Childhood Obesity - A Weighty Matter

Mrs. Goodson, your son is 18 kilos. overweight.

I stared at my pediatrician in horror as she told me this. I felt that I had failed him as a parent. Timothy was only 6 years old and weighed nearly 45 kilograms. Sure, I am obese, and so is my husband. Our lifestyle was not conducive to weight loss or good health. We knew we all needed to lose weight, but how?

At first, we couldn't seem to stop beating ourselves up emotionally for making our child fat. It's just our genetics, we reasoned helplessly.

Of course, genetics can indeed play a role, but it doesn't really tell the whole story. In the book What Are We Feeding Our Kids? What Parents Must Know About Their Children's Unhealthy Diets, authors Michael F. Jacobson Ph.D. and Bruce Maxwell cite both genetics and lifestyle as major factors that determine whether a child becomes obese.

Since there was more to it than genes, we knew we had to educate ourselves. If we could arm ourselves with facts, we had a better chance of success.

The first thing we learned was that the number of children who are overweight has doubled in the last two to three decades; currently one child in five is overweight, according to researcher Carol Torgan, Ph. D. ( Word on Health June 2002). It's no secret that the United States struggles with epidemic numbers of obesity. However, we didn't realize that it was so prevalent among our children.

What exactly causes childhood obesity? Experts cite many factors ranging from excessive consumption of soft drinks to watching too much television. There seems to be no clear-cut answer to this question, although the factors seem to be similar to what causes obesity in adults.

In Beyond Change: Information Regarding Obesity and Obesity Surgery, an online newsletter, Cynthia Buffington Ph.D states that obesity occurs when food intake exceeds energy requirements or, in other words, when we eat more calories than our body uses.

We had to admit that we are more than we should, and didn't exercise enough. That was a bitter pill to swallow. The truth usually is. We knew the road to change would be long and hard, yet very necessary. We were eating too much, especially refined, over-processed foods. Our nights were spent on the couch playing video games or watching television. On weekends, we went to the movies or out to eat. Our lives had become food-oriented.

We couldn't let Timothy do this alone. We have never been 'do-as-we-say-not-as- we-do' type parents. All three of us had issues with weight, and this process would benefit us all. L. Lee Coyne agrees that you can't expect success if parents indulge in soda pop, French fries, potato chips and heavy desserts but expect the overweight child to follow different rules. (4) We were overwhelmed. We just didn't know where to begin until Timothy reminded us of the key role of exercise and activity.

Mom, dad, I want to play baseball, he told us one spring day. We figured that getting him involved in sports, which he loves, was a good idea. He wasn't moving enough, and any added activity would be a good start. It was nowhere near the 60 minutes of moderate daily physical activity that experts suggest, but we were beginning to encourage him to play outside with his friends more often, and took more family trips to the park to walk or play. We decided that we would build up to that goal slowly, and thus have a better chance of success.

As a result, we began to watch a little less television. At our worst, we catalogued our TV-watching at 30 hours in a single week! According to an article published by Ebbeling, Pawlak and Ludwig in the August 2002 edition of The Lancet, television viewing is thought to promote weight gain not only by displacing physical activity, but also by increasing energy intake. Children seem to passively consume excessive amounts of energy-dense foods while watching television.

If the amount of television we watched was excessive, we tended to eat dinner and have snacks around the television. Timothy would watch commercials for pizza and other fast foods and beg to have them. We all fell for the marketing ploys. We just hadn't realized how bad that habit was. We still watch television, but less of it than we used to. Our mantra is becoming small changes make a big difference.

Next, we tackled how much we ate and drank daily. We monitored our daily intake by making food logs and charts and asking questions about the nutritional value of foods before we ate them. This process led to some unpleasant conversations about how our eating and our emotions were entwined. We learned that it wasn't just about the food, but about how we felt about ourselves and what we were eating, etc.

Alan Green, MD FAAP, an Obesity expert, applauds the practice of keeping a food log. He writes, Cutting excess intake is best achieved by first keeping a careful record of food consumed, to identify particularly high-fat or high calorie problem areas in the diet.

As we engaged in this activity, we discovered that our family ate a lot of desserts, fried a great deal of our food, and drank too many sugary drinks and not enough water. When we thought of all of our bad habits at once, we got scared and regressed a little bit, it was so overwhelming. We realized that to move forward, we needed to go at a steady snail's pace which was better than not doing anything at all.

As we brainstormed what to do next, I found a Lancet study, Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis (Volume 357, Number 9255, 17 February 2001), that described the obesity/soft-drink link. The fact we found most startling was that the odds ratio of becoming obese among children increased 1-6 times for each additional can or glass of sugar-sweetened drink that they consumed every day.

Since Timothy was drinking at least 4-5 of these drinks a day, we decided that reducing and eventually eliminating this unhealthy habit would really make a big difference over time—for all of us. My husband and I weren't benefiting from the extra 500 - 600 calories a day we consumed this way either. So, we made the slow move to diet soda and we implemented a rule that Timothy had to drink at least two 24oz. bottles of water every day. My husband and I drink at least 64 oz, which is the minimum daily amount for adults.

At this point, our weight loss was almost non-existent but we needed some validation that we were moving in the right direction. At a regular office visit, I mentioned my concerns about dieting to Timothy's pediatrician. I was relieved and amazed because she did NOT advocate a diet or reduction plan for him. I found this concept reinforced in the Baylor College of Medicine brochure, Your Child's Weight: Help your Child with Successful Weight Management , which describes the ideal goal as one of keeping weight stable while the child grows taller and more muscular over time.

Timothy had not gained weight, and he had actually lost a pound or two in the past few months. He had also stopped drinking regular soda for the most part, he was exercising more, and he was not eating after 8 p.m, something all of us were trying to do. He even gained an inch or two. It was slow progress, but progress, nonetheless.

Although we are still overweight, we are progressing slowly in our goals. The most important change we made was in our mindset. We've finally realized that there is no quick fix for obesity in children, or adults. Successful weight-management requires slow progress and a lifelong commitment. We will be doing this the rest of our lives.

Instead of fizzling out like the hare in the old children's story, we are going at it like little tortoises, inching our way back to good health. So far, it's working.