Sixteen-year-old Lindsey weighs more than 200 pounds and is ashamed of the way she looks. “I can’t wear cool clothes from Abercrombie or Gap because they don’t come in my size.” And, according to Lindsey, she’s never been on a date, has few friends, and spends most of her social time on the Internet.
Nine-year-old David also feels the pain of being “chubby.” “Kids call me names like ‘fatso’ or ‘lazy-boy’ and I always get picked last for teams in gym class.” Too embarrassed to play sports, he spends his time watching TV or playing video games.
Sad as these kids’ stories are, “the harmful effects of being overweight as a child go far beyond hurt feelings,” said Keith Ayoob, associate professor of pediatrics at Albert Einstein College of Medicine in the Bronx.
Studies show that overweight kids tend to have lower self-esteem and are more likely to be depressed than their thinner counterparts. What’s more, they’re experiencing health problems that used to afflict only adults, such as cardiovascular disease, hypertension and Type 2 diabetes. Less than 4 percent of the childhood diabetes cases in 1990 were Type 2, but that number has skyrocketed to 20 percent, with 85 percent of those kids diagnosed as being overweight.
“Getting these chronic diseases earlier means they’ll be dealing with them for many more years,” Ayoob said, “which is a shame because they’re all preventable.”
Race, weight and age
Since the 1960s the percentage of overweight children has almost quadrupled. The most recent statistics from the Centers for Disease Control and Prevention reveal that about 15 percent of all children and adolescents between the ages of 6 and 19 are overweight. And when you break that number down by race and sex, you’ll find that while the percentage of overweight youth has increased for all ethnic groups, the most dramatic rise has occurred among black and Hispanic boys and girls, particularly teenagers. The prevalence of overweight in these groups increased more than 10 percentage points since 1999.
Why certain ethnic groups are more vulnerable to obesity remains unclear, but according to a recent University of North Carolina at Chapel Hill study, it appears that income and education are not the top factors, as once was thought.
Penny Gordon-Larsen, lead author of the study that appeared in the January issue of Obesity Research, and her colleagues analyzed nationally representative data collected from 13,113 U.S. adolescents enrolled in the UNC-based National Longitudinal Study of Adolescent Health (also known as the Add Health study).
“We found that overweight was lower among white, Hispanic and Asian girls from higher-income, better-educated families, but overweight did not similarly decrease with high income and education among black girls,” Gordon-Larsen said. “In fact, it increased. The pattern was not as extreme among males, with higher overweight among Hispanic and black males versus white and Asian males, even at the more elevated income and education levels.”
Who, and what, to blame?
Though research indicates that 90 percent of kids with two overweight parents are more likely to be overweight, heredity is only part of the equation. It appears that environment plays a role too. The most recent surgeon general’s report emphasized that it is caused by a lack of activity and unhealthful eating patterns. Gordon-Larsen said that the current generation of children is the least physically active in this country’s history.
“Less than 25 percent of kids get 30 minutes of daily physical activity, let alone the new Institute of Medicine’s recommended 60 minutes of physical activity each day,” she said.
“Onscreen” time has replaced “outside” time. Study after study has shown that kids who watch the most TV have higher body fat percentages than kids who watch two hours or less a day. With the average child spending about 24 hours a week in front of a TV, not to mention how many additional hours are spent playing video games or on the computer, the effect on weight can be potent.
Add kids’ decreasing activity to high-calorie foods and you’ve got a recipe for a problem. National surveys have noted that kids are drinking less milk and more soft drinks. Pop was the second leading food source of carbohydrate among children 2 to 18, according to the 1989-91 Continuing Survey of Food Intakes by Individuals.
Then there’s fast food. While no one has proved that its fat and calories are contributing to obesity, one thing is certain: The industry’s “super-sizing” phenomenon is taking its toll on people’s perception of portion sizes.
“Our country’s super-sizing trend, which began in the 1970s, directly parallels the increasing prevalence of overweight,” said Lisa Young, adjunct assistant professor in the Department of Nutrition and Food Studies at New York University, who has studied portion sizes.
Note that we’re not just super-sizing at fast-food restaurants; we’re doing it in our kitchens.
“Because restaurants offer huge portions, people expect to eat bigger servings at home too,” Young said. As evidence of the trend, she offers recipes from classic cookbooks and long-popular food products that now sport larger portions. For example, a brownie recipe that appeared in the 1975 “Joy of Cooking” yielded 30 servings; that same recipe today yields only 15. And while the 1984 recipe for Toll House cookies yielded 100 servings, the same recipe on today’s packages reports that it makes only 60.
What’s a parent to do?
Prevention is the best cure for childhood overweight. But Gordon-Larsen says that prevention “hinges on helping families develop new lifestyles and creating supportive environments where healthful eating and physical activity can be promoted.”
The same message applies to families with kids who are currently concerned about their weight. The best strategy for helping heavy youngsters grow gracefully into their weight is to teach them to eat healthfully and be physically active. Children should not be placed on a restrictive diet, unless supervised by their pediatrician.
“Dieting is not recommended for children because they need calories to grow and develop properly,” Ayoob said. “Although dieting methods often used for adults such as low calorie diets, pills and even surgery may seem appealing for quick weight loss, they have not been proven safe for children.”
More intervention needed
Over time, most children will grow into a healthier weight if parents focus on offering more nutritious foods and encouraging activity.
Some children will need additional help, though. If your pediatrician has determined that your child is overweight, or is at health risk unless he or she loses weight steadily, you may want to consider nutrition counseling with a dietitian, or having your child participate in a group weight management program such as Shape Down, which is designed for overweight children. (Many local hospitals offer Shape Down classes.)
If your child is extremely overweight, your pediatrician may want you to participate in a more comprehensive treatment program like the one located at La Rabida Children’s Hospital in Chicago. These types of programs involve doctors, registered dietitians, psychologists and exercise physiologists who specialize in treating childhood and adolescent obesity.
Helping overweight kids:
Tips from Keith Ayoob, associate professor of pediatrics at Albert Einstein College of Medicine:
– Be a role model. If your children see you being active, or drinking milk with dinner, chances are they’ll follow your example.
– Involve the whole family in building healthful habits. It doesn’t single out the overweight child.
– Make changes slowly. Pick one habit you want to change every month.
– Stock the fridge with fruit, pre-cut vegetables, fat-free or low-fat milk, and water–instead of junk food and soft drinks.
– Limit your family’s TV time to two hours a day.
– Accept and love your child at any weight. Take time to talk to him about weight and ask him to discuss his feelings. Over-weight children need support, acceptance and encouragement.
