More than one-third of the children I see in my practice are obese. Granted, my practice is skewed because we deal with a number of problems in which obesity takes a major role, e.g. obstructive sleep apnea and extra-esophageal reflux disease (reflux from the stomach that comes up into the airways). At least twice a day, two days a week I spend significant time “counseling” children and their families about diet and lifestyle
Most people are clueless about the three prongs of weight management:
- What “healthy eating” means,
- What constitutes “exercise,” and
- What the schools are making available to their kids to eat.
Education, exercise and elimination of school snacks. Sounds simple Not so fast.
First we need parental education (and schools) about the basics of self-regulation of a child’s food consumption. And like everything in today’s world, self-regulation is thwarted by too many choices that tempt even the most resolute. Education about how we digest different foods, e.g. carbohydrates and proteins. Education about calorie consumption. Education about portion control. The number of blank stares I get when we talk about these basics is nothing short of discouraging.
When I bring up the issue of exercise the responses range from: “she has phys. ed. twice a week” to “he starts football in the fall.” Regular exercise is simply not on the radar of most kids and most families with obese children. My “favorite” excuses are “we don’t have the money to join a gym” and “it’s those video games, I can’t get him to stop playing them.” Ever hear of pulling the plug, or finding things around the house to cause children to be active, like chores? Maybe help with the cleaning?
But the most difficult and insidious problem is the food that is available to children at school. Many kids get both breakfast and lunch in school! Subsidized lunch programs have morphed into large profits for corporations. This is no joke, and this is a serious problem. We have to fight for elimination of snacks and drinks at school.
When the Robert Wood Johnson Foundation puts out a newsletter touting how the schools are going to be encouraged to provide “healthier” snacks in vending machines at schools, I know the battle is just about lost. Do kids really need snacks all day long? What happened to a good breakfast, a modest lunch, a small afternoon at home and dinner? What about water fountains? Small boxes of milk? One piece of fresh fruit?
The only winners are the vendors. It is a mistaken to think that children should be “snacking” every few hours. Aside from the calories consumed, this is time taken out of the educational day. The child then gets an “energy bump” and becomes easily distracted. And then we consider a diagnosis of ADHD and medicate him or her.
Eat less, eat right and exercise. Want to do the kids a favor? Make parent education mandatory, create exercise regimens that have a purpose to keep them responsible for their own lives, and eliminate the snack machines from schools.
Next post: Weight reduction strategies for children and their families.