Childhood Obesity
The May Institute

Q: My eight-year-old son has always been a big child, but now he weighs over 100 pounds and I am worried. I have struggled with my weight since I was an adolescent and would like to help him avoid the unhappiness that comes with being fat. What can I do?

A: “Your son is not alone – the prevalence of childhood obesity has increased dramatically in the past few years. It has been estimated that 25 to 30 percent of children in this country are now affected,” states Lauren Solotar, Ph.D., chief psychologist for May Institute, who specializes in eating and anxiety disorders, depression, and childhood obesity.

“You are right to be concerned,” continues Solotar. “ Being obese – weighing 20 percent more than your ideal weight – does have psycho-social implications. There is ample evidence that being overweight in childhood and adolescence contributes to emotional disturbance, impairments in self-esteem and self-concept, and disturbances related to body image. Studies also show that obese youngsters are more likely to develop serious medical conditions such as heart disease, diabetes, some forms of cancer, and orthopedic problems."

According to Solotar, hormones or genes rarely cause obesity, although a medical doctor should rule out these factors. “Childhood obesity is usually the result of eating too much and exercising too little,” she explains. “It has been estimated that if obese children do not slim down by the end of adolescence, 80 percent will become obese adults. The good news is that you can help your son change his eating and exercise habits and get control of the situation. As with so many conditions, 'early intervention' is key in preventing future problems."

It is important to see an eating disorders specialist who can complete a detailed assessment of a child’s eating habits and level of physical activity. A good evaluation would include an assessment of your child’s cardiac risk factors such as family history of early cardiovascular disease, blood pressure levels, the presence of diabetes mellitus, and high cholesterol levels. This evaluation would also include a screening for orthopedic problems such as bowed legs or weak knees and ankles.
Television viewing habits and time spent playing computer games should also be reviewed.

Although obesity is very difficult to treat, it has been proven that "behavioral treatments," or teaching children and their families new eating and exercise habits, are superior to alternative treatments. With these techniques, children can begin to expend more calories than they consume by learning how to eat a well-balanced diet and increase physical activity.

Suggested behavioral treatment techniques include:
• Controlling portions: eating favorite high-calorie foods in moderate amounts while increasing intake of low-calorie foods
• Slowing down while eating: putting utensils down between bites, chewing food ten times before swallowing
• Eating in only one place - not in front of the television or in the bedroom
• Making low-calorie snacks (fruit and vegetables) more accessible than high-calorie snacks
• Decreasing television and computer time
• Increasing caloric expenditure - walk and play outside more, sit less
• Drinking more water and skim milk; drinking less fruit juice, whole milk, and sugared sodas.

The May Counseling Center in West Roxbury, Mass., offers a comprehensive outpatient program designed to serve clients with major mental illness, mood, anxiety, and personality disorders. For more information, visit www.MayInstitute.org