Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
When the goal is to help a child or teenager reach and maintain a healthy weight, parents must take the lead. Health care professionals and nutrition consultants are there to help. However, parents exert the most control over their child's activities and habits and thus are in the prime position to make and support healthy lifestyle changes.
The most important thing parents can do for an obese child is to be supportive. Your child's feelings about himself or herself are at least partly determined by your feelings. Let your child know that you love and accept him or her -- at any weight.
Do not criticize.
Be aware of your child's concerns about appearance and social relationships.
Weight loss itself is rarely a goal in an obese child or teenager. Rather, the goal is to slow weight gain or simply to maintain a weight over time. The idea is to allow the child to grow into his or her body weight gradually, over time. This may take a year or two, or even longer, depending on the child's age, weight, and growth pattern. Remember, an obese child does not have to become an obese adult. When weight loss is set as a goal, the safest and most practical objective is 2 pounds per month.
For such a plan to succeed, it must involve long-term changes in the habits of the entire family. The obese child should not be singled out. Parents, brothers and sisters, and other family members living in the home all will benefit from a shift toward a healthier lifestyle. Remember that children learn best by example -- set a good one.
Self-Care at Home
The cornerstones of a weight-control plan are physical activity and diet management. Old habits and attitudes -- your own and your child's -- must change. The sooner a plan is put in place, the better, because it is much easier to change habits in children or even teenagers than in adults.
The single best thing you can do is restrict the amount of time your child spends watching TV, sitting at the computer, or playing video games. These activities burn few calories and encourage snacking and drinking. The U.S. Surgeon General recommends moderate to vigorous physical activity for children and adolescents every day for at least 60 minutes.
Encourage children and teenagers to enjoy physical activities that burn calories and use different muscle groups. These include games which involve running, swimming, skating, or riding a bicycle. The most effective activities raise the heart rate moderately and cause mild sweating. The child should not become exhausted, overheated, or severely short of breath.
Allow each child or teenager to try different activities in order to find those that he or she enjoys.
The goal is to participate in continuous, moderately strenuous activity for at least 30 minutes every day (with total activity for at least one hour daily).
Be a role model for your children. If they see you being active and having fun, they are more likely to be active and stay active into adulthood.
Plan family activities so that everyone can get some exercise and have fun. Walk, dance, or bike together.
Encourage your children to get involved in sports at school or in the community.
Don't force children to take part in activities they find uncomfortable or embarrassing.
Whatever activities your children become involved in should be appropriate for their ages and development. Make sure children understand basic safety rules. Make sure they have plenty of water to drink to replace fluid lost by sweating.
First, educate yourself about your child's nutritional needs. Use what you learn to help your children learn a healthy attitude about eating.
If you are unsure about selecting and preparing foods for a healthy diet, tell your health care professional. He or she can make recommendations or refer you to a nutritionist.
Involve your children in food shopping and meal preparation.
Don't dictate exactly what your children eat. Children should help choose what they eat and how much.
Offer your children a variety of foods, including natural sweets and snacks (such as fresh fruit). All foods have a place in a healthy diet, even foods high in fat and calories -- as long as they are eaten occasionally and in moderation. Familiarize yourself with appropriate serving sizes. A dietician can help with this training.
Encourage your children to eat slowly. This helps them recognize the feeling of fullness and stop eating when they are full.
The family should eat together whenever possible. Make meals a pleasant time for conversation and sharing the events of the day.
Don't forbid snacks. While continuous snacking contributes to weight gain, planned snacks are part of a healthy diet for children. A nutritious and tasty snack after school will give children the energy they need for homework, sports, and play until supper.
Identify high-risk situations such as having too many high-calorie foods in the house or watching television during meal times. With the distraction of television, many people overeat.
Don't deprive your child of occasional treats (like chips, cake, and ice cream), especially at parties and other social events.
Meal and snack suggestions
Most of your diet should be whole grains, fruits, and vegetables. Serve a variety of vegetables (green, red, yellow, brown, and orange), fresh fruits, and whole-grain breads, pasta, and rice.
Eat two or three servings of low-fat (1% milk) or nonfat (skim) dairy products every day. A dietician can help identify healthy portions based on individual physical factors and age.
A healthy diet also includes two to three servings of foods from the meat and beans group. This group includes lean meat, poultry, fish, cooked dry beans, eggs, and nuts.
Limit fats to no more than 25%-30% of total calories.
If you now use whole-fat dairy foods, do switch to low-fat (1% milk) or nonfat (skim) dairy products.
Trim all fat off meat and remove skin from poultry.
Choose low-fat or fat-free breads and cereals.
Avoid fried foods.
Choose low-fat and tasty snack foods.
Fruit, fresh or dried
Low-fat or nonfat yogurt or cheese
Nuts, sunflower, or pumpkin seeds
Whole-grain breads, crackers, or rice cakes spread with a fruit spread or peanut butter
Frozen desserts such as frozen yogurt, fruit sorbet, popsicles, and fruit juice bars
Do not limit fat intake for children younger than two years of age. However, avoid deep-fried foods at these young ages.
Select snacks for young children carefully to avoid choking hazards. For example, cut whole grapes into at least four or five smaller portions.