Obesity Prevention in Children

In 1975 I published my first book, Growing Up Thin, which addressed the problem of obesity in children. It was a huge success and received a great deal of publicity. Yet despite these efforts, 40 years later, children are fatter than ever.

So what happened during these past 40 years?
1.      More and more meals are being eaten in “fast-food” establishments.
2.      Portions sizes are now larger.
3.      Besides TV, we now have computers, cell phones, and tablets for children, all which increase sedentary time – what I call “S.O.B. Syndrome” (Sitting On Butt).
4.      Physical education time in schools has become more limited.
5.      More safety issues have become associated with outdoor play, such as increased automobile traffic and fear of abduction.

In truth, the obesity problem actually dates back to the 1950s, during which period food production in the United States dramatically increased. Starting at that time, billions of dollars began being spent to produce and market high-density, high-calorie foods at a relatively low expense to the consumer. According to a New York Times report in August 2008, sugar consumption rose by nearly 33 percent due to the use of high fructose corn syrup alone. The average American was now eating 1.8 more pounds of food each week.

The statistics are frightening. About 6 percent of Americans were obese in the 1950s, rising to 25 percent by the 1970s. Today, the figure is about 35 percent. The prevalence of childhood obesity has also increased significantly – two- to three-fold – just in the past few decades. An early childhood longitudinal study of over 7,000 children published in the New England Journal of Medicine (July 2014) showed that over 25 percent of children entering kindergarten were either overweight or obese. These overweight and obese kindergarteners were four times as likely to have remained obese into the 8th grade, as compared to children of normal weight entering kindergarten. In fact, nearly two out of every three children who enter kindergarten obese will remain obese as teenagers; in turn, most of those will end up obese as adults. In other words, if your child starts kindergarten overweight or obese, he will be at an extremely high risk of remaining that way throughout childhood and beyond.

The current childhood obesity epidemic is in large measure due to the modern high-density, high-calorie sugar-laden diet. This, together with a more sedentary lifestyle explains why today we have so many overweight and obese children (and adults). Yet the consequences of developing obesity as a child are well known: in addition to reducing an individual’s overall lifespan, other negative results include the development of type 2 diabetes, elevated cholesterol, orthopedic problems, sleep apnea, and a variety of psychological/social problems brought on due to a lack of self-esteem and self-worth. Obese children are also more likely to be bullied and socially isolated.

What’s worse, this epidemic of childhood obesity has remained with us despite massive efforts to halt it in place-or at least slow it down. Up to this point, the majority of our efforts have been unsuccessful, if well intentioned. The answer is obvious. Having been a practicing pediatrician for over 40 years now, with a particular interest in this subject, my experience (as well as that of many other pediatricians caring for obese children) strongly suggests that the treatment of both school-age and adolescent obesity is almost always unsuccessful. Sad though it is to say, the treatment of obese school-age children and older teenagers is usually doomed to fail.

The basic problem is that neither the pediatric community nor the parents of young children are taking early-onset obesity seriously enough. It is often difficult to convince parents that during the first five years of a child’s life there even is a problem. In truth, most pediatricians do very little to encourage parents toward lowering the risk of obesity in their very young children. It is of interest to note that, within the recommendations of the American Academy of Pediatrics “Bright Futures” program, none of the well-child visits for children aged 2-4 years list either diet or nutrition as a priority.

What has become increasingly obvious to me is that the only way to make any inroads into the problem of childhood obesity is to not to let it happen in the first place. In other words, prevention-rather than treatment-is the key to success. The earlier you start, the better chance you have of preventing obesity from ever becoming a problem for your child.

And that is what this book is all about.

Quoting from an editorial in JAMA Pediatrics, August 2013, in an issue devoted to childhood obesity: “Targeted interventions aiming to prevent obesity before it is established . . . may offer the potential to break the vicious cycle of obesity.” The article goes on to say, “Infancy and the early childhood years are ‘sensitive’ periods of growth and development, presenting the opportunity to either reduce or increase the risk of later obesity.” Based on the results of many studies on the treatment of childhood obesity, the authors conclude that parental motivation plays a strong role in predicting the effects of childhood obesity intervention. Further, family-based interventions have been found to be most effective, and the earlier they are started, the better.

When the entire family works together, intervention becomes much more successful. There is nothing magical about this program. It is simple, straightforward, and safe. It is based on extensive experience as a practicing pediatrician, as well as the most recent scientifically proven studies about childhood obesity. Learn to take an active role in your children’s health. Protect your child from ever having to worry about being overweight or obese.
 
The 10 commandments for “Winning the Obesity Battle”
1.      Monitor your child’s weight percentile regularly
2.      Encourage outdoor physical activity each day
3.      Less TV
4.      More sleep
5.      Cut down on juice
6.      No soda or sweetened fruit drinks
7.      Healthy snacks
8.      Never use food as reward
9.      Feed your child a nutritious, well-balanced diet
10.  Eat family meals together