Healthy Weights for Healthy Kids: What Should I Do if My Child Is Overweight?

Authors: Elena Serrano, Extension Specialist, Department of Human Nutrition, Foods, and Exercise, Virginia Tech and Kathryn Branstad, former graduate student, Virginia Tech

Publication Number 348-273, revised October 2007

If your child is overweight, he or she is not alone. Overweight is growing at epidemic rates among American children and teens. The rate has tripled in thirty years and is expected to rise. In 2004, 18 percent of children ages 6 to 11 and 17 percent of adolescents ages 12 to 19 were considered overweight.

How do I know if my child is overweight?
It is important to remember that there is not one healthy weight for your child. A healthy weight can be a range of weights depending on gender, age, and body type. The best way to assess if your child is overweight is to talk to your child’s doctor or other health professional. They can use growth charts developed by the Centers for Disease Control (CDC) to decide if your child is overweight and developing optimally. Overweight is classified as a BMI-for-age-and-gender of greater than or equal to the 95th percentile. BMI, or body mass index, is calculated as weight divided by height squared (in kg/m²). Health professionals can also track any weight gain over time to see if the weight gain occurred slowly or rapidly. If it’s sudden, it is possible that the child’s height has not caught up with his or her weight. These factors, along with information about body type (such as amount of muscle), diet, physical activity, and emotional stress, can provide information to use in developing a care plan for your child

What are some concerns for overweight children?
Thinness is emphasized in our society. As a result, overweight children often complain of being teased or singled out by other children. This can be extremely traumatic and may lead to low self-esteem, poor body image, and feelings of isolation.

Overweight is also associated with a number of health problems. Overweight children are at higher risk for asthma, type 2 diabetes, high blood pressure, and sleep disorders. They are also more likely to become overweight adults. Maintaining a reasonable weight, eating well, and being physically active during childhood, are important for a lifetime of good health.

What can I do to help my child?
While overweight is certainly a concern that has many health and social consequences, it is important not to overemphasize weight, but rather to focus on health. Weight is only one factor in health. Plus, research shows that it may be healthier to be fit and overweight than unfit and thin. If overweight is accompanied with an unhealthy lifestyle, then you need to take steps now to improve your child’s lifestyle. If you feel that there may be a psychological basis for the overweight, consult a health professional. Nutritious food choices, plenty of physical activity, and a positive body image help create a healthy kid at any size. As a parent, you play a vital role in creating supportive and healthy environments and opportunities for your child to achieve these goals.

What should my child eat?
Do not place an overweight child on a calorie- restricted diet unless it is recommended and supervised by your doctor. First, such restrictions could lead to nutrient deficiencies or other health concerns. Second, focusing on weight loss may cause some overweight children to develop an eating disorder or other unhealthy attitudes toward food.

Instead, examine your family’s overall diet. The best way to do this is to go online at www.MyPyramid.gov and enter your personal information (age, gender, and activity level) for each person in your family. Try to make small, simple, gradual improvements in the quality of food offered to your whole family. Do not single out your overweight child. He or she may feel deprived or additionally sensitive about his or her weight. The changes needed depend on your family’s current practices. The following list provides a few examples of areas you may be able to target for improvement.

• Does each member of your family consume at least five fruits and vegetables each day? Bring your child to the supermarket with you to select one new fruit or vegetable for your family every week. Create fun ways to incorporate fresh fruit and vegetables into your family’s diet, such as fruit smoothies made with yogurt. Involve your child in food preparation.
  
  
• How often do you order super-size portions at fast-food restaurants? Consider ordering regular size or splitting meals rather than super sizes. Even better, choose fast-food restaurants that offer sensible portion sizes and lower-fat entrees.
  
  
• What types of high-fat or high-sugar foods are available to your family? These may include fried foods (such as fried chicken, French fries, potato chips, donuts), whole milk, creamy soups, gravies, butter or margarine, bacon, mayonnaise, ice cream, soda, candy, cookies, and cake. Start by identifying one or two items that your family eats regularly and offer a healthier lowfat and/or low-sugar alternative. These could include pretzels, low-fat milk, frozen yogurt, and fruit in place of sugary items and oven-baked meats and potatoes in place of fried foods. Over time, replace other foods and drinks with healthier options.
  
  
• What types of beverages do you offer your family? Soft drinks are the number one source of sugar in American diets. They offer little nutrient value. In place of soft drinks, offer seltzer water (it’s bubbly without all the additives), low-fat milk or vegetable juice.
  
  
• Do you offer high-fat or high-sugar snacks near or before mealtime? Provide fresh fruit or vegetables with a low-fat dip before dinner for family members who are hungry and having trouble waiting.

How much should my child eat?
Young children need smaller servings than adults. Teach your child to listen to his or her body. It is important for a child to eat when he or she is hungry and stop when full. Don’t ask children to “clean their plates.” It is important to teach children how to gauge their hunger and self-regulate their food intake, using internal, not external, cues. Most adult portion sizes and super sizes offer too much food to a child. Provide smaller portions on smaller plates; then let your children know they can have a second helping. Rather than focusing on quantity and quickness, work toward quality. This can be done a few ways:

• Eat and chew slowly.
  
  
• Take time to enjoy a meal or a snack. Don’t eat on the run or standing up. Schedule regular meals. Sit down. Set your table. Make eating a pleasurable experience for your family.
  
  
• During meal times, eat slowly and encourage happy conversations. Avoid sitting in front of the television.
  
  
• Encourage using all of the senses when eating. Enjoy food.

Finally, show your children what is involved in healthy eating. Children, even teenagers, may argue when lectured, but they will follow the example set by their parents. Involve your children in planning and preparing meals. Be careful not to use food as a reward or punishment. They will form positive or negative associations with food. They will also have mixed messages about food. Good deeds should get good rewards, not unhealthy ones.

How can I promote physical activity?
We live in a sedentary society. Children can spend all day studying in school, doing homework, working on a computer, and watching television and never be active. Many schools no longer require physical education or even recess. Children need daily physical activity to be healthy and alert and to learn better. Current recommendations suggest 20 minutes of vigorous physical activity—enough to break a sweat or breathe hard—three or more days each week, and at least 60 minutes of total physical activity each day.

It is important to make physical activity a fun part of each day. Don’t make exercise a chore, and avoid criticizing or labeling your child “bad” at sports. Take part in activities as a family. Buy gifts that promote movement, emphasize fun rather than skill, and plan parties and vacations around physical activities such as swimming or ice-skating. Remember to set a good example for your children. Limit the hours spent watching television, playing on a computer, or being sedentary to no more than two hours a day. Encourage your children to try new activities, join community or school sports groups, and enjoy the simple pleasures of playing.

How can I create a positive body image in my overweight child?
Remember that each child is unique. Children come in different sizes, shapes, and weights. They also grow at different rates. Every body is a good body.

Be sensitive about discussions focusing on weight, weight loss, dieting, and food. Also be cautious about singling out an overweight child from other children in your family who may not be overweight. Weight is only one aspect of a child’s make-up and health.

Here are some ways to promote a healthy body image among kids:

• Provide praise and positive comments to children that focus on personal strengths, not on weight.
  
  
• Build a sense of uniqueness in your children.
  
  
• Create an environment of acceptance.
  
  
• Recognize that body shapes will change with growth.
  
  
• Understand that children may be healthy at a variety of weights.
  
  
• Teach children to treat their bodies with love and respect.
  
  
• Have a positive attitude about your own body and weight, too.

A healthy weight is a weight that can be maintained healthfully, insuring that children are well nourished, active, and have a positive attitude about their body and size.

Where can I get more information?
If you have any questions or concerns about your child’s weight, consult your physician or a registered dietitian. They can work with you to determine if your child is at a healthy weight and how to proceed if there are any concerns.

Virginia Cooperative Extension offers educational and cooking classes on preventing childhood overweight for parents, childcare providers, and children. Visit the Virginia Cooperative Extension website at www.ext. vt.edu to locate your nearest Extension agent for more information on food, nutrition, and health programs and resources.

For more resources and information:

Visit www.MyPyramid.gov to obtain an individualized eating plan for everyone in your family. The website also has links to other diet and physical information and a Web page for kids that includes the My Pyramid Blast Off game and tips for families.

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