If you work with parents of overweight or obese children, it’s essential to offer recommendations that not only will help the children lose weight but also improve their overall health. After all, obese children are at a greater risk for type 2 diabetes; high blood pressure, high cholesterol, and CVD; joint and musculoskeletal problems; anxiety and depression; fatty liver disease; and breathing problems such as asthma and sleep apnea. I’ve worked with such clients for the past three years, and what I’ve found to be most effective is to present research-based information in a motivating and engaging way. Offer two to three tips families can implement the same day as the session. Here are a few recommendations for effectively counseling children and their families.
Give a visual explanation. A picture is worth a thousand words. The Centers for Disease Control and Prevention growth charts are used for US children aged two to 19 years by plotting their height, weight, and BMI. A child is classified as overweight when his or her BMI is ≥85th percentile and <95th percentile. Obesity is measured as a BMI ≥95th percentile. Showing parents where their child plots on the curve is an attention-grabbing technique. It may encourage the family to be more attentive to their child’s BMI trends and receptive to healthful lifestyle recommendations.
Encourage parents to be prepared. Having healthful, ready-to-eat food is helpful for the whole family. Suggest cutting up fresh fruit and veggies in advance and placing them in snacks bags. Fill a refrigerator drawer with healthful and preportioned snacks that parents and children can grab, such as bean salad, fruit with low-fat cheese, or hummus with pepper sticks. Limit processed foods by making your own version of baked sweet potato chips or muffins with grated zucchini or carrot.
Limit the sweet stuff. Excessive sugar intake has been linked to obesity and type 2 diabetes. Instruct parents to limit foods with added sugar and replace with items that have natural sweetness such as fruit and low-fat yogurt. For example, cut up whole wheat waffles with a side of low-fat yogurt as a dip instead of loading them with syrup; top unsweetened cereal or oatmeal with fresh fruit; stuff a whole wheat peanut butter sandwich with banana slices to replace jelly; omit sugar-sweetened beverages and encourage water; and infuse water with lemon, melon, or cucumber. (For optimal taste, allow infused beverages to sit for a few hours in the refrigerator.)
Make it a family affair. Advise parents to lead by example—children are always watching. If the whole family is involved and supportive of healthful habits, the overweight/obese child likely will follow suit. Suggest family members go on walks together, the kids participate in grocery shopping and meal preparation, and be engaged when spending time together.
Keep moving! It’s recommended that children participate in 60 minutes of physical activity daily, but this doesn’t mean they need to hit the gym! Suggest fun activities such as an organized team sport, biking at the park, dancing at home, or using a child-friendly exercise app.
Be a media mentor. It’s 2017, and it seems electronics are glued to children’s fingers! Generally, screen time should be limited to less than two hours per day. This includes cell phones, tablets, video games, and television. The American Academy of Pediatrics offers an extensive Family Media Use Plan on its website that creates an individualized guide for meeting a family’s needs and goals. Device curfews, digital safety, and setting screen-free zones are a few areas clients should consider when developing media use plans for their families.
Reinforce with nonfood rewards. Advise parents of obese/overweight children to create motivation and reinforce healthful habits with incentives. A family trip to the park, a game night, a new book, or a music download all can reward a child for meeting his or her health goals and persisting with effort.
— Kimberly Wolf, RD, LDN, CDE, is a registered dietitian and certified diabetes educator in the Philadelphia area. She has experience working with pediatrics and adults to better one’s health. Her areas of interests include wellness, writing, and motivational interviewing.