I listened as Michelle Obama was interviewed by Larry King on CNN recently about her thoughts and plans for solving the difficult problem of increasing childhood obesity. Mrs. Obama has taken some heat for using her own daughters as an example and for using the ‘DIET’ word. Mrs. Obama explained that recently their pediatrician warned that her girls were gaining weight and that she should change their diets. She reported serving dessert less often and serving water instead of sugary drinks and low-fat milk instead of whole milk. Mrs. Obama also reduced the girls’ TV time. Mrs. Obama was careful to say that her efforts are strictly about health and not appearance. Eating disorder organizations, though, have responded that anytime weight is focused on and weight loss diets are prescribed the results can be weight prejudice (stigmatizing those considered overweight), poor self-esteem, poor body image, eating-disordered behaviors, and even full-blown eating disorders.
Although Mrs. Obama is not adopting the approach that eating disorders advocates would like, the truth is that childhood obesity is a serious problem, there are no quick fixes and many approaches can cause more harm than good. My clinical experience of 20 years working with families and children struggling with weight have led me to conclude that the best solutions are:
* Well balanced family meals that include fun food every day. (see our Food Plan)
* Limiting "screen time" (TV, video games, internet surfing, social networking, IM-ing, etc.)
* Understanding that exercise can be fun and good for health but doesn't lead to weight loss
* Lots and lots of love and acceptance
On the dessert issue we disagree strongly with Mrs. Obama. Making desserts special by just serving them occasionally is likely to lead to overvaluing of desserts, overeating, and even weight gain.
A new study to be published in the March issue of Pediatrics involved a cross-sectional analysis of 8,550 4-year-old U.S. children shows that preschool children exposed to three household routines -- regularly eating family meals, getting adequate sleep, and limiting screen-viewing time -- had a roughly 40 percent lower prevalence of obesity than those exposed to none of these routines.
Now, onto my [Marcia's] soap box: All kids regardless of their weight need to have some exercise in their lives to maintain good health. In the perfect world, schools would provide 30-60 minutes of various physical activities everyday during the school day up through and including high school. The last thing any child needs is to have parents pushing them to exercise. Kids who are forced to exercise end up hating it and their bodies.
For parents looking for a good book on this subject check out [Your Child's Weight: Helping Without Harming by Ellyn Satter].
Marcia Herrin and Nancy Matsumoto, authors of the [Parent's Guide to Eating Disorders, GürzePress]