When you have an overweight child, fighting our country's obesity epidemic is exhausting. With the problem now almost as old as Justin Bieber, virtually every parent knows what to do. We've heard it all thousands of times: healthier foods, fewer snacks. More activity, less TV. Takeout, no; family meals, yes.
It's doing all those things consistently that wears families down. The drive-through is easy; buying, chopping, and then cooking vegetables is harder. Our best intentions get railroaded by a world that seems to conspire against us: classmates with "better" (unhealthier) snacks; the bank that gives out lollipops; the grandmother who always arrives with a little bag of cookies. And then there's that most disheartening word of all: yuck, as a preschooler spits out the healthy meal we worked hard to buy, prepare, and serve.
We're battle-weary, and the misleading message so many of us want to believe -- that there's no need to do anything drastic, and every little bit helps -- isn't working for many families today. To put it bluntly, we're losing the war. "We live in a culture with a toxic food environment, and it undermines practically everything families do to stay healthy. It takes a lot of effort to work against that," explains Parents advisor David Ludwig, M.D., Ph.D., professor of pediatrics at Harvard Medical School and director of the New Balance Foundation Obesity Prevention Center at Boston Children's Hospital. The fight against what's unhealthy in society is way beyond any one parent, it's true. "We can immediately change what we do in our home, though, making it a sacred space that supports health," Dr. Ludwig adds.
Last month, we introduced you to the Evans family of Youngstown, Ohio, who are helping 7-year-old Morganne get on track toward a healthy weight. (See link to their story below.) But every family has its own challenges, of course, from working night shifts to dealing with interfering in-laws. Dr. Ludwig and other experts help parents of overweight children overcome nine common obstacles.
Denial is a major problem in treating overweight children. A University of Maryland study recently found that mothers of overweight toddlers were 87 percent less likely than those of normal-weight kids to accurately perceive their child's body size. Because so many kids are heavier these days, those with a weight problem don't look unusually big, says Vandana R. Sheth, R.D., a registered dietitian in Los Angeles and spokeswoman for the Academy of Nutrition and Dietetics.
But a child's Body Mass Index, or BMI, doesn't lie. This measure is a ratio of height and weight, adjusted for age and sex, and then plotted against national percentiles. Parents should now get the percentile for BMI at every checkup, starting at age 2, according to the American Academy of Pediatrics. A child with a BMI in the 85th to 95th percentile is overweight. And a child with a BMI above the 95th percentile is obese.
If you have a relative who's in denial, take him to the next doctor's visit. "I sometimes even write a prescription for the other parent to come in for an appointment, so I can explain," says Dr. Ludwig. "After hearing about the health risks, the other parent may better appreciate the importance of addressing the child's size." Your child probably won't just outgrow his weight problem, he adds. Without some kind of intervention, overweight toddlers are five times more likely to still be overweight at age 12, found research from the National Institutes of Health.2. "My biggest obstacle is our schedule -- there is never enough food in the house or time to shop and cook. So I usually give in and order something."
"Time is a huge issue," agrees Amy Jamieson-Petonic, R.D., director of wellness coaching at the Cleveland Clinic and a spokeswoman for the Academy of Nutrition and Dietetics. "It's important to put your supermarket trips on the calendar, sketch out a meal plan for the week, make a list, and get your coupons organized," she says. If possible, avoid shopping on weekends. "Tuesday and Wednesday are typically the least busy days in stores, so you can get in and out more quickly," says Jamieson-Petonic. And although it's fine to shop alone for the sake of efficiency, take your kids along now and then. "The more involved they can be in making food choices, the more cooperative they'll be at home."
Prewashed and chopped vegetables may cost a little more, but they're a big time-saver. And many frozen veggies are just as nutritious as fresh ones. Keep a few other fallbacks in the freezer too: Kashi, Amy's, and Digiorno all make reasonably healthy and kid-friendly pizzas. Serve with milk, vegetables, and fruit for dessert, and you've turned a cop-out into a solid supper.
And don't rule out takeout altogether. "Bring home a rotisserie chicken and put it in a salad, or add it to chicken broth with brown rice and vegetables," suggests Columbus, Ohio, dietitian Sally Kuzemchak, R.D., who blogs at realmomnutrition.com. "Asian rice dishes -- like chicken or shrimp with veggies -- are great, if you can request brown rice and sauce on the side."