In my pediatric endocrinology practice at Westchester Health, I often see young patients who are overweight or obese, and parents who are worried about their children’s health, especially when it affects how they’re being treated at school. Sadly, I’m quite used to it.
Childhood obesity is a major health problem in America today and only getting worse
According to Partnership for a Healthier America, nearly one in three children in the U.S. are either overweight or obese. During the past 40 years, the obesity rate for children ages 12 to 19 (from 4.6% to 20.6%) has tripled, and for ages 6 to 11 has more than quadrupled (from 4.2% to 17.4%).
And that’s not all. Overweight adolescents have a 70% chance of becoming overweight or obese adults. For children with disabilities, obesity rates are approximately 38% higher than for children without disabilities. And nearly 45% of children living in poverty are overweight or obese compared with 22% of children living in more affluent households.
However, in spite of these negative statistics, there is good news. As I tell my young patients and their parents, change can take place and overweight kids can take real steps toward changing their habits and adopting a healthier lifestyle. Granted, this takes a concerted effort from many people involved in a child’s life, but childhood obesity can be avoided, and in many cases, reversed.
Why are there so many overweight and obese children in the U.S.?
According to the U.S. Department of Health and Human Services, most children in the U.S. are not eating enough nutritious foods or getting sufficient physical exercise. These statistics help explain why:
- Only one in three children are physically active every day
- Children now spend more than 7½ hours a day in front of a screen (TV, videogames, computer)
- Only about one in five homes have a park, fitness or recreation center within a half-mile
- Nearly one-third of high school students play video or computer games for 3 or more hours on an average school day
- The typical American diet exceeds the recommended limits in calories from solid fats and added sugars, refined grains, sodium and saturated fat
- Americans eat less than the recommended amounts of vegetables, fruits, whole-grains, dairy products and oils
- More than 23 million Americans, including 6.5 million children, live in food deserts—areas that are more than a mile away from a supermarket
- The estimated annual health care cost of obesity-related illness is a staggering $190.2 billion, or nearly 21% of annual medical spending in the U.S.
- Childhood obesity alone is responsible for $14 billion in direct medical costs
- Unhealthy foods are disproportionately marketed to children, with African-American youth exposed to a greater amount of unhealthy food marketing than Caucasian youth
How childhood obesity is measured
Because children are still growing, obesity is measured differently for them compared with adults. Instead of simply calculating their BMI (body mass index) measurement, a child’s BMI is compared to others of the same age and gender. Children with BMIs at the 95th percentile or above are considered obese, and those with a BMI between the 85th and 95th percentiles are considered overweight.
Obesity can be reversed with healthy eating and exercise patterns
Just because a young person is obese in childhood does not mean they have to remain that way for the rest of their lives. Healthy lifestyle habits, including good nutrition and physical activity, can be learned. When put into practice, these healthier habits can change a child’s life, both physically and emotionally.
Here are three important influences to help this happen:
- Schools play a critical role in influencing a child’s weight by establishing a safe and supportive environment that supports healthy behaviors. They can provide opportunities for students to practice healthy eating (nutritious lunch options) and physical activity (gym class), and just as importantly, they can work hard to stop bullying behavior toward overweight students.
- Your child’s pediatrician plays a vital role in helping your child reach and maintain a healthy weight. He/she can explain the health risks and benefits of a healthy and physically active lifestyle, create a customized diet and exercise plan, and encourage your child when he/she is struggling. Also, with regular checkups, your child’s doctor is more likely to notice changes in your child’s weight, both positive and negative, and can respond quickly to issues.
- Parents probably have the most influence on a child’s eating and exercise habits. They can make sure there are healthy foods available at home, consult a nutritionist for meal guidelines, plan regular family exercise sessions (the gym, a bike ride or simply a walk), and praise their child when he/she makes positive progress.
14 great tips for fighting childhood obesity
As a pediatric endocrinologist with a special focus on trying to reverse childhood obesity, helping my patients lose weight and become healthier and more active is very important. To bring parents into that effort, here are several tips that have proven to be effective in many families:
- Serve and eat a variety of foods from each food group, especially fruits and vegetables. Limit starch and sugars. Also, encourage your child to try a variety of different foods from an early age. As he/she grows older, he/she will be more likely to incorporate these healthy foods into their own diet.
- Serve small portions. Child portions should be smaller than adult ones. More food can always be added if needed.
- Bake, broil, roast or grill meats instead of frying them.
- Limit the use of high calorie, high fat and high sugar sauces and spreads.
- Encourage participation in sports and other physical activity at school and on local sports teams and community leagues.
- Be active as a family. Go on walks or bike rides together. Play basketball or kick around a soccer ball.
- Limit TV and computer time.
- Avoid eating while watching TV. TV viewers typically eat too much, too fast and are influenced by the foods and drinks that are advertised.
- Replace sugary drinks, especially sodas, with water.
- Limit fruit juice intake to two servings or less per day (one serving = ¾ cup). Many parents allow their children unlimited intake of fruit juice because of the vitamins and minerals it contains. However, children who drink too much fruit juice easily consume too many calories.
- Encourage physical play. Provide environments that allow your child to play indoors as well as outdoors.
- Model healthy dietary practices yourself. Eat nutritional snacks and stay active.
- Limit your child’s sodium (salt) intake.
- Avoid using food as a reward for good behavior or good grades.
Helpful websites we recommend
- Partnership for a Healthier America
- CDC: Childhood Obesity Facts
- President’s Council on Sports, Fitness and Nutrition
Concerned that your child is overweight or obese? Please come see me.
If you’re worried about your child’s weight and the effect it is having on his/her health, please call (914) 458-8800 to make an appointment with me. I’ll meet with you and your child, assess his/her weight and overall health, and together with you, decide on the best course of action going forward to steer him/her toward a healthier lifestyle and better weight. Whenever, wherever you need us, we’re here for you.
By Joan DiMartino-Nardi, MD, pediatric endocrinologist with Westchester Health, member of Northwell Health Physician Partners