Addressing the Problems of Childhood Obesity

Debra Gill, Ph.D., knows what it feels like to be an overweight child.

When the behavioral director of the Healthy LIFE® Pediatric Weight Management Program at Saint Barnabas Medical Center talks to overweight children about the challenges of losing weight and adopting a healthy lifestyle, she speaks from experience. She spent her grade school years struggling with this issue and the stigma attached to being overweight.

"When I was a Brownie Scout, at the end of every meeting we stood quietly in a circle and each girl made a wish,” says Dr. Gill. “Every week I wished that I could be thin."

Simply wishing to be thin did not help, especially when she would eat too many cookies that were given out at those same Brownie meetings. Like many of the young people Dr. Gill now counsels, she did not understand the link between food consumption, lack of exercise and weight gain.

“My heart goes out to these kids and the problem they are dealing with,” adds Dr. Gill. “It is hard to deny yourself great tasting food, no matter how much you want to be thin and healthy. Our hope, through the program, is to provide children with the information and skills needed to make healthy choices that are enjoyable and last them a lifetime.”

By the sixth grade, Dr. Gill had learned how to lose weight. It took much longer for her to learn how to keep the pounds off, avoid feelings of deprivation and failure and lead a balanced lifestyle where food was a source of enjoyment.

Today, she and Henry Anhalt, D.O., Medical Director of the Healthy LIFE®, located at the Saint Barnabas Ambulatory Care Center in Livingston, use those physically and psychologically healthy approaches to weight management to help children. Drs. Anhalt and Gill say they feel fortunate that Saint Barnabas has committed to running a world-class, comprehensive pediatric weight management program, and that they are passionate about helping families prevent and treat obesity.

Pediatric Obesity: A Growing Problem

According to the American Academy of Pediatrics (AAP), the prevalence of childhood obesity is “increasing at an alarming rate in the United States.” The AAP reports that American children today are also less physically active than they were in previous generations.

Dr. Anhalt says that many more children are becoming overweight and obese at younger ages.

“In the last 40 years the rate of obesity has doubled in children ages 6 to 11 and tripled in children ages 12 to 17,” says Dr. Anhalt. “Overall, kids are 11 pounds heavier than they were 20 years ago.”

Obesity in children can lead to a variety of other risk factors, including diabetes, hypertension and elevated cholesterol, and can lead to obesity in adulthood. Type 2 diabetes due to overweight is the fastest growing childhood disease in the United States.

In addition to physical health problems, the AAP reports that “the psychological stress of social stigmatization imposed on obese children may be just as damaging as the medical morbidities.” One study in the Journal of the American Medical Association(JAMA) found that severely obese children have a quality of social life that is five times lower than children who are healthy. The study also found that the obese children face social life problems comparable to children who had been diagnosed with cancer.

“There is a prejudice against overweight children,” says Dr. Gill. “They are chosen less often as playmates; they are picked last for teams; and they are often the targets of bullies. Being overweight tends to be incorrectly associated with laziness and other false negative stereotypes.”

Making the Connection to a Healthy Lifestyle

In order to address pediatric obesity, children and families can be taught how to improve the unhealthy eating habits and low physical activity that results in weight gain.

Dr. Anhalt, nationally-known expert in pediatric obesity, co-directs Healthy LIFE® with Dr. Gill, who was the former clinical director of the weight-management clinic at Cooper Institute in Texas. Healthy LIFE® teaches participants how to choose healthy foods and become physically fit. The program uses researchproven methods to help children lose excess body weight and to maintain a healthy weight and active lifestyle forever.

In Healthy LIFE®, children and families receive expert instruction, weekly guidance and encouragement, and the opportunity to practice newlylearned behavioral skills over a 6-12 month period. Through weekly planning, problem solving, and praise for effort and accomplishments, children learn to handle challenging situations in healthy ways.

Dr. Anhalt reports that there are four factors leading to the dramatic rise in pediatric obesity. An understanding of these factors can help families to better address food-related problems:

• Children are programmed to eat when food is available, and food is now associated with most activities. From treats after Little League games to junk food at birthday parties and social gatherings, children have more opportunities than ever to snack.
• More of the foods children consume are high in calories. In the past, healthy school lunches were brought from home and a home-cooked dinner was eaten as a family. Today, lunches purchased at school often include fatty foods and sugar-laden snacks; and high-calorie, low nutrient dinners from restaurants are frequently what is served. Half of all family food dollars are spent eating outside the home.
• The portions children receive at mealtime are often twice the size they need. Super-sized meals contribute to the over-consumption. Large fries in an extra value meal contain 835 calories, almost half the total calories (1,800-2,400) a child should eat in a day.
• Children are less active than in previous years. Leisure activity is increasingly sedentary, with wide availability of entertainment such as television, videos, and computer games. There has also been a decrease in frequency of physical activities of daily living, such as walking to school and doing household chores.

Here are some tips from the Healthy LIFE ® program: Share a common goal of staying active. Involve the family in nature walks or other physical pursuits. Promote healthy eating by offering nutritious snacks (vegetables and fruits, low-fat dairy foods and whole grains.) Pack healthy school lunches with lean meats, fruits and vegetables and whole grains. Or, to save calories, try “light” high fiber breads (you can even find white bread with added fiber). Model healthy food choices for your child and speak positively about the inclusion of healthy foods. Promote physical activity, including unstructured play at home, and sports activities. When eating out, consider the portion size to be the equivalent of two meals. Eat half the meal, and then take the other half home to mix with vegetables for a second dinner the next night. Limit television and video time to a maximum of 2 hours

For more information about the
Pediatric Weight Management Program,
please call Healthy LIFE®
at (973) 322-7496.