put on extra pounds nonetheless. This is all very confusing.

In some of these cases, the problem may be a function of genetically inherited metabolic abnormality (lower basal metabolism). And in other cases, it may very well be that a lack of adequate physical activity is the main culprit in supporting weight gain.

It is generally accepted that if the parents are overweight, there is a significantly greater likelihood that the child will be also. Again, this may be due to genetic predisposition, OR just poor lifestyle modeling (more on that later!). More likely it is a combination of both.

Our children learn many things from us that we are not even aware of. Values, habits, priorities and responsibility are legacies for which we are truly accountable. The approach "do what I say, NOT what I do" just doesn’t work with our children. If you have developed poor lifestyle habits that translate to increased body weight and poor health, your children will too.

As in many areas, the first step in preventing, or solving, a problem with childhood obesity is to determine risk factors. The following is a list that might help in making an accurate assessment:

BOX TWO:

• Family history of obesity.
• Family history of obesity-related health risks such as early cardiovascular disease, high cholesterol, high blood pressure levels, type 2 diabetes.
• Family history of cigarette smoking and sedentary behaviors.
• Psychological / Psychiatric Issues. Poor self-esteem, negative self-image, depression, and withdrawal from peers have been associated with obesity.
• Patterns of sedentary behavior (such as too much television viewing and computer play) and low physical activity levels.
• Taller height - children with obesity are often above the 50th percentile in height.
• Smoking initiation. Research studies show that youngsters use smoking as a method of weight control.

There are many reasons why children put on excess weight. There is, of course, weight gain associated with puberty. This is transitional, and will correct itself naturally. However, there are many specific physical causes that contribute to weight gain in children and adolescents. Here is some of them:

• Overfeeding in Early Childhood
• Genetic Pre-disposition
• Lack of Activity
• Glandular Problems
• Poor Diet Patterns

Additionally, there are environmental and psychological factors that are at the root of this imbalance. Some of them are:

• Poor Parental Modeling
• Lack of Nurturing and Expressed Affection
• Stress Caused by Sibling Rivalry
• Parental Overindulgence
• Using Food as a Tool
• Using Food as a Reward
• Withholding Food as a Punishment

Establishing healthy eating and exercise habits are the key to a healthy lifestyle and need to begin early. And what you teach your child may very well become a valuable tool for your own increased health and fitness!

Next week, we will examine specific strategies that will assist parents in preventing this problem from severely effecting their child. Don’t miss it!

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