Pediatrician weighs in on childhood obesity
By ERIN COLELLAJournal Staff WriterLISBON - For children, being overweight can take both a mental and physical toll, according to a Columbiana pediatrician.
(Second of four parts)
Richelle Keleman, M.D., of the Pediatric Care Center of Columbiana cited her own experiences and research into the problems facing overweight children.
"I don't think obesity is more acceptable, I think it is more visible," Keleman said. "Unfortunately, I think it is more widespread today compared to years ago."
Keleman said according to eMedicine, "Obesity is the most prevalent nutritional disorder among children and adolescents in the United States. Currently, available data reports that approximately 40 percent of children in the United States are either overweight or obese."
The bottom line is an overweight child is unhealthy for a number of reasons.
Obesity in children is generally considered to be a body mass index (BMI) of 20 percent higher than a healthy weight for a child of that height, but there is no general agreement on the definition of obesity in children as in adults.
"In general, the proportion of children with obesity who have obesity as adults increases with increased age at onset of obesity, such that 26-41 percent of preschoolers with obesity have obesity as adults, compared with 42-63 percent of school-aged children," Keleman said citing eMedicine. "Additionally, studies show the higher the degree of obesity during childhood, the higher the risk of adult obesity."
Health problems are a major factor for obese children both now and as they age. Keleman said a number of issues arise earlier and more frequently if a child is obese.
"Obese children are more prone to Type 2 diabetes, high blood pressure, elevated cholesterol levels, liver and renal disease, and reproductive problems," Keleman said. "In addition, obese children are at higher risk for adult obesity and cardiovascular disease. Other health problems arising from the effects of obesity are asthma and arthritis."
In addition to the physical difficulties obese children experience in general, there are also mental issues which should concern parents.
"Psychological and social consequences are of grave concern," Keleman said. "Obese children and adolescents are more prone to social isolation, negative comments from other children and poor self-esteem."
Depression and eating disorders also have been reported, according to Keleman.
Keleman admitted obesity can be a challenge to address with families, but facing it is very important.
"(Bringing up the subject is) vital to the long-term health of the child and, indirectly, to the entire family," she said. "Obesity is a difficult subject for families to bring up. The obese child may be only one of several family members who suffer from obesity, and appropriate management of the child often necessitates a change of the whole family's approach to eating and regular exercise."
So what can parents do to monitor their child's eating habits and exercise? Keleman said there are a number of "simple things parents can do."
Keleman said she believes breaking that cycle can be difficult.
"Obesity can definitely be a vicious cycle in families," Keleman said. "Parents need to be role models for healthy eating habits and regular physical activity.
"To encourage this, parents can involve children in food shopping and preparation," she said.
Keleman said that limiting television, computer and video games is a start, as well as limiting fast food, sugar drinks - most go along with fast food - and processed snack foods.
"Kids are leading more sedentary lifestyles now with the increased popularity of television and computer and video games," Keleman added.
According to eMedicine, children in the United States average more than 3 hours per day watching TV, and less than half of children have parents who exercise on a regular basis, Keleman reported.
Keleman suggests that you monitor what your child eats and offer a variety of healthy foods to chose from.
"Read labels to assess calories and portion sizes," she said. "Decrease intake of sugar and fruit drinks. Offer healthy snacks such as fruits and vegetables and pack healthy lunches."
Keleman also said anyone should avoid eating when not hungry.
"Don't make children eat if they are not hungry. Don't make them finish or rush through a meal. Don't use food as a reward," she said.
Keleman said an important note is to not limit fat intake in children under 2 years old.
"It is important to involve your child's doctor in any diet and exercise plan for an obese child," she recommended. "Any obese child needs a thorough history and physical examination to be sure there are no medical conditions causing or attributing to the obesity."
Keleman said exercise along with a healthy diet will help prevent obesity.
"Excellent exercises that can be shared by the whole family are walking, running, biking and swimming," she said. "Arrange family activities that involve age and developmentally appropriate exercise.
Keleman said prevention is the best policy.
"In the end, prevention of the development of obesity is much easier than treating the long-term effects of obesity in adults," she said.
(Tomorrow: What are our schools doing to help fight obesity in children?)
