Pediatrician's Diet Tips for Overweight and Obese Children

Of all the strategies for preventing childhood obesity, the only one with scientific evidence of efficacy is breastfeeding. The odds of becoming overweight are 20-30% lower in children who were breastfed. Interestingly, these effects are delayed- they are best seen in preadolescents and adolescents. It is not clear why breastfed babies are thinner- perhaps it is b/c breast fed babies stop feeding when they are full; formula-fed babies often get a few "extra swallows" pushed on them at the end of a feed. It is also best to defer solids until age 6 months. There is a common misconception that cereal helps a baby sleep through the night but there is no evidence of this. Infants and children are often resistant to new foods and will grimace when first introduced to something new. Keep offering the same foods repeatedly and the child is likely to accept them. Studies indicate that it often takes 5-10 experiences with a food before some children will accept them. Children are programmed to like sugary, high fat foods but often must be TAUGHT to like healthy foods. Be sure to let your child watch you enjoying healthy foods. Children always like to eat what others are eating. Teach your child the "tasting game"- all foods must be tasted but may be spit out if they don't like them. And never force your child to eat something they do not want to eat- that will only create negative associations with healthy foods.

GENERAL GUIDELINES

General guidelines to starting your child on a healthy path include restructuring the home environment, eating meals as a family, modeling healthy behaviors, showering your child daily with praise, allowing for open communication, and avoiding force.

OFFER ONLY HEALTHY OPTIONS

I think that Dr. Susan Okie, a leading expert in child obesity, put it best: While young children are in control of when they eat, parents are in control of what they eat. Clear your house of junk food and offer only healthy options. Then, let your child choose whatever they want to eat (from the available choices). There is no need to have chips and candy in the house; these foods should be special treats. If it is in the house, your child will eat it. Your child will not become ill if he/she misses a meal or two. If your child refuses to eat the healthy food that you serve, you should wrap it up and wait. Sooner or later he/she will be hungry and will eat it. Make it clear that your child does not make the rules- you do! Just make sure to pick a healthy food that your child usually enjoys.

3 SQUARES A DAY

Children should eat three meals and two snacks each day. Ideally, meals should be a time for the family to relax and enjoy. Turn the TV off, clear away all the toys and books, and sit at a table (not in front of the TV). Encourage family conversation. Start each meal with a non-cream based soup and a salad (with low fat or fat-free dressing). Serve recommended portion sizes on smaller plates. Studies show that people eat fewer calories when served their meals on smaller plates because the plate looks very "full". Always serve a vegetable with dinner. You should also let your children help cook dinner- they are more likely to eat the healthy foods that you make if they have assisted in their preparation. Encourage your children to eat slowly- it takes time to realize that you are full.

PRACTICE WHAT YOU PREACH

It is imperative to always be consistent and "practice what you preach". You can not eat chips and then expect your child not to. This goes for Dad and for any siblings, regardless of their weight. The entire family needs to practice healthy eating habits. Do not single out your heavy child- it will backfire. Besides, regardless of weight, everybody's health will benefit from a healthy diet and nobody should be eating chips and cupcakes on a regular basis.

WAY TO GO!

Be sure to give your overweight child daily praise for their healthy actions. Avoid any negative or critical comments. Do not constantly remind them that they are overweight. And make sure they know that you love them, regardless of their size.

LETS TALK ABOUT IT

Open communication is key to losing weight. Let your child know that weight loss isn't easy and that you are there to help. Sit with your child and discuss upcoming events that might involve unhealthy foods, like parties and restaurants, and brainstorm ways to handle them. Teach your child the benefits of a healthy lifestyle. Discuss the risks of being overweight- in language they can understand. Explain that you are eating chicken instead of pizza because chicken is lower in fat which is healthier. Listen to your child's thoughts and feelings. Talk about their friendships. Try to agree with your child on specific short-term goals- whether it is decreasing TV watching, increasing physical activity, or cutting down on fattening snacks. Agree on rewards for reaching those goals- but make sure the rewards don't involve food. Preferably, pick a privilege or activity that your child would like. Just make sure that your child is given choices- let them choose the type of activity they want to do and the types of healthy foods they want to eat.

YOU ARE NOT THE FOOD POLICE

Be a guide, not a dictator. Provide healthy foods and let your child choose. Do not force your child to eat a particular food- the more you push, the more they will resist. Do not "forbid" any foods- that only makes them more desirable. Do not use food as a bribe- it makes children resistant to foods that they may be neutral about- "if they have to bribe me then it must be bad". Do not provoke conflict or scold your child for making an unhealthy choice. Especially with teens, if you watch too closely or criticize too often, they will likely eat more simply to prove that they are in control.

DR. DOLGOFF'S WEIGH

It is not easy to fight childhood obesity- not on a national level and not on an individual level. But we need to try. If you are not able to tackle the problem on your own, help is available. My weight management program, Dr. Dolgoff's Weigh, consists of a traffic light-based eating system, regular individualized counseling sessions, and medical monitoring tools. Kids and teens learn a simple program based on red-light foods, yellow-light foods, and green-light foods. Parents can feel secure knowing that their child is losing weight safely, under the careful guidance of a board-certified pediatrician. Go to http://www.DrWeigh.com to learn more about the only online diet program for children!