Excess Weight in Children

How to Prevent Excess Weight in Children and Address It: Parenting Tips

Excess weight has become the "epidemic" of recent years and gradually evolves into one of the prevalent and challenging health issues of our time. This phenomenon affects children as well, and in some regions of the United States, it's estimated that up to a third of children are overweight. In Israel, the numbers are slightly lower but are steadily rising, causing concern.

Excess weight, and even more so obesity, can lead to the development of various health problems in the short and long term (such as diabetes, increased blood pressure, elevated cholesterol, and heart attacks). Overweight children and adults are at a higher risk of developing fatty liver, which can lead to abdominal pain and chronic inflammation. Childhood obesity is linked to body image issues, especially during the period when adolescents are forming their personalities in relation to society.

The reasons for the trend of weight gain are numerous and linked to changes in lifestyle and diet. We engage less in physical activity while simultaneously increasing screen time (television, computers, and smartphones). The dietary shift is also drastic. We are heavily exposed to advertisements for processed foods, consume calorie-rich fast food, drink sugary beverages, and tend to snack while watching television. Research has shown that removing vending machines from one school in the United States significantly reduced students' weight, without any other interventions!

To stop this trend, we must change our lifestyle, alter our menu composition, and engage in more physical activity as part of our routine. This can prevent both physical and psychological complications associated with excess weight gain while ensuring healthy growth and development for children and adolescents. The simple path is this: weight decreases when we consume fewer calories than we burn through physical activity. Reducing calorie intake through proper nutrition combined with an increase in physical activity will necessarily lead to weight loss. However, achieving this goal in children and adolescents is challenging, requiring perseverance and determination, yet with gentleness and sensitivity to avoid affecting their emotional development.

"Ten Commandments" for Maintaining Weight in Adolescents:

1. Increase physical activity. Tailor the activity to the child's preferences: biking, swimming, running, walking, sports games, etc. Set clear times for regular physical activity at least three times a week.
2. Limit screen time to 1.5 hours per day (including TV and computer).
3. Change your shopping list: eliminate sugary drinks, sweets, and snacks. What's not in the house won't be eaten!
4. Buy low-fat dairy products, with no more than 5% fat content. This also improves blood lipid profiles.
5. Reduce consumption of processed and junk food and limit eating outside the home. Calorie-rich fast food is less healthy than fresh food.
6. Have a family mealtime once a day. This can model healthy eating behavior and improve overall family bonding.
7. Define the eating area in the home. Avoid eating in front of the TV and in bedrooms to prevent mindless snacking.
8. Establish regular meal times and limit snacks between meals. Emphasize that you're not limiting the amount of food children can eat. Avoid situations of hunger in children and adolescents. Encourage healthy snacking – between meals, consume fruits or vegetables to curb hunger.
9. Encourage water consumption instead of sugary drinks. Beverages like cola or lemon-lime soda contain alarming amounts of sugar (which is unhealthy regardless of weight).
10. Use smaller plates during meals and serve smaller portions. Encourage drinking a glass of water before meals. At the same time, encourage slow eating.

What NOT to Do:

• Do not impose demands on your child that you cannot uphold. If you're eating in front of the TV, you can't forbid your child from doing the same. A personal example is key to success. Do not ban certain foods at home; such restrictions or limited food quantities encourage counterproductive behavior, like secretive eating and frustration.
• Do not use the word "diet." Instead, refer to it as "healthy eating" for everyone in the household.
• Avoid pressuring your child. Instead, engage in conversations and explanations with ease and delight. Do not obsess over food quantities or weight; this can encourage negative behaviors like secret eating. Do not compare children.
• Do not talk about weight in extreme or dramatic terms. It's important to note that alongside the increase in obesity rates in adolescents, there's also an increase in the prevalence of the reverse phenomenon – eating disorders like bulimia and anorexia. Bulimic patients often have periods of excess weight and may vomit deliberately due to feelings of guilt about eating. Some anorexia patients start with excess weight and, due to parental and environmental encouragement, do not know when to stop dieting.
• The feeling of failure leads to the opposite outcome. To succeed, give positive reinforcement (not rewards) generously. Instill a sense of support and belief in your child, and avoid negative reinforcement. Statements like "When you lose weight, you'll feel better about yourself and be healthier. We will do this together because we believe in you and know you can do it!" are much more effective. Remember that as parents, you are an integral part of creating change. You serve as models for imitation, control the type and quality of food in the house, and create an appropriate atmosphere for change and the development of healthy eating habits and behaviors for the entire family. Persistence will lead to both short-term and long-term changes in eating habits.

Professional treatment for childhood and adolescent obesity is offered through dedicated obesity clinics, which include regular medical evaluations and guidance from dietitians and other professionals. In some cases, medication may be recommended (such as for fatty liver or insulin resistance). Surgical intervention (known as bariatric surgery) in children is avoided whenever possible, although extreme cases of obesity might make this option necessary. The multidisciplinary obesity clinic for children and adolescents at Shaare Zedek Medical Center in Jerusalem, led by Dr. Lena Rachman, offers comprehensive care for excess weight. The team includes a dietitian, psychologist, and social worker in addition to medical staff. An individualized physical activity plan is developed in collaboration with the center's cardiology department. Appointments can be scheduled at 02-6555307 or 02-6555634.