Complications of Weight-Management
ProgramsAdverse effects of childhood weight loss may
include gall bladder disease, which can occur in ado-
lescents who lose weight rapidly. Another concern is
inadequate nutrient intake of essential or non-essen-
tial nutrients. Linear growth may slow during weight
loss. However, impact on adult stature appears to be
minimal. Loss of lean body mass may occur during
weight loss. The effects of rapid weight loss (more than
1 pound per month) in children younger than 7 years
are unknown and are thus not recommended.
There is a clear association between obesity and
low self-esteem in adolescents. This relation brings
other concerns that include the psychological or emo-
tional harm a weight loss program may infer on a
child.Eating disordersmay arise, although a suppor-
tive, nonjudgmental approach to therapy and atten-
tion to the child’s emotional state minimize this risk. A
child or parent’s preoccupation with the child’s weight
may damage the child’s self-esteem. If weight, diet,
and activity become areas of conflict, the relationship
between the parent and child may deteriorate.
Preventing Obesity: Tips for Parents/
caregiversRespect a child’s appetite: children know when they
are full and do not need to finish every bottle or meal.
Prepare and supply fresh, non-processed foods often.
Avoid sugared foods when possible.
Limit the amount of high-calorie foods kept in the
home. Do not supply sodas; sugar flavored drinks,
candy, cakes, cookies in the home.
Provide low fat foods such as, lean proteins, and low-
or non-fat dairy products and choose lower fat
options for foods when available. Skim milk may
safely replace whole milk at 2 years of age.
Choose high fiber foods by selecting whole grains,
legumes and fresh fruit and vegetables.
Do not provide food for comfort or as a reward,
instead use positive reinforcement.
Do not ‘‘force’’ a child to eat their meal in order to get
dessert.
Limit amount of sedentary activities such as televi-
sion viewing, computer time, and video games to two
hours or less per day.
Encourage active play by offering the support
needed for the child to be active.
Establish regular family activities such as daily
walks, and other outdoor or indoor activities.Treatments
Once the need for obesity treatment has been
identified, a medical professional may suggest one or
more options. Consultation with a dietitian / nutri-
tionist that specializes in children’s needs is often a
valuable part of obesity treatment.Behavior Therapy
Behavior therapy involves changes in diet and
physical activity habits that promote weight mainte-
nance or loss. Some behavioral therapy strategies for
children and adolescents should include parent and
family involvement. And should be supervised by a
medical professional.
DRUG TREATMENT.The U.S. Food and Drug
Administration has not yet approved the use of any
drugs to treat obesity in children. However, clinical
trials are under way.
SURGERY.Surgical procedures such as gastric
bypass have been performed successfully on adoles-
cents. However surgery for adolescents is usually con-
sidered only when severe medical conditions are
present that can improve with the surgery and other
treatment options have failed.Resources
OTHER
BMI age-for-growth charts for the United States are avail-
able at http://www.cdc.gov/nccdphp/dnpa/bmi/bmi-
for-age.htm.
Encourages kids to get physically active. http://www.verbnow
.com/.
Healthy eating and physical activity tips for kids and
parents. http://www.kidnetic.com/.
Information about nutrition and fitness for kids. http://www
.kidshealth.org/.
MyPyramid Plan. MyPyramid replaces the Food Guide
Pyramid. Available from the U.S. Department of
Agriculture (USDA) at http://www.mypyramid.gov.
The Shapedown Pediatric Obesity Program. http://www
.shapedown.com.
Tips for Using the Food Guide Pyramid for Young Children
2 to 6 Years Old. Available from the U.S. GovernmentQUESTIONS TO ASK YOUR
DOCTOR Will my child just grow out of his/her weight?
How do you know if my child’s weight may be
negatively affecting his or her health?Children’s diets