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Talk the talk. Take a walk.



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Old 07-31-06, 04:09 PM   #1 (permalink)
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Talk the talk. Take a walk.

Talk the talk. Take a walk.
There are many ways to fight childhood obesity, but it starts with communication
By KRISTIN FINAN
Copyright 2006 Houston Chronicle

Although the Centers for Disease Control and Prevention purposely avoids using the word obese in reference to children, many doctors are now recommending that parents be more frank when discussing issues of weight with their kids.

"To ignore the weight issue (of an adolescent) is almost like the elephant in the room that no one's talking about," said Roberta Anding, a clinical dietician in adolescent medicine at Texas Children's Hospital.

Thanks to a recent debate criticizing the CDC's fuzzy terminology — which categorizes obese children as "overweight" and overweight children as "at risk of overweight," in part to avoid hurt feelings — the issue of childhood obesity has once again been brought to the forefront.

If untreated, overweight and obese children can find themselves with serious health problems such as Type II diabetes, high blood pressure, hypertension, depression and low self-esteem. Currently, about 17 percent of U.S. children are considered obese.

"Many parents of obese children do not perceive their children to be obese," said William J. Cochran, vice chairman of the Department of Pediatrics at the Geisinger Health Clinic in Danville, Pa., and a member of the American Academy of Pediatrics' task force on obesity. "It's important to catch it early on in life."

Here's a guide for evaluating your children and talking to them about their weight.

First, you'll want to determine if your child is overweight or obese using his or her body-mass index, which is based on height and weight. Doctors generally consider children overweight if their BMI is between the 85th and 94th percentiles and obese if their BMI is in the 95th percentile or higher.

Although many BMI calculators are available online, the best way to get a sense of where children fall in the percentiles is to visit their doctor.

"They can always use their pediatrician who knows their child for an accurate assessment," Anding said. "Primary care would be the first line of defense if you believe your child has a weight problem."

Once a problem is determined, have an honest but gentle conversation with your child.

"Be a partner with your child rather than being critical," she said. "Be sensitive to their concerns."

Rather than nagging your children or criticizing them, outline little changes to be made over a period of time.

"Diet and physical activity are the two key pillars, and they're both equally important in my estimation," Cochran said. "It's going to be overwhelming, so try to achieve one or maybe two changes a week."

He said little things — such as switching from ice cream to fat-free Popsicles or going for nightly walks or bike rides — maintained over long periods of time can ultimately result in great changes.

Additionally, try not to single your child out but rather emphasize that the changes are intended to make the whole family healthier. Make sure the rest of the family is on board.

"It's tough if you have Dad come home and break out the chips and watch TV all night long and tell the 10-year-old child you can't do that," Cochran said. "You need to have a significant lifestyle change."

Also, reinforce to your child and remind yourself that you don't expect to see any changes overnight.

"Some parents can be overzealous. We see children who start off obese initially and end up undernourished. We don't want to impair their growth," Cochran said. "The longer the child has been overweight and living the unhealthy lifestyle, the harder it is to change things."

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