More Listening to Kids

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Childhood Obesity News has been talking about different ways that parents, teachers, and health care professionals have found of listening to kids and putting the information to useful work. A nonprofit group called ACTIVE Life attempts to fight obesity through social activism (link is PDF). The organization believes it has some answers, which the website Be Smart. Be Well. (BSBW) elicited from its executive director Baker Harrell in an interview.

He advises looking for opportunities to do things together as a family, and asking the kids for help in figuring out how to make nutritious eating habits a central part of life within the home. In fact, BSBW offers on one of its pages an entire list called “Childhood Obesity: Habits2Have.” Harrell says:

Young people in this generation seek out empowering experiences — experiences that allow their voice to be heard. For parents, what’s important is not talking down or telling a child to do something and instead becoming a collaborative partner with that young person. Let their voice be heard and let their perspective be heard and let their fears and desires be heard.

A while back, the ABC network show “Nightline” produced a segment called “Childhood Obesity: Two Kids’ Stories.” The first kid is Samantha, four years old, the biggest girl in her preschool class, weighing in at 54 pounds. Little Samantha is described by her mother, Lori Cohen, as a carbohydrate addict. That’s what Mom says. The child has a formidable appetite for bread, pasta, and all the usual white and sweet stuff. And chocolate. But she also appreciates meat and cheese as much as a soldier returning from a 15-mile hike, and is never shy about asking for a second helping.

Samantha’s mom signed her up for a six-month program with Dr. Joanna Dolgoff, a pediatrician whose specialty is managing children’s weight. The little girl’s body mass index (BMI) was characterized as “dangerously high.” She was definitely in the obese category, and at risk for medical illness as a consequence.

One of Dr. Dolgoff’s techniques is to divide all foods into three types. Green is go; it’s okay to eat however much of this food you want. Yellow means use caution, and red means stuff that’s bad for you, and you can only get it twice a week. Her program is called “Red Light, Green Light, Eat Right.” Dr. Dolgoff says:

Using that to relate to food just makes it easy for them. They get it… after a while, the kids learn sometimes they can have those unhealthy foods and sometimes they can’t.

Is this sustainable? Maybe not, because one of the things we know for sure about addiction is, an addict can’t have just a little bit of the addictive substance. Dr. Pretlow makes the comparison to an allergy. If you know peanut butter will send you to the hospital, you just don’t eat peanut butter, ever. Any time an addict flirts with just a little bit of whatever, it’s a recipe for backsliding and disaster.

Dr. Dolgoff feels that, the younger a child is caught and intervened with, the higher the likelihood for success. Samantha will probably make it. Over the six months, she lost three pounds and squeaked out of the obese category back into just plain overweight.

Another child on this show is Nick, eight years old, 117 pounds. He weighs more than his 13-year-old brother. His mother reports that he is “just hungry all the time.” Strangely, Nick is very active, but his calorie-burning can’t keep up with his intake. Reporters John Donvan and Melia Patria say that:

… his weight has already impaired his health. Nick had to have his tonsils removed because the thickness of his neck was causing sleep apnea.

Nick also went into a program where his progress was monitored and recorded by the network team. His was in Tennessee, in the pediatric weight management clinic of Dr. Greg Plemmons, who found that Nick’s BMI was over the 95th percentile, and he could be staring type 2 diabetes in the face. There was an intense consultation with Nick’s mom about how meals are usually cooked and served, or procured from outside sources like fast-food joints. Gatorade was identified as a major problem.

Unlike adults, where the goal of a program is to lose weight, we are told by the reporters:

The goal for overweight kids is to get them just to stay at one weight for a while, a weight their bodies can grow into until it becomes more normal for their height and age… If Nick could maintain his current weight over the next several months, while also growing taller, his BMI would drop and that would mean success.

But, alas, Nick gained five pounds and didn’t grow at all. Dr. Plemmons used this occasion to point out how difficult it is to accomplish the goal even when the family is supportive and the child is in a program. Dr. Plemmons, who has treated over 500 kids, says that by Nick’s age, there is only a 50-50 chance of reversal. And for Nick, even though he’s only eight, it might be too late.

Now, here is an important point made by Dr. Dolgoff, who is quoted as saying:

We don’t understand what a normal child looks like any more. Overweight has become the norm.

A dad looks around the neighborhood, the building, the mall, or the school, and sees hordes of other chubby kids, and his own little flabster fits right in. As long as there’s some kid around whose bulges are even more outrageous than her own kid’s, why should a mom worry? Apparently, unhealthily overweight children now appear normal to the eyes of many adults. This is indeed a bad sign.

Your responses and feedback are welcome!

Source: “How do we stop childhood obesity? Ask your kids, expert says” (PDF), Be Smart. Be Well.
Source: “Childhood Obesity: Two Kids’ Stories,” ABC News, 05/17/10
Image by rx2web, used under its Creative Commons license.

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Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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