Obesity is prevalent among the pediatric population, with CDC statistics showing numbers as high as 17 percent among children and adolescents from 2-19 years old. The numbers are much higher in Hispanics and non-Hispanic blacks. Definition of obesity is based on meeting the 95th percentile and above for Body Mass Index compared to other kids of the same age and gender. The BMI is obtained by comparing the weight to the height of the child. The BMI is an alternative measure to estimate body fat and more easily completed versus other, more accurate techniques that require more time to complete and the help of a specialized practitioner.
During well-child visits, the weight and height of children are obtained and a BMI is calculated to let us know if the child has a normal or abnormal BMI. In my practice, I focus on two main areas to help with getting an adolescent into a healthy BMI range. First, I discuss diet with families. Any changes to diet should be made by every family member versus having only one child or certain children make changes. It helps the child with their self-esteem when they are not made to feel different because of their obesity. Dietary changes can be made easily by using the internet to look up healthy food preparation methods. A free website that is very helpful is CalorieKing.com. This site also has a variety of ideas for healthy meals.
Clearly, serving size will also contribute to your calorie intake. I tell kids their plate should be the size of their palms and fingers placed side by side. The palm on one hand should be the serving size for carbohydrates — like pasta and rice, and the other palm should be for protein — like fish and meats. The fingers represent fruits and vegetables, and if they want more servings of the fruits and vegetables, they can spread the fingers to eat more. A visit to a nutritionist can also provide helpful ways to make this work.
Physical activity helps to burn calories. In order to lose weight, you need to burn more calories than you consume. For children, depending on where they fall with regards to their BMI, can maintain weight as they grow taller, while other children may need to lose weight to get into a healthy range. This can be discussed with your pediatrician or primary care provider. I recommend activities that will make the heart rate increase, such as swimming, brisk walking, dancing, running, riding bikes and a host of other physical activities. During the fall and winter seasons, when it is harder to do outdoor activities, places like the YMCA or other facilities that provide indoor activities for children can be helpful. If unable to visit these facilities, have fun as a family and try some dance moves at home. The goal is three to five days of activity with three episodes of 10 minutes or one episode of 30 minutes a day.
While caloric intake and physical activity are the two main areas helpful for achieving a healthy BMI, some children may require further interventions with the assistance of their primary care provider. The goal of getting into a healthy range is to prevent health complications that can occur from lifelong obesity. I encourage you to take that first step toward keeping kids healthy and active. In doing this, you will encourage healthy habits that can last a lifetime.
Ufuoma A. Onyemachi, M.D., Lima Memorial Physicians, Lima Pediatrics