Since the last editions subject on diet disorders I have had several enquiries from parents on how to encourage healthy eating in youngsters without causing paranoia about the child’s appearance or size. Here are some ways that we can sensibly address obesity in childhood and correct this problem as a family without tears or tantrums.
WEIGHT PROBLEMS IN CHILDHOOD
Many more children are overweight today than in the past. Just look around any of the supermarkets and see the slightly more than cuddly affluent juniors waddling around the aisles. This is a concern for our younger generation many of whom are almost force-fed into obesity by their parents who have been geared to believe that a “fat” child is healthy, well nourished and cute or “lucu”, or that a large male child is “strong”. How many times have you marvelled at the happy toddler playing while a well-trained pembantu is shovelling porridge into the poor child’s mouth at every opportunity! This cultural “force feeding” is one of many other reasons that our knee-highs are waging the battle of the bulge. There is now 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 get less exercise as they are driven to school rather than walk (to keep them safe) and may have less opportunities for being active. Being overweight can cause problems for children both in health and in how they feel about themselves.
NORMAL DEVELOPMENT
Many children look plump in babyhood and early childhood. This is partly due to body shape at this age. It is normal for children to be round at the corners, and we should not strive to create a mini version of Brittney Spears at the grand age of 5! As children grow, their legs get longer compared with their bodies & they become more active and so they naturally lose this “roundish” 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 some help with healthy eating and exercise. Charts which give average acceptable growth statistics are available on sites such as the CDC or WHO websites. If you are unable to locate them your doctor or community health nurse should have copies of these charts.
CAUSES OF CHILDHOOD OBESITY
The causes of being overweight in childhood are mixed. A large part of the cause is due to what the child inherits (25 -75%). The way the body controls energy, uses up fats and feels hungry is different for different people. (Ever wondered why the guy sitting next to you can eat twice as much at one time and then put away 3 donuts for desert and not have an ounce of fat on him!?). 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. Some different cultural groups are more likely to be overweight due to their traditional diet. Sedentary activities such as television or computer games are related to overweight problems; children often watch TV instead of more active play and they are likely to have snacks while watching. So being overweight (obesity) 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 overweight or 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.
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. We may have to assess our own eating habits as it is no good enforcing a healthy diet on a child if the parents do not follow suit.
- Avoid drinks that are sweetened with sugar, such as soft drinks. Children drink many more soft drinks now than in the past. Soft drinks often contain more sugar than is healthy for children’s food needs.
- It is most important to keep up your child’s self esteem and not to let anyone tease them about their weight.
- 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 growth.
- 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 e.g. not in front of the television.
- Source information about healthy eating and living as a family. Long term weight loss is possible when the whole family is involved and everybody changes the way they eat.
- Teach children about healthy nutrition and suitable food choices. Change the way you shop and cook e.g. don’t have a lot of fatty type snacks such as sweet biscuits and cake in the house.
- Try to help the child to aim for being healthier rather than counting calories (or kilojoules).
- 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 the 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 e.g. helping at home could be to take the dog for a walk instead of drying the dishes. Try using the stairs in shops instead of the escalators.
- If television is a problem you could have a television 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.
- If you also have a weight problem it helps children if they see you taking good care of yourself.
Remember helping children to manage their weight in childhood has not been shown to lead to eating disorders such as anorexia.
EXERCISE
Exercise rather than limiting food intake is the best and safest way to become healthier. 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.
CHILDREN’S FEELINGS
Being overweight can expose children to being teased. 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 he or she does well, let them know that you love and value and approve of them. 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 they 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.
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Kim Patra is a qualified Registered Nurse and Midwife that has been living and working in Bali for almost twenty years. She now runs her own private practice and medical referral service from her Kuta office. Kim is happy to discuss any health concerns with you and she may be contacted via e-mail at info@chcbali.com”.
