Managing Overweight Children
Childhood obesity is best treated by a non-drug, multidisciplinary approach, including diet, behavior modification, and exercise. Children should be screened for obesity at age 6, and referred to weight management programs if needed at that time. Moderate-to-intense programs have the highest rate of success with children and adolescents. These programs include counseling and behavior modifications.
Evidence suggests that reducing calories by only 200 - 260 per day would prevent weight gain in most overweight children. Here are some tips for children who are overweight:
- Limit (or avoid, if possible) take out, fast foods, high-sugar snacks, commercial packaged snacks, soda, and sugar-sweetened beverages (including too much juice).
- Let children snack but make sure the snacks are healthy. Eating small frequent healthy meals (instead of two or three large ones) has been associated with being thinner and having a better cholesterol profile.
- Let children choose their own food portions. One study indicated that children naturally ate 25% less when they chose their own portion size. When they were given larger portions their bite sizes were larger and they ate more.
- Do not criticize a child for being overweight. It does not help, and such attitudes could put children at risk for eating disorders, which are equal or even greater dangers to their health.
- Limit television, video games, and computer use to a few hours a week. This can contribute significantly to weight control, regardless of diet and physical activity.
- For young children, try the traffic-light diet. Food is designated with stoplight colors depending on their high caloric content: Green for go (low calories), yellow for "eat with caution" (medium calories), and red for "stop" (high calories).
- Try a low glycemic index diet. This may be as beneficial, possibly more, than a standard reduced-fat diet in overweight children. Such a diet focuses on certain carbohydrates (for example, dried beans and soy), which raise blood sugar more slowly than other types of carbohydrates. This diet is sometimes used in diabetes, and as a dietary approach in overweight adults. [For more information, see In-Depth Report #42: Diabetes Diet.]
We Can! (Ways to Enhance Children's Activity & Nutrition) is a new national program designed to help children live healthier lives. This program "focuses on three important behaviors: improved food choices, increased physical activity and reduced screen time." We Can! Is a collaboration of the National Heart, Lung, and Blood Institute; the National Institute of Diabetes and Digestive and Kidney Diseases; the National Institute of Child Health and Human Development; and the National Cancer Institute.
Support Groups and Behavioral Approaches
Commercial and Nonprofit Support Programs for Weight Loss. There are many different types of weight-loss program. (This report cannot address all of the many commercial and nonprofit weight-loss programs currently available, nor can it assess their claims.)
Review Date: 04/14/2010
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital (4/14/2010).