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I think my child might be overweight. How can I tell if it's a problem?
Carrying extra weight can put your child at risk for health problems like heart disease and diabetes now and in the future. Don't get too worried if your child is a little chunky at this age, but do talk with his doctor about your concerns. She can help you determine whether your child's weight is a problem that you should start addressing now.
Keep in mind that while being chubby as a child can predict being overweight as an adult, it can also be just a stage, especially at your child's age. So even though your preschooler may seem a little heavy to you, as his body changes in the next few years, he may take on a leaner look. Children tend to grow into their weight — that is, they generally thin out as they become taller. (They don't stop gaining weight altogether, of course, but ideally their height catches up and the two become proportional.)
Your preschooler is more likely to "outgrow" being overweight than an adolescent is. Still, if your child was severely overweight as a toddler, and still is as a preschooler, his chances of remaining overweight increase, says Nancy F. Krebs, M.D., professor of pediatrics and co-chair of the American Academy of Pediatrics' Task Force on Obesity.
How will the doctor determine whether my child is overweight?
Your child's doctor will measure his height and weight and plot these numbers on a growth chart. Doctors today are using a new series of growth charts from the Centers for Disease Control and Prevention that take into consideration a child's body mass index, or BMI, which indicates whether his height and weight are proportional. The BMI is a better indicator of whether your child is carrying too much body fat than a weight measurement alone. While the BMI of an adult is calculated with a straight formula, children's BMIs are based on gender and age, to allow for the change in body composition that happens as a child gets older.
Like a standard growth chart, your child will be ranked in percentiles compared to his peers. If your child's BMI is in the 85th percentile — meaning it's higher than that of 85 percent of children his age and gender — he would be considered overweight. If he's in the 95th percentile, he's considered obese.
In addition to your child's height and weight, his doctor will factor in how much his parents weigh, how long he's been heavy, and his overall health.
If my child is overweight, what can I do about it?
Doctors don't usually recommend restrictive diets or weight loss programs for children, as they're necessary only in extreme cases. In fact, a restrictive diet can be harmful to a child's health and interfere with his growth and development if it's not carefully monitored. In most cases, the goal is to maintain the child's weight with a healthy diet so that as he grows his weight will be more proportional to his height.
Ask your doctor for suggestions on how you can help your child develop healthy eating habits. She may suggest that you follow the Food Guide Pyramid, which advises offering your child three servings of vegetables and two servings of fruit each day, in addition to servings of whole grains, milk, and meat. Of course, you'll want to limit sweets and other high-calorie, low-nutrient foods. The doctor may also recommend that you consult a registered dietitian to help you create a balanced eating plan for your child.
Keep in mind that if the whole family is eating healthy foods for each meal and snack (and enjoying plenty of exercise), your preschooler will find it much easier to do the same.
Help your child steer clear of these bad habits, all of which can cause him to gain weight:
- Unsupervised snacking. Limit or eliminate choices like cookies and chips, and replace them with healthy options like fresh fruits and vegetables and low-fat puddings, yogurts, and cheeses. Make sure your child isn't grazing all day, either, even on healthy foods.
- Eating while watching television. A child who's distracted may not recognize when he's full. Help your child learn to listen to his body's signals to tell him when he's had enough.
- Consuming excessive amounts of soda or juice. Save soda and other sweet beverages for special occasions, if you serve them at all. Fruit juice does count as a serving of fruit, but too much juice can fill your child up so that he won't be hungry at mealtime for the other nourishing foods he needs. Limit juice based on these recommendations from the American Academy of Pediatrics.
- Indulging in vending-machine food. Most vending-machine food isn't very nutritious. If your child is going to be out and about at snack time, pack something healthy for him.
- Spending too much time in front of the TV or computer. Kids can get sucked into sitting still for hours. In addition, TV advertisements encourage the consumption of high-calorie, nutrient-poor "junk" foods. To encourage physical activity, keep TVs out of children's bedrooms.
- Eating too much at meals. See our expert's advice on how to handle overeating.
Instead of nagging or ridiculing your child about his weight, which is likely to make him resentful and rebellious, give him the opportunity to choose healthy foods and activities, and praise him for it when he does. And don't forget to set a good example by eating well yourself. "Especially for young children, the importance of parents' modeling healthy eating and healthy lifestyles can't be overemphasized," says Krebs. "Children learn what they see!"
Don't start subjecting your child to regular weigh-ins at home, either — they can become a source of anxiety. However, if your child's BMI is above the 95th percentile, your doctor may ask to see him once a month to monitor his progress. Just treat these visits like any other trip to the doctor, and don't make a big deal about the weigh-in process. Keep the focus on developing healthy habits, rather than on your child's weight.
How can I encourage my child to become more active?
Exercise is a key component of weight maintenance, and many kids don't get enough of it. The 2000 Dietary Guidelines for Americans from the U.S. Department of Agriculture (USDA) and Department of Health and Human Services (DHHS) recommend at least 60 minutes of activity per day for kids — ideally, done with their parents. Instead of settling on the couch after dinner, encourage your family to take a walk or bike ride together. Try in-line skating or dancing. And look for ways to be more active throughout the day — by walking or biking instead of driving, for instance, or by taking the stairs instead of the elevator. For most children, encouraging more time outdoors is all it takes to get them to have more active playtime.
What if my child remains overweight as he grows up?
You can help improve your child's future by showing him how to eat better and become more active now. This will boost his chances of heading off a weight problem and growing into a healthy adult. Even if he never achieves a "normal" weight, he'll be healthier if he eats well and is active.