My child is too fat

Dr. oec. troph. Eva-Maria Schröder

Obesity is not only a problem for adults, but also increasingly for children and adolescents. According to recent studies, the proportion of overweight boys in Germany has more than doubled since 1985, and that of the girls has even tripled. About every fourth boy and third girl is now too heavy for their age and height. One speaks of 2 million overweight children! The hope of many parents that their children’s overweight would “grow together” over time is – without appropriate measures – mostly wrong. It turns out that 40% of overweight children and about 80% of overweight adolescents also become “fat” adults. Today’s fat children are tomorrow’s risk patients. To prevent this, prevention and suitable measures must be started as early as possible if the body weight is already too high. The health awareness of the children and their families must be awakened at an early stage, because here too the following applies: what Hänschen does not learn, Hans never learns!

This article deals with this “serious” problem, helps you to assess whether your child is overweight and provides practical tips on nutrition and exercise to help you normalize weight.

Obese children have a hard time

Fat children do not have it easy – there is a risk that their bacon is already the basis for later illnesses and damage to the holding and locomotor system. In addition, they are constantly exposed to the teasing of their classmates, who mock them with terms such as "fat", "fat sack" or "pug", especially when the performance is not right in games and sports. Children can be brutal! Obviously, the overweight children suffer from this early on; this can lead to isolation and psychological damage. If this negative weight development is not counteracted in a timely and professional manner, fat children also face the “great chance” to carry their overweight into adulthood and keep it for life. High blood pressure, cardiovascular and metabolic diseases are preprogrammed for later due to untreated childhood obesity.

Improper diet and lack of exercise

Two major components are responsible for the high weight of our young population: improper nutrition and lack of exercise, i.e. too high in fat, too much sugar, and all of this in connection with lack of exercise due to the TV and computer age. Fast food, chips and sweets, washed down with sweet soda and cola drinks, all in front of the television or computer – this unhealthy trend is increasingly suppressing the image of the slim and young child romping around in all kinds of weather.

What can you do?

Prohibitions are not enough. Rather, a long-term change in misconduct must be sought. The child – and in most cases the whole family – has to recognize where the causes of the overweight lie. Only in this way, in connection with the necessary motivation, is it possible to have a positive influence on the eating and exercise behavior of the overweight child.

Of course, you shouldn’t use violence (cures) and one-sided adult diets against the extra pounds in children, because adolescents have a particularly high need for high-quality nutrients. It is better to help the entire family (fat children often have fat parents!) By educating and changing the wrong eating habits in the long term to grow leaner and healthier. At this age, it is often sufficient to keep the weight constant for a few months through appropriate nutrition; the child then automatically becomes slimmer as it grows. A targeted exercise program is ideal, ideal for the whole family. If psychological problems are the cause of excessive eating, experts should be consulted.

Is my child too fat?

In addition to the visual impression in the undressed state (bacon rolls, belly attachment), which also allows laypeople to make a superficial assessment of the nutritional status, you can now determine exactly whether the child has it by measuring skin folds (subcutaneous fat tissue thickness) or calculating the body mass index (BMI) There is a need for weight loss.

The BMI is calculated as follows:

One divides the body weight by the body size in the square:

BMI = body weight (kg) / (height (m)) 2

Then you compare the value with the percentile curves for boys and girls (Fig. 1 and 2; Source: Kromeyer-Hauschild K, Wabitsch M, Kunze D, et al., Monthly Schröder Kinderheilkd 2001; 149: 807-818). If the age-specific weight is at or above the 90th percentile (P 90), one speaks of obesity requiring treatment, from P 97 even obesity (obesity).

BMI for boys
Example: A boy is 1.20 m long, weighs 30 kg and is 6 years old. His BMI is calculated as follows: 30 kg divided by 1.20 m x 1.20 m, i.e. 30 divided by 1.44 = 20.83.

20.83 is the BMI value, which is now compared with the curves in Fig. 1 (for boys): for a 6-year-old, the BMI of 20.83 is above the 97th percentile (P 97); the child is therefore very overweight (obese), so weight normalization is urgently indicated.

Treatment of overweight children

The primary goal of the treatment of mild to moderate obesity in childhood is not primarily a drastic weight loss in a short time, but rather a constant body weight for a longer period of time, possibly also a moderate weight loss (about 1 kg per month). Because of the length increase, the weight in children often normalizes itself. In addition, the intensity of movement has to be increased significantly. By emphasizing plant-based foods and reducing fat and sugar products, nutrition should aim to reduce energy density without the child going hungry.

If you are overweight, a light to moderate diet is also indicated. The treatment of obese children should be carried out under professional supervision, if necessary during a spa stay.

The practice: healthy weight loss at home

In order to counteract malnutrition in children at home, long-term energy consumption through eating and drinking must be reduced and energy consumption through sports and games increased. Both measures, especially when used in combination, reduce the fat deposits since the body now has to draw on its reserves. The extent of success, i.e. weight loss, is greater the lower the energy consumption and the higher the energy consumption. Nevertheless, radical cures are absolutely unsuitable for children, just as physical exertion must be discouraged. The child’s organism is still very sensitive due to its growth and development processes; any kind of exaggeration would do more harm than good here.

The factor “time” is of great importance: For health and well-being, continuous small weight losses – but over a longer period of time – are much better and more permanent in the long term than a strong weight loss in a short time. Keeping the weight constant during a growth phase is often sufficient and can be the means of choice for children, because unlike us adults, children have the huge advantage of length growth, which one should definitely take advantage of when normalizing weight: with constant weight Weight plus growth automatically make children leaner!

Unilateral diets are strictly forbidden for children, because the supply of vital nutrients is neglected here and a deficiency has a harmful effect on the child’s health. Lightning and crash diets, which can be found in every newspaper for adults every week, should also not be used in children, because firstly they also usually contain too few nutrients and secondly because of rapid weight loss (initially primarily water loss) the child’s organism too much encumber.

The means of choice for children is a slow and gentle weight reduction through a diet that is specially adapted to children’s needs and dosed increase the movement. In addition, eating habits should be checked and, if necessary, changed.

Nutrition tips for overweight:

Reduce energy intake (slightly), especially saving fat and sugar
varied and balanced food composition
little fat and sugar, lots of vegetables, fruit, whole grain and low-fat milk (products) every day
Avoid cravings
Snacks: fruit, yogurt, crispbread, raw food
High-fiber, filling meals (potatoes, rice, cereals)
full plates – but little energy: lots of vegetables, salad, raw food
Reduce spread fat (semi-fat, no fat under spread sausage)
lean meat / fish and sausage (aspic, ham or fat rim)
Avoid breaded bread
plenty of herbs and spices instead of salt, possibly sweetener
Reduce sweets and fast foods
Eat without distraction, chew thoroughly, eat slowly
Select calorie-saving preparation methods (cooking, grilling, roasting foil, Roman pot, coated pan)
drink a lot in between: 1.5 to 2 liters of calorie-free liquid a day
Sports and exercise-intensive games support the dietary measures

Nothing is completely forbidden, because bans increase the attractiveness of food. So metered amounts of sweets are allowed – sometimes a hamburger!

This is how exercise, play and sport help

The extent of physical activity also contributes to good success when losing weight. Exercise uses energy, and the more energy is consumed with reduced food intake, the more intensely the body’s fat stores (= energy stores) are emptied. The consequences are better weight loss and easier maintenance of the lower weight.

However, being overweight is already a not insignificant restriction of the child’s mobility. It would therefore be nonsense to say to a very overweight child: "Just do more sport and you will become leaner". This advice is helpful if the child is carrying around 5 kg too much, but how should a child who is 15 kg overweight jog or climb a mountain? Here it is necessary to proceed differently, namely through a fundamental change in movement behavior in everyday life. Suitable sports can be added to support.

The lack of exercise in everyday life found in adults can also be found in children and adolescents. What the car is for the adult, the bus for many children and the moped for teenagers, i.e. getting around without spending any energy. It would be much better to walk or cycle more often if you value good health and a slim line. The stairs are preferable to the elevator. Weekend trips should be done by bike or on foot rather than by car. And instead of sitting in front of the computer or television in the house, a table tennis match with daddy in the fresh air might be a good idea.

It is important that the movement takes place regularly and becomes a habit. An act of violence once a week brings far less than an hour of intense exercise and sport every day – preferably in the fresh air. The more the better!

Slowly introduce your child to more exercise-intensive activities. Go out into the fresh air with him if your time allows. Or go on excursions on weekends where the whole family is on the move. Take a ball or games (badminton, family tennis, frisbee, etc.) with you. Go swimming or sledding or skating in winter. There are countless ways to compensate for the lack of exercise, either alone or in the family. It is good for everyone, including adults. It is fun and promotes family life.

What is important in sports is what the child can achieve due to his excessive body weight. Suitable sports in which the weight is relatively insignificant include swimming, cycling, strength training or gymnastics. The overweight child should first do the sport that he enjoys. Excessive demands or even overexertion are not required. It is important that the child likes to do the exercises and does them regularly.

As the weight drops, the child will enjoy it more and more Sport and Find a game because it becomes more powerful. If it wants to join a sports club or gym, promote this activity. Because school sports and occasional leisure sports are usually not sufficient on their own. In addition, there are professional instructions in the sports club or gym to reduce overloading and thus the risk of accidents.
How to help your child “shed extra pounds”

Important steps to success are:

The family has to stick together now. Lead by example when it comes to improving eating habits. If necessary, try to lose weight with your child – this helps all!
Don’t push the child into an outsider role. A child-friendly low-fat and low-sugar diet is not a punishment, but should be seen as a completely normal change in diet.
Do not try to succeed in your child’s adult fast diets! You are endangering his health!
Slow, continuous weight loss with a balanced diet is better than a one-sided radical cure that does not bring lasting success.
Combine energy-reduced food with increased exercise: in everyday life, prefer stairs instead of lifts, bicycles instead of buses and legs instead of cars. In their free time, exercise, play and sport should get the whole family busy. This is fun, increases fitness and is healthy for everyone!
Motivate and praise your child frequently for being willing to "nibble" on their pounds!
Don’t set the goals too high. Small intermediate goals let success be seen better than the final goal in the far distance!
Small rewards (nothing edible!) For achieved intermediate goals promote your child’s stamina. Better a trifle per pound gone than the prospect of a big gift when you reach your target weight.
Comfort your child with failures and setbacks. Motivate it again and show understanding. Rome wasn’t built in a day either – and the extra pounds finally had time to "grow"!
Happiness and cheerfulness make losing weight easier. Keep your child busy and distract them from thoughts and opportunities to eat.
Take your time and rest at mealtimes and consider: Lovingly arranging the dishes will make you forget about the reduced energy content, because it is well known that the eye eats too!
Discuss the meal plan with your child. Take his wishes into account.
Don’t completely deny your child their favorite dishes. When preparing, however, make sure to reduce fat and sugar. And the amount doesn’t have to be as big as it used to be; Low calorie and filling side dishes help!
Prevent cravings with suitable snacks in the morning and afternoon!
Drinking plenty is necessary and also helps to drive hunger away.
Weigh your child regularly and write the success clearly on a weight curve or table.
Once the target weight has been reached, weight control remains essential. The new eating and exercise habits should definitely be maintained!
If your child gains weight again without growing, you should step in immediately, because a few pounds are gone faster than after a long time several kilos!

Help for families with overweight children: SlimKids 2000 – a program for weight loss at school age

Many families feel overwhelmed with the problem of enabling their overweight children to lose weight in a healthy way at home and would like to receive help from outside. However, this often proves to be problematic, as competent contact persons for support are missing in many places. Many doctors are also unable to provide adequate support for their little patients in their efforts to normalize weight. Group work through health insurance companies is not offered everywhere; and the excess weight of the child may not be strong enough for an inpatient treatment lasting several weeks.

Help is offered here by SlimKids 2000, a nationwide program for children who “have more than that”. SlimKids 2000 is a postal advisory program to support the weight loss of overweight schoolchildren at home.

With SlimKids 2000, families can now easily fight the extra pounds at home: together, child-friendly and with delicious recipes. There is no cure, no group meetings – the children (families) are simply looked after in writing for three months by post. Every 14 days a thick advice letter comes in with a menu adapted to the needs of school children as well as a nutritional education and training program for the kids. The parents are also provided with interesting information on the right nutrition. Aversion to certain foods can be taken into account. If necessary, mom, dad, brother and sister can join in and also become slimmer – without additional costs. SlimKids 2000 is a real family diet program!

SlimKids 2000 has proven to be effective as the sole therapeutic measure for weight loss at home for slightly to moderately overweight people. If you are already overweight, which requires an inpatient treatment, it has been proven to be effective in aftercare at home after the treatment to stabilize or expand the success achieved there.

The consultation for three months costs 155 euros. More information can be found here.

Further contributions by the author here in our family handbook

author

Dr.oec.troph. Eva-Maria Schröder (M.P.H. postgrad.) Is a nutritionist and health scientist, freelance journalist and head of the nutritional counseling service in Tutzing.