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Overweight and obesity pose very real health risks to children, but how can parents implement positive changes without introducing their kids to new dangers, including eating disorders?

We've all heard the talk about the "obesity epidemic" sweeping across the United States and many other developed and developing countries, an epidemic that is affecting increasing numbers of children and adolescents as well as adults. Childhood obesity has more than doubled in the United States over the last three decades — leaving 18 percent of six- to 12 year old children obese in 2012, as well as 21 percent of adolescents between the ages of 12 and 19, with many more being overweight but not obese. 

Those statistics are worrying, but they take on a whole other dimension if your own child is affected. As a parent, you want your child to be physically and emotionally healthy. You know that overweight children are more likely to also be overweight as adults than those children who are at a healthy weight, and you know that this places them at risk of type 2 diabetes, heart disease, and even certain cancers. 

You want to protect your child from these risks — but as an informed parent, you will also have heard that eating disorders are becoming more prevalent among children. The American Academy of Pediatrics noted a 119 percent increase in hospitalizations for eating disorders in the under-12 population between 1999 and 2006. 

By encouraging your child to lose weight, could you inadvertently be putting them at risk of developing an eating disorder instead? Even in the absence of an eating disorder, anyone who was overweight as a child knows that this is an incredibly sensitive topic: say the wrong thing, and you are in danger of making your child feel terrible, putting a strain on your relationship with them and perhaps setting them up for lifelong negative self-image feelings. 

That begs the horrendously difficult question: How on Earth do you encourage your overweight or obese child to lose weight in a healthy manner, without damaging their self esteem or causing an eating disorder?

First Things First: How Do We Define Overweight And Obesity?

As with adults, Body Mass Index (BMI) is the measure that is used to determine whether a child is overweight or obese. A BMI measurement is calculated by dividing weight in kilograms by the square of their height, in centimeters. In children, however, this number is compared to that of other children of the same age and sex in percentiles. Children whose BMIs are above the  85th percentile are considered overweight, with those above the 95th percentile falling into the obese category. This can be assessed by your child's pediatrician at a routine well-child checkup or during a separate appointment made specifically because you are worried about your child's weight. 

Should Your Child Go On A Diet?

One thing is clear: children, who are still developing, should never be placed on a weight loss diet without the strict guidance of a healthcare professional. Indeed, taking a very critical look at the whole family's eating and exercise habits and making family-wide changes that do not single your overweight or obese child out may be the best approach to healthy weight loss for your child. That does not mean you can battle this problem by yourself, however — getting your child's doctor in on the decision-making process is the best thing you could ever do.

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