Obesity in children - management

Children who are overweight or obese can reach a healthy weight with the help of their parents and family. The whole family will benefit from making healthy lifestyle changes. These include paying attention to good nutrition, limiting takeaway and junk food, increasing physical activity and seeking professional advice. Crash diets, appetite suppressants and humiliation or teasing will not help an overweight child.

Overweight and obesity often start during the primary school years. This is a major concern because most overweight children will continue to be overweight as adults. The main influence on the diet and lifestyle of primary school children is their parents. Simple techniques in the home can have a dramatic effect.

How to assess if your child is overweight or obese
Body mass index (BMI) is used to assess whether a person is underweight, normal weight or overweight. BMI is calculated by dividing your weight in kilograms by your height in metres squared (m²). There is a calculator on the Better Health Channel that will help you to work out BMI.

A child’s BMI changes according to their age and stage of physical development. BMI measures alone are not appropriate for children. BMI-for-age percentile charts are designed specifically for children from two to 18 years. These are used in addition to the weight and height growth charts to give a more accurate picture of children’s development.

It is important that a child’s BMI is compared against his or her age and gender percentile charts. The BMI percentile range includes:

• Under 3^rd percentile – underweight
• 3^rd to 85^th percentile – normal range
• 85^th to 95^th percentile – overweight
• 95^th percentile and above – obese.

• Get good nutrition advice – nutrition advice may help to change the whole family’s eating habits. There are many fact sheets on the Better Health Channel that can guide you in making healthy choices.
• Shop carefully – stock your fridge and pantry with healthy snacks. Limit fatty or sugary treats. Switch to low fat versions of dairy foods, such as milk, cheese and yoghurt.
• Eat a good breakfast – make sure you all have a healthy breakfast every day. Choose a low fat, low sugar, wholegrain breakfast cereal.
• Provide healthy snacks – snacking is an important part of children’s eating habits and shouldn’t be discouraged – just make sure the snacks are mostly low in kilojoules. Fruits and vegetables make excellent snacks.
• Reduce unhealthy drinks – don’t buy sugary soft drinks. Offer water and some low fat milk.
• Eat more vegetables – if your child refuses to eat vegetables, try being creative with how you use vegetables; for example, finely grate carrot and zucchini into lasagne or spaghetti sauce.
• Offer smaller serves – some children will clear their plate at dinnertime, no matter how huge the serving size, so give them a little less. Serving 10 or 20 per cent less over time can make a significant difference.
• Limit takeaway meals – try to have takeaway food only once a week (or less often). Takeaway food is often higher in salt and fat than home-cooked meals.
• Plan ahead – try cooking a dish the night before so that the meal is ready when you come home from work or cook large quantities and freeze meals for use later. If you plan your meals, you’re less likely to opt for takeaway food, which can seem an easy option when you’re tired.
• Make mealtime a happy time – you should all try to enjoy this time together. Involve everyone in preparing healthy meals together.
• Ask the extended family to help too – encourage carers and grandparents not to give children unhealthy foods.

• Set a good example – children tend to follow their parents’ lead.
• Increase activity – children should be encouraged to be physically active. Encourage outdoor play.
• Become active as a family – go for walks together, play cricket, toss a frisbee in the backyard, go bike riding, take the dog for a walk or go swimming together. Children need a minimum of 60 minutes of activity every day. Aim for everyone to be active outside school time or at least for 30 minutes each day.
• Reduce passive pastimes – reduce television viewing and computer games to a total of less than two hours per day (combined).
• Find out as much as you can – seminars and educational activities run by teachers and community groups can help parents and children learn more about obesity and how to prevent it.
• Choose activities as rewards – instead of giving fatty or sugary treats as a reward, suggest outings or a favourite game or story.

• Weight targets – don’t set specific weight targets. Instead, focus on healthy eating habits and increased activity with praise for your child when they are successful in these areas.
• Crash dieting – a growing child needs a wide range of foods for proper development. A crash diet that limits kilojoules too drastically or cuts out a food group (such as dairy foods) should be avoided. Reducing kilojoules by a small amount and doing that every day is the goal.
• Dramatic changes – family habits can’t be changed overnight. Children may resist dramatic changes to diet and lifestyle, so concentrate on changes that you can make part of your family life. Be guided by your health professional.
• Appetite suppressants – no current medications (pills) are safe for growing children.
• Ridicule – teasing a child for being overweight is harmful. Ridicule will only make the child feel self-conscious and upset and will not promote weight loss.

• Talk over your concerns with the school nurse.
• Ask your child’s teacher or principal for further information about any healthy lifestyle education offered at the school. Follow up at home to reinforce the messages.
• Don’t pack high fat snacks (such as potato chips) in your child’s lunchbox.
• Educate your child about making healthier choices at the school canteen.
• Talk to the principal and other parents about the food choices available at the canteen. Suggest improvements if necessary.

• Your doctor
• An Accredited Practising Dietitian, contact the Dietitians Association of Australia
• School nurse
• http://www.goforyourlife.vic.gov.au")>Go for your life Infoline Tel. 1300 739 899
• School Nursing Program, Office for Children, Department of Human Services Victoria Tel. (03) 9096 8417
• The Royal Children’s Hospital Tel. (03) 9345 5522

Things to remember

• Parents and carers can take an active role in helping their children to develop healthier habits.
• Children who are overweight or obese will find it easier to achieve a healthy weight if the whole family makes healthy lifestyle changes.
• Limit the amount of time children spend watching television or playing computer games, and encourage physical play.

You might also be interested in:
Body Mass Index (BMI).
Children - getting them active.
Food to have sometimes.
Growth - assessing primary school children.
Growth - assessing teenagers.
Healthy eating for kids.
Kilojoules and calories explained.
Lunch box tips.
Obesity in children - causes.
Overweight children - healthy lifestyle tips.
Weight loss - a healthy approach.

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