Too Heavy, Too Young

At 16, Lloyd Lamb already knows a thing or two about cruelty and loneliness. The Marion, Ind., 10th-grader is bright and outgoing. He plays golf and wrestles. He is also 5 ft. 8 in., weighs 200 lbs. and at times suffers the taunts of classmates. Lamb says he works hard to ignore them, but there are moments, he admits, when he gets “depressed and lonely.”

There must be a lot of lonely kids in America these days, judging from the skyrocketing rates of childhood obesity. According to the latest federal figures, the percentage of youngsters ages 6 to 11 who are overweight has tripled since the 1960s, to 13%. As many as 1 in 7 kids is obese, and doctors are seeing dangerously obese children as young as age two.

“We’ve never had a population like this before,” says Naomi Neufeld, a pediatric endocrinologist and director of KidShape, a nonprofit weight-loss program in Los Angeles. “Children who are overweight are 20% to 30% heavier now than they were even 10 years ago. We can’t even imagine the medical costs we will be seeing in the future. It feels like Armageddon.”

That’s hardly an exaggeration. Last month the Surgeon General issued an urgent call for the nation to fight its growing weight problem, a move that was sparked in part by the epidemic rates of childhood obesity. Overweight children are more than twice as likely to have high blood pressure or heart disease as children of normal weight. Even more alarming is the number of children with Type 2, or non-insulin-dependent, diabetes. Once known as adult-onset diabetes–before so many children started getting it–Type 2 diabetes puts kids at risk for very adult ailments, including blindness, nerve damage, kidney failure and cardiovascular disease.

What can parents do to protect their children from the dangers of too much poundage? A lot–especially if they start early, before their kids get into the habit of eating high-fat, high-sugar foods and out of the habit of exercising regularly. Kids are most vulnerable to ballooning weight in early childhood and then again in adolescence, says Dr. William Dietz, director of the division of nutrition and physical activity at the Centers for Disease Control and Prevention in Atlanta. Children normally lose fat from ages one to six or seven. When they start putting on excess pounds as toddlers, they are at heightened risk for obesity in adulthood for reasons that are not well understood.

Genes certainly contribute, but there’s much that parents can do to influence the way their children eat and to lower the chances they will end up obese. Young children are keenly attuned to how many calories they need to grow and maintain a normal weight; they know when they are hungry and when they are full. But most kids quit listening to those internal cues by the time they reach school age. The reason? Parents, says Leann Birch, a psychologist at Penn State University. “There are things parents do with the best of intentions that turn out to be counterproductive,” she says. A familiar example: insisting that children clean their plate, a rule that can teach kids to eat when they are not hungry.

Parents can influence what their children like to eat. Kids are born with a sweet tooth and a salty one, but they have to learn to enjoy other tastes. They often need repeated introductions to such healthy fare as beans and other veggies. Using dessert to bribe kids into eating nutritious food can backfire, says Birch. “If kids are given one food as a reward, they will learn to prefer that food,” she says–and they will learn to feed the vegetables to the dog.

A better technique is to put several items on the plate and get kids to try a bite of each. Birch also recommends that parents learn to serve appropriate portions (two sites that provide excellent guidelines: www.health.gov/dietaryguidelines and www.cspinet.org/kids/index.html) Parents should limit the amount of treats and junk food in the house, she says, including soda and fruit juice. Restricting access to a pantry full of fatty snacks and sweet drinks can make forbidden foods seem all the more desirable.

The flip side of the weight equation is, of course, exercise, which American children are getting less of than ever before, due at least in part to television, computers and video games. According to a recent Nielsen report, kids between the ages of 2 and 11 watch an average of 20 hours of TV per week, an activity that doesn’t burn many calories and tends to encourage snacking by exposing kids to all manner of food and beverage advertising. Simply turning off the tube can help kids keep off the excess weight.

In a landmark study published in 1999, Thomas Robinson, a pediatrician at Stanford University, compared the TV habits and weights of two groups of third- and fourth-graders. Half the kids, most of whom were of normal weight, attended classes that taught them how to monitor their television and computer time and to replace it with other activities. At the end of the year, kids in the special program had gained an average of 2 lbs. less than the control group. Obesity experts recommend that parents remove the television from their children’s rooms and set strict limits on time spent in front of a screen, including the computer. Giving kids alternatives to zoning out in front of a screen is key, says Robinson.

Once a child has gained too much weight, it’s time to get outside help. Many parents turn to weight-loss camps for kids, an industry that seems to be growing as fast as America’s waistline. Camp can seem like the answer, especially when an overweight child comes home as much as 50 lbs. lighter–but beware. Kids who lose in the summer often gain it right back come fall.

Parents should look for a camp that teaches kids to make lasting changes in their eating and exercise habits. Lloyd Lamb attends Camp Vanguard, in Lake Wales, Fla., where he has learned to look at the labels on food for fat content and to walk after meals. He lost 40 lbs. last summer, his fifth at the camp. His parents have also learned to follow a healthier diet.

Indeed, any program that treats kids successfully has to involve the entire family, says Leonard Epstein, a psychologist at State University of New York at Buffalo and director of one of the most successful pediatric-obesity programs in the country. “You really need to include the parents as part of the treatment,” he says, if only because parents of obese children are often overweight or obese themselves. Usually, the entire family could stand to modify its diet and reduce high-fat foods and sweets. Epstein encourages families to build exercise into their daily lives, taking walks together after dinner, for instance, or turning off the TV on weekends.

If parents want to protect their kids from obesity, they need to look beyond the home to their children’s schools, where phys ed and recess are going the way of art and music. At the same time, hundreds of cash-strapped school districts around the country have turned to soft-drink bottlers, who offer as much as $100,000 a year for exclusive “pouring” contracts to place vending machines in school hallways. Principals have opened their cafeterias to such fast-food franchises as Taco Bell and Burger King. “If your task was to make the American child as unhealthy as possible, could you do much better than fast food and soft drinks in the cafeterias?” asks Kelly Brownell, a psychologist at Yale University.

Parents can try to change some of these things, but they can do only so much by the time their children reach adolescence. Restraint and self-control have never been America’s strong suits. It’s tough for parents to teach teenagers to listen to their bodies, to eat when they are hungry, to taste what they are eating, to eat appropriate portions and to leave food on their plate. Lasting behavioral change cannot be imposed from the outside. These are internal battles and will ultimately have to be fought by the kids themselves, one chubby bulge at a time.

–Reported by Ellin Martens/New York, Jeanne McDowell/Los Angeles and Maggie Sieger/Chicago