More Thoughts On Child Obesity
By Charles H Geneslaw, MD
March 13, 2018
Category: Uncategorized
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We are all aware of the obesity epidemic throughout our population; as a pediatrician I focus on its presence in children. In this month’s Pediatrics http://pediatrics.aappublications.org/content/early/2018/03/02/peds.2018-0233 a study followed overweight children, who’s parents encouraged dieting for weight loss, for 15+ years into adulthood. They found 72%> binge eating, 79%> unhealthy weight control behaviors into adulthood. The “adult kids” were 50%> pushing their kids to diet and 40%> having unhealthy family food communication (teasing)– important and wholly predictable information. https://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/if-your-mom-was-big-on-dieting-your-kids-may-pay-the-price-731685.html

My advise is don’t initiate specific, direct dieting/weight loss discussion. OK if your teen asks for dieting advise to be encouraging–“I think its a good idea. You’ll feel better and better about yourself. How can I help you?”–good, complete response(follow through, please).

Otherwise even pushing about “healthy eating” is largely unhelpful–most teens are savvy enough to see “health” as a thinly veiled euphemism for “weight.” Discussing “manners” and “etiquette” is fair game (see below)– kids are mostly unconcerned at the thought of being “unmannerly” rather than “unattractive.” Mostly concentrate on environment(“under the radar”), so better food choices are obvious and made by them. Suggestions:

  1. Limit fluid calories. Lower fat milk, mostly water, seltzer (a squeeze of orange, lemon, or lime). Loaded with “empty” calories (fattening, not satisfying) and carbs. Simply don’t have these in the house, period. Fruit juice is virtually identical https://www.npr.org/sections/thesalt/2014/06/09/319230765/fruit-juice-vs-soda-both-beverages-pack-in-sugar-and-health-risk (OK for breakfast). Sugar causes pancreatic insulin release for absorption which also stimulates appetite. The dissolved sugar in drinks causes faster and greater insulin release and appetite stimulus..
  2. More fiber–fresh fruit and especially low carb vegetables, some whole grain starches (bread or pasta). Less fast food and prepared food from boxes or freezer. The sugars in the fruit, unlike the juice, is INSIDE the cells. Your body has to “break open” the cells to absorb it. This slows down the process causing less and slower insulin release and less appetite stimulation.
  3. Eat slower and wait >15′ before “seconds” (especially desert/snacks). Slows down the process as above and allows the “insulin rush” appetite stim from the first helping to dissipate. Here’s where “etiquette” comes in. Make conversation during mealtime. Then you can say “stop talking while you are eating. It’s impolite.” They can perform table chores–clear used dishes, get ketchup out (“help your poor Mother–be polite.”) NOT getting seconds–you do that (“Be polite–wait until everybody has had.” “I will serve seconds; you’ll spill and make a mess for me to clean. Be polite.”) Get it?
  4. OK to have some “fun food” snacks (pastry, ice cream)–modest amounts lasting a week. If they finish off quickly, here’s your answer: “I don’t have all the time and money to go back to the supermarket repeatedly, so you’ll have to wait. Next week pace yourself. Be polite.” To stop one child from gorging from siblings buy or cut into individual serving sizes and mark for each. Taking others’ things is stealing and impolite.
  5. Exercise. I say “throw the bums out”(weather permitting). if they are outside with their friends they are more likely to engage in calorie burning play instead of staring at the computer. Exercise with them some. Better for your health and family bonding as well.

Above you have never mentioned weight, appearance, even health. But you make the point. Finally– delicately–be a role model. It’s useless to forbid soda but bring it home to guzzle yourselves. Kids hate hypocrisy and they’ll likely just steal and drink it themselves anyway.

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