Childhood Obesity – What Parents Must Know

The speedily increasing incidence of obesity among children is one of the most challenging dilemmas facing the society today. Obesity has become an epidemic among children and adolescents in the United States, effecting about 17 percent of them. Obesity increases the risk for diabetes, hypertension, and other chronic health problems. It also decreases the quality of life. Growing public awareness of the magnitude and adverse health consequences of childhood obesity has led to an array of efforts aimed at increasing physical activity as well as promoting healthful eating.
 
As childhood obesity is a serious public health problem calling for immediate reductions in obesity prevalence and in its health and social consequences, parents need to understand this entity and how to address it without adversely affecting the child’s psychology. Parents are concerned or would soon get concerned about the ideal weight that their child should have to remain healthy. The World Health Organization defines health as a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

Consistent with this, the “health-at-any size” approach is encouraged. This is focused on health rather than weight. It focuses on the whole person, physically, mentally, and socially. This approach shifts the emphasis to living actively; eating in normal, healthful ways; respecting each individual; as well as health and wellbeing for all at whatever size they may be. Health-at-any-size advocates support for appropriate lifestyle and behavior changes to achieve these objectives.

This must clearly be understood that being overweight does not mean that he or she is obese too and that there is a difference between being overweight and obese. How do we decide whether an individual is overweight or obese? There are scientific guidelines which decide this and classify obesity. The commonest parameter is “body mass index” commonly known as “BMI”. It is the ratio of weight in kilograms to square of height in meters. Now how do you calculate this? Suppose John's weight is 80 Kilograms and his height is 1.6 meters. Then multiply 1.6 by 1.6 (this will give square of height in meters), we get 2.56. Now divide 80 by 2.56 (This is the ratio of weight in kilograms to square of height in meters). The answer is 31.25. So John's BMI is 31.25. A person is said to be overweight when his body mass index is over 25 while he or she is called obese if it is 30 or more. This classification helps to choose the various modalities of treatment available for obesity and also identifies simply overweight individuals who can adopt measures to prevent their progression to obesity.

Height and weight measurements and BMI need to be considered as part of an overall assessment and not as the single measurement for determining health status. Use of this measure alone has resulted in inaccurate labeling of children. Tables for BMI are based on assumptions that higher weight means higher body fat. However, some children with higher body weights will not be over fat, depending on physical activity, age, stage of puberty, gender, and ethnicity. For example, a recent study shows that one in four children categorized as “at risk” have normal body fat, and one in six in the normal weight range have high body fat.  Children grow and mature in different ways, and a child’s weight for height or BMI can best be evaluated in relation to his or her own growth history. Also, growth spurts may be preceded by an increase in body fat. Thus an over ambitious attempt to impose BMI standards on children in a blanket manner may interfere with normal growth of many.

Parents have a large role to play. Diet pattern and physical activities of children are to be focused upon. They should be aware that eating slowly helps children to recognize when they are full, so encourage slow eating. Planned and low-fat snacks which are portion-controlled can help keep kids remain satisfied between meals and stay away from overeating; thus snacks must be planned. Allocation of specific areas for eating and that too on a table is essential but it should not be in a room with a television. Children should focus on meals while eating rather than becoming unaware whether they are full while watching the television. A particular type of food like candy or cookies should not be abandoned and let everyone in the family enjoy them in moderation. Be aware of what is served at school or pack a nutritious lunch for your child. Have a dinner with the whole family as regularly as possible. Use this time to enjoy your meal and learn about your child's activities that day. Unless your doctor recommends it, do not put your child on a restrictive diet. Children have specific nutritional needs, so limiting what your child eats can interfere with healthy growth and development.

It should also be understood that when you are physically active, your child is more likely to be physically active. Find activities that you are comfortable participating in and have your child join you. When your children get praise and positive feedback while they are being active, they are much more likely to keep going with the activity, thus, applaud your children whenever they engage in any sort of physical activity. Be a proud parent, show enthusiasm and give appropriate rewards for engagements in physical activities.  Mention your child's successes to your friends while your child is around. A step further, get together with neighbors and start a regular group activity plan for all the children on your street. If you see an opportunity for starting a new activity in the community, volunteer to help.
Last but not the least stigmatization of an obese or overweight child either at home or at school brings about loss of self esteem, depression and compensation through satiety of overeating. It leads also to a perception that the child is doomed to his or her fate and efforts to loose weight are not destined to bring about positive results. Thus encouragement and appreciation of the children’s overall capabilities, behavior and personality, may encourage them to approach correction of obesity more positively. Parents should propose to the schools that acceptance and respect for oneself along with others can be effectively addressed as part of the overall school policy on acquiescence of diversity. Refusal to tolerate teasing or harassment of or by students or staff should become a strategy. Obesity prevention programs need to be periodically assessed by appropriate professionals to ensure that they do not create unintentional stigmatization or promote dangerous eating and exercise behaviors. All aspects of the measures required to control obesity are to be exercised in a comprehensive manner to meet the advancing menace of this draconian problem - an obese society.