The work is not the responsibility of the counselor and patient alone—for Kitay’s work to be most effective, “the whole family has to be committed to it,” she adds. That means modeling healthy eating.
“Parents need to set a good example for their children. If children see their parents regularly drinking soda and eating french fries, that’s what they’ll learn.” Kitay suggests stocking the refrigerator with hummus, sliced peppers and carrots, so kids can quickly reach for a healthy snack when they come home famished. Also, involving kids in the food preparation and cooking process can encourage them to try new foods.
Cooking and eating meals together can be a real challenge when both parents work and families are on-the-go constantly.
“These days nobody is fully aware of exactly what the children are eating,” observes Dolgoff. “Parents are relying on fast food or pre-made foods for quick dinner options. These choices rarely are as healthy as home-cooked meals. It is imperative that somebody is monitoring what a child is eating each day.”
The team approach—when governments, schools, communities and families work together—may prove most successful. The West Babylon community joined forces to do it and now the school district sets good examples for students for healthy living. After the town started a private wellness organization, partially initiated by elementary physical education teacher Lou Howard, the idea of eating healthier foods at school and exercising more generated much excitement and support.
“We threw out all the deep-fat fryers, no longer sell sugared drinks, make sure that foods are baked, not breaded and follow other health guidelines,” says Goldenbaum. The district has more nutrition improvements in the works.
Howard has helped start various fitness programs, and the district has seen much success. It was honored in August by the Alliance for a Healthier Generation, a group that former President Bill Clinton started in 2005 to fight childhood obesity.
“It’s not just about eating healthy, it’s about education and moderation, it’s the whole approach,” says Howard. Early education, he continues, is key. “The earlier kids learn to have healthy lifestyles, the more likely they are to stick.”
Distress Signals
“Since obese children may be up to five times more likely to suffer with depression or an associated psychiatric disorder, [obesity] prevention and screening should focus on both disorders and should start in childhood,” says Dr. James B. Snyder, director of Long Island Psychiatric in Roslyn. Snyder lists the following as signs that an overweight child or teen may benefit from psychiatric help:
• low self esteem and lack of self confidence
• reduced energy or interests and reluctance to enter into social relationships or other activities
• seems increasingly sad, lonely, angry or withdrawn
• has few friends outside of the family
• expresses wish or desire to hurt or kill self or others
• obsessive or impulsive eating habits causing unhealthy changes in weight
• sleeping too much or not enough, trouble getting out of bed
• frequent refusal to go to school and/or deteriorating academic performance
• frequent complaints of stomachaches and other bodily discomforts without any apparent physical cause
Healthy Active Living for Families
The scientific community agrees that each one of the following can positively impact overweight and obesity in children and/or adolescents:
• Eat five fruits and vegetables per day
• Get one hour of physical activity per day (does not need to be consecutive)
• Limit screen time to less than two hours per day
• Limit consumption of sugar sweetened beverages
• Eat breakfast daily
• Switch to low-fat dairy products
• Regularly eat family meals together
• Limit fast food, take out, and eating out
• Prepare foods at home as a family
• Eat a diet rich in calcium
• Eat a high fiber diet
• Breastfeed exclusively until six months and maintain breastfeeding after introduction of solid food until 12 months of age
Source: American Academy of Pediatrics
Health Risks to Overweight Children
Dr. Joanna Dolgoff identifies how being overweight can have negative effects on a child’s body functions:
BRAIN: Overweight children are very often depressed and anxious. Brains of overweight children don’t respond well to leptin, a hormone that tells the brain your child is full. Therefore, overweight kids are even MORE likely to overeat and gain more weight. Overweight children are more likely to have atherosclerosis (fatty deposits in the carotid arteries) that can lead to stroke.
LUNGS: Overweight children are more likely to have asthma. Asthma makes obesity worse because asthmatic children tend to avoid exercise, thus leading to more weight gain.
HEART: Overweight children are more likely to have atherosclerosis (fatty deposits in the arteries of the heart). Atherosclerosis can lead to heart attacks. Overweight children are more likely to have high blood pressure, also leading to heart attacks.
STOMACH: Overweight children are more likely to have GE reflux and constipation.
BONES: Overweight children are more likely to have bone problems that can lead to hip pain, knee pain, and back pain. This also makes weight gain worse because children in pain do not exercise.
Pressure from excess weight increases the risk of bone fractures.
PANCREAS: Overweight children are more likely to become resistant to the effects of insulin, causing diabetes (type 2).
GALLBLADDER: Overweight children are more likely to have gallstones. Gallstones are also common in overweight kids who lose weight too quickly.
LIVER: Overweight children are more likely to have fat accumulate in the liver, commonly known as “fatty liver.” If severe, fatty liver can lead to cirrhosis and liver failure.
PSYCHOLOGICAL: Overweight children are often depressed, anxious, and socially isolated.
Courtesy: Dr. Joanna Dolgoff