Children's weight management

About 17% of children and adolescents 2 to 17 years of age are overweight or obese. Childhood obesity increases the risk of obesity in adulthood. For the child who is obese after 6 years of age, the probability of obesity in adulthood is significantly greater if either the mother or the father is obese. Obesity that began in childhood tends to lead to hypertension, elevated LDL cholesterol, diabetes, and triglycerides in adulthood. 

Children become overweight and obese for a variety of reasons. The most common causes are genetic factors, lack of physical activity, unhealthy eating patterns, or a combination of these factors. Only in rare cases is being overweight caused by a medical condition such as a hormonal problem.

Children who have growth failure and under nutrition in utero and in the early years of life tend to become overweight in later childhood with subsequent risks of elevated blood pressure, lipid and glucose levels.

In determining whether or not your child is overweight, doctors measure your child's weight and height and compute body mass index, to compare this value to standard values. Doctors also consider your child's age and growth patterns. Assessing obesity in children can be difficult, because children can grow in unpredictable spurts. 

If you're worried that your child may be overweight, make an appointment with your doctor, who can assess eating and activity habits and make suggestions on how to make positive changes. The doctor also may decide to screen for some of the medical conditions that can be associated with obesity.

Overweight children should not be put on energy-restricted diets. The treatment goal for the child who is overweight should be weight maintenance or a slowing of the rate of weight gain. This gives the child time to grow into his/her weight. If the weight appropriate for the child’s anticipated adult height has already been reached, maintenance at that weight should be the lifetime goal.

The child who already exceeds optimal adult weight can safely experience a slow weight loss up to 12 lb per year until optimal adult weight is reached. The child who needs to reduce weight is going to require more attention from family. The attention should be directed to family’s modification of eating habits and increased physical activity. People in the same family tend to have similar eating patterns, maintain the same levels of physical activity, and adopt the same attitudes toward being overweight. 

Increased physical activity is extremely important in a weight management for children. Inactivity usually coupled with excessive TV watching or sitting in front of a computer or game screen must be changed for the child to eventually reach the long-term weight goal. Energy expenditure is lower during television watching than during rest in children 8 to 12 years of age, especially in obese children.

Parents must be aware of kids' hunger cues. Even babies who turn away from the bottle or breast send signals that they're full. If kids are satisfied, don't force them to continue eating. Reinforce the idea that they should only eat when they're hungry.

The primary goal of treatment in obese children is to achieve healthy eating and activity, not to achieve ideal body weight. Balanced micronutrient intake for children includes 45-60% of calories from carbohydrates, 25-40% from fat and 10-35% from protein.

Start good habits early. Healthy nutrition is critical to children’s bone and muscle development and all other aspects of healthy growth as well, including brain development and intelligence. Help shape food preferences by offering a variety of healthy foods. Encourage kids' natural tendency to be active and help them build on developing skills. Teens like fast food, but try to steer them toward healthier choices like grilled chicken sandwiches, salads, and smaller sizes. Teach them how to prepare healthy meals and snacks at home. Encourage teens to be active every day.

If you eat well, exercise regularly, and incorporate healthy habits into your family's daily life, you're modeling a healthy lifestyle for your kids that will last. Talk to them about the importance of eating well and being active, but make it a family affair that will become second nature for everyone.

Most of all, let your kids know you love them — no matter what their weight — and that you want to help them be happy and healthy.

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