The Surgeon General's call to action to prevent and decrease the incidence of overweight and obese children

The problem of overweight and obese children and adolescents

• In 1999, 13 percent of children ages 6 to 11 years and 14 percent of adolescents ages 12 to 19 years in the United States were overweight. This prevalence has nearly tripled for adolescents in the past two decades.
• Risk factors for heart disease, such as high cholesterol and high blood pressure, occur with increased frequency in overweight children and adolescents compared to children with a healthy weight.
• Type 2 diabetes, previously considered an adult disease, has increased dramatically in children and adolescents. Overweight and obesity are closely linked to type 2 diabetes.
• Overweight adolescents have a 70 percent chance of becoming overweight or obese adults. This increases to 80 percent if one or more parents is overweight or obese. Overweight or obese adults are at risk for a number of health problems including heart disease, type 2 diabetes, high blood pressure and some forms of cancer.
• The most immediate consequence of being overweight — as perceived by children themselves — is social discrimination. This is associated with poor self-esteem and depression.

The causes of becoming overweight:

• Children and adolescents generally become overweight through lack of physical activity or unhealthy eating patterns, or a combination of the two, with genetics and lifestyle also playing important roles in determining a child's weight.
• Our society has become very sedentary. Television, computers and video games contribute to children's inactive lifestyles.
• 43 percent of adolescents watch more than 2 hours of television each day.
• Children, especially girls, become less active as they move through adolescence.

Determination of overweight children and adolescents:

• Doctors and other health care professionals are the best people to determine whether your child or adolescent's weight is healthy, and they can help rule out rare medical problems as the cause of unhealthy weight.
• A Body Mass Index (BMI) can be calculated from measurements of height and weight. Health professionals often use a BMI "growth chart" to help them assess whether a child or adolescent is overweight.
• A physician will also consider your child or adolescent's age and growth patterns to determine whether his or her weight is healthy.

General suggestions:

• Let your child know he or she is loved and appreciated whatever his or her weight. An overweight child probably knows better than anyone else that he or she has a weight problem. Overweight children need support, acceptance and encouragement from their parents.
• Focus on your child's health and positive qualities, not your child's weight.
• Try not to make your child feel different if he or she is overweight. Instead, focus on gradually changing your family's physical activity and eating habits.
• Be a good role model for your child. If your child sees you enjoying healthy foods and physical activity, he or she is more likely to do the same now and for the rest of his or her life.
• Realize that an appropriate goal for many overweight children is to maintain their current weight while growing normally in height.

Physical activity suggestions:

• Be physically active. It is recommended that Americans accumulate at least 30 minutes (adults) or 60 minutes (children) of moderate physical activity most days of the week. Even greater amounts of physical activity may be necessary for the prevention of weight gain, for weight loss or for sustaining a healthy weight.
• Plan family activities that provide everyone with exercise and enjoyment.
• Provide a safe environment for your children and their friends to play actively; encourage swimming, biking, skating, ball sports and other fun activities.
• Reduce the amount of time you and your family spend in activities such as watching TV or playing video games. Limit TV time to less than 2 hours a day.
• Use age and growth patterns to determine whether a child's weight is healthy.

If your child is overweight:

• Many overweight children who are still growing will not need to lose weight. Instead, they can reduce their rate of weight gain so that they can "grow into" their weight.
• Your child's diet should be safe and nutritious. It should include all of the Recommended Dietary Allowances (RDAs) for vitamins, minerals and protein and should also contain the foods from the major Food Guide Pyramid groups. Any weight-loss diet should be low in calories (energy) only, not in essential nutrients.
• Even with extremely overweight children, weight loss should be gradual.
• Crash diets and diet pills can compromise growth and are not recommended by many health care professionals.
• Weight lost during a diet is frequently regained unless children are motivated to change their eating habits and activity levels for a lifetime.
• Weight control must be considered a lifelong effort.
• A physician should supervise any weight management program for children.

Healthy eating suggestions:

• Follow the Dietary Guidelines for healthy eating (www.health.gov/dietaryguidelines).
• Guide your family's choices rather than dictate foods.
• Encourage your child to eat when hungry and to eat slowly.
• Eat meals together as a family as often as possible.
• Carefully cut down on the amount of fat and calories in your family's diet.
• Don't place your child on a restrictive diet.
• Avoid the use of food as a reward.
• Avoid withholding food as punishment.
• Children should be encouraged to drink water and to limit intake of beverages with added sugars, such as soft drinks, fruit juice drinks, and sports drinks.
• Plan for healthy snacks.
• Stock the refrigerator with fat-free or low-fat milk, fresh fruit and vegetables instead of soft drinks or snacks that are high in fat, calories or added sugars and low in essential nutrients.
• Aim to eat at least 5 servings of fruits and vegetables each day.
• Discourage eating meals or snacks while watching TV.
• Eating a healthy breakfast is a good way to start the day and may be important in achieving and maintaining a healthy weight.
• Understand portion sizes and use them. When snacking, never eat out of the package. Always take a proper portion from the container for a snack.

For more information, call the Children's Hospital Community Relations Department at (865) 541-8165.

Reproduced and modified from:
www.surgeongeneral.gov/topics/obesity/calltoaction/fact_adolescents.htm