...... Healthy Weight Kids Coalition of Southern Kentucky is a coalition of health-related professionals and organizations with the goal of preventing and treating the serious  problem of overweight in children.

Strategies for Treating Overweight
(as outlined in the AAP Pediatric Nutrition Handbook, 2004)

The first order of business is to identify those children who are at risk for obesity and the health hazards associated with it. Although not diagnostic, the BMI is a useful tool to identify a subset of children with a high probability of developing obesity.

The BMI (Body Mass Index) is a measure weight per height squared. Carrying too much weight for height increases the risk of  heart disease, diabetes, stroke, hypertension, and many other disease states.

The BMI is calculated by the weight in kilograms divided by the square of the height in meters. Without having to convert to metric, take the weight in pounds divided by the square of the height in inches and multiply by 703. The easy way is to look on a BMI calculator chart, or use this web page.

In children the average BMI increases gradually with age. Above the 85^th percentile is considered at risk for overweight. Under age 7, this level stays pretty close to 17. For ages 7-15, for both boys and girls, a BMI of “your age plus ten” is at the 85^th percentile. This method allows easy calculation of the BMI at 85th%, without having to refer to growth charts.

[The only variation from the "Age + 10" rule is boys 12-14 years old (tall and lanky) but this only lowers the BMI by one point.]

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Does Breastfeeding Prevent Obesity?

Studies are conflicting about the effects of breastfeeding on later obesity. In populations with a lower incidence of obesity, there seems to be a modest beneficial effect if breastfeeding over 6 months. Some studies show no effect, especially in populations where the incidence of obesity is over 20%, inferring that other environmental factors can easily out-weigh any beneficial effects of breastfeeding. Of course the many other benefits of breastfeeding still compel pediatricians to encourage the practice to new moms.

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 AAP Treatment Recommendations*

   * taken directly from the AAP Nutrition Handbook (2004).

What to Tell Families of Overweight Children

 Physicians should stress the following points to families of overweight children:

1. Risk of obesity in adulthood is greater the longer a child remains overweight.
2. There are serious medical consequences of overweight (including diabetes, heart disease, and stroke).
3. The whole family must be involved in the treatment of an overweight child.
4. The treatment for overweight (healthy lifestyle changes) is beneficial to all family members, even if they are not overweight.
5. The goal of treatment is long-term healthy weight and lifestyle, not just short-term weight loss.
6. The earlier healthy lifestyle habits are learned, the higher the chance that they will continue in adulthood.

Specific Treatment Strategies for Overweight Children

1. Families should be strongly encouraged to take up new activities which involve physical exercise on a daily basis. These activities should include the parents, such that parents are setting a good example for their children. Additionally, the parents will receive health benefits themselves. (Examples would include walking outdoors together, exploring new places, bicycling, tennis, swimming, and frisbee golf.)

 2. Specific dietary changes should be explained in detail. However, the number of dietary changes should be kept to a minimum to aid in compliance. With this in mind, concentrate on just two areas: high-sugar drinks, and concentrated-calorie foods.

 3. The family should try to eliminate high-sugar drinks, such as cokes, sugar-containing tea or kool-aid, and juices. Note that even 100% “natural” juice contains a large amount of fructose and carries a high caloric load. If sweetened drinks are a "necessity", as they are in most families, a sugar substitute should be used instead of sugar. Diet drinks are acceptible for children.

 4. The concept of concentrated-calorie foods is difficult for most patients to understand. Doctors will want to direct patients toward a diet which generally conforms to the AHA “heart healthy” diet, which supplies at least the minimum essential amounts of protein, vitamins and minerals, and limits the saturated fats to less than 10% of total calories (and total fat less than 30%).

 5. Specific "wrong food choices" should be taught to parents and children. (A good place to start might be the list of junk foods to be eliminated from vending machines in schools, as outlined in the Task Force on Child Obesity)

6. Set specific rules which will bring about lifestyle changes for the family. These are the rules offered by the AAP:

Ten Rules to Maintain Healthy Weight

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