About one in four children, and sixty per cent of adults in Australia are overweight or obese, which means there is now a skewed perception of what a healthy weight looks like, according to Paediatric Endocrinologist Dr Gary Leong.
In lower socioeconomic areas particularly, where the obesity rate is higher, “everyone can start to look normal even though they’re overweight or obese,” said Leong, who has a private practice, The Children’s Clinic in Bondi Junction. He said that parents’ lack of perception about their own weight and their children’s is a barrier to tackling the issues behind childhood obesity.
It’s a family affair
“A child’s diet and lifestyle habits can stem from their parents’ history as children. Often an overweight child has one or two [overweight or obese] parents....With the stress of money and mortgages, often both parents work and perceive themselves as time-poor. The family’s social behaviour can revolve around watching TV and eating [junk food instead of] home-cooked nutritious meals.
“Children [typically] get driven to school, to the shopping centre, to pick up takeaway. Unless they’re in a sporting program or active [with their] family, weekends can be sedentary.
“A lot of what I do involves [empowering] the parents [with knowledge on what being healthy means], to get the mother and father on the same narrative...They need to set common boundaries around food and lifestyle habits, like putting the iPad or iPhone away and exercising outside instead.”
Leong advocates the Ellyn Satter Institute’s eating and lifestyle-habit philosophy. A registered dietitian, Satter discusses the division of responsibility. “The parent is the role model, providing the child with healthy food and peaceful [mealtimes]. The child’s responsibility is to eat [what’s provided],” Leong said.
Giving a ‘fussy eater’ chicken nuggets and chips instead of the grilled chicken and vegetables everyone else is having “isn’t the solution.
“Parents should be introducing a variety of fresh real foods to their children as soon as they start solids at six months.
“If a child immediately spits out avocado, the parent might [assume] they don’t like it. But the child needs [to explore healthy food] and will acquire a liking for it if given the chance.”
The key to successful weight loss for kids
Readiness to change, with parental acknowledgement that the whole family needs to make diet and lifestyle-habit changes is crucial, Leong said.
“This often only happens after a parent has their own health crisis, for example [a heart attack, or the] development of type 2 diabetes due to being overweight or obese. This [prompts them] to search for a solution for their child with obesity.
“Most of the children I see do successfully lose their excessive weight or slow their weight gain down...Younger children are clearly more amenable to their [parents’ influence]. It’s harder in the teenage years when adolescents have established unhealthy habits and their own views and are trying to develop independence.
“While [overweight and obesity rates] may be levelling off in children under five, the prevalence of severe obesity is worryingly increasing from adolescence.
“Once you’re well above the 99th BMI percentile [as a teenager] you’ve got a [greater] risk of complications - prediabetes, type 2 diabetes, fatty liver disease, and sleep apnoea. The [earlier] you can slow your weight gain down or grow into your current weight the better.”
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