To Reverse Childhood Obesity We All Have to Work Together

Earlier this week I attended an eye-opening overview of a Scientific Statement published and funded by the American Heart Association in January of this year. The lead author, Myles S. Faith PhD, associate professor, Gillings School of Global Public Health, University of North Carolina discussed how parents' behaviors impact (or not) the actions of obese children.

Much discussion fills the space in broadcast, print and online media about how parents need to model eating and exercise behaviors in order to help their obese children lose weight and get in shape. It is not quite that simple.

The study, "Evaluating Parents and Adult Caregivers as 'Agents of Change' for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps," begins by surveying a total of 939 pediatricians (22% of the total), pediatric nurse practitioners (31%) and registered dieticians (47%). The study found that 39% of pediatricians perceived themselves as having "low proficiency" in behavioral management strategies. Their topline was that many health professionals lacked the knowledge of core behavior change strategies to manage childhood obesity.

The statement also reported on another survey of 87 primary care pediatricians and nurse practitioners and found that just over one-quarter of them knew the definition of childhood obesity and only 9% knew how prevalent it is. While one could argue that it is not the role of a physician or nurse to teach parents about childhood obesity, who will lead the discussion with the parents? I was surprised to learn that in the first year of a baby's life, more than a third of this surveyed group never discussed fast food, television or candy with the parents.

Dr. Faith explained that simply having parents involved in the treatment does not necessarily yield improvement -- and parental intervention results have been mixed. Many factors, including smallish studies, impact of more vs. less motivated parents and, of course, whether one of more of the parents themselves are obese does have an influence.

President Obama has issued a President's Challenge and First Lady Michelle Obama has declared a war on child obesity, stating that the goal of the Let's Move Program is to reverse this situation in a decade. But as this study reports, "many parents of obese children do not perceive their children to be obese and therefore may not be inclined to make changes."

So what can we do?

This review does offer concrete solutions. First step is to identify specific behaviors to be changed -- both by the child and the parents. The more specific, the report notes, the more effective. Rather than using generalizations (eating healthier or exercising more) detailing the exact amount of calories or fat or the amount of time on an exercise bicycle works better.

Myles Faith underscored the importance of self-monitoring -- writing down or keeping track of behaviors including what and how much is eaten and physical activities as they occur. The result is that this activity raises the awareness before the activity begins, which can stimulate a change. In fact, they state that the more someone self-monitors, the more weight loss and the longer term weight loss. Choose My Plate offers a free terrific online self-monitoring tool.

Parents must also offer positive reinforcement and praise. The statement actually recommends that this is one of the strongest strategies; in addition to: spending time together, non-monetary prizes and nonfood rewards (more positive empowering strategies for parenting are available from the American Academy of Pediatrics).

It is time to stop pointing fingers and start all working together: at home, in schools and in our doctors' offices.

(Full disclosure: I also presented "Consumer Trends Influencing Purchase Behaviors in the Supermarket" at this conference without receiving any payment or reimbursement).

 

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Comments

[Phil Lempert]

04:52 PM on 03/19/2012

Appreciate everyone's comments on this column - thanks. But do want to clear up any confusion that has been raised over my relationship with ConAgra Foods. I am proud to be associated with this company who prides itself on offering some of the top brands in our supermarkets. My role is to help shoppers understand where our foods come from, how to read labels and how to save money and shop smarter. ConAgra Foods has never influenced or edited what I write or say in my columns here on Huffington Post, on my website supermarketguru.com, in my newsletters, on my radio show or television programs and appearances. Our relationship is one I value, which is why right here, and everywhere else I am upfront and disclose our partnership.

[Karl Wilder]

02:16 PM on 03/15/2012

It is up to the parents and really simple. Buy almost nothing in bottles, boxes, cans or jars (except things like dried beans, lentils, rice etc. ) Both you and your children need to eat less and move more.

[Jason Lilly]

02:10 PM on 03/15/2012

Solving childhood obesity starts with the parents. They are the role models that will be followed. Obesity is preventable, but the problem is that the health and fitness industry are out to make money, not help people get results. Billions are spent on fitness, yet the obesity rate keeps rising. There is an obvious disconnect there.

That is why I started a non-profit organization that provides a complete program...exercise, nutrition, personalized support from people who really care...100% for free. We take money out of the equation and make it about helping people. It is called LiveFit Revolution.

We are getting incredible results and touching a lot of lives. Hundreds of people losing thousands of pounds. We are making in impact. We are fighting to get the word out there: if you want to lose weight and need help, we are here for you.

Thanks again for the article. Jason - livefitrevolution.org

[HealthHabits]

11:22 AM on 03/15/2012

Another new study came out today saying that the number one way in which parents can help an obese child lose weight is to lose weight themselves. In this study, it was the most important predictor of child weight loss.

http://www.healthhabits.ca/2012/03/15/childhood-obesity-monkey-monkey/

[John2021]

10:28 AM on 03/15/2012

No, Mr. Lempert, you can not be both a Con Agra Spokesman and a credible voice against food abuse.

What next? The Pablo Escobar Drug Treatment Center?

We were born recently, but not yesterday.

[radfatty]

11:09 PM on 03/14/2012

I would like to recommend the free NAAFA Child Advocacy ToolkitSM (CATK) and other written guidelines/resources to assist you looking at programs.

A Yale Rudd Center report reviewed existing research on weight stigma in children and adolescents, with attention to the nature and extent of weight bias toward obese youths and to the primary sources of stigma in their lives, including peers, educators, and parents. As a result of weight bias and discrimination, obese children suffer psychological, social, and health-related consequences. http://www.yaleruddcenter.org/resources/upload/docs/what/bias/StigmaObesityChildrensHealth.pdf

Rebecca Puhl of the Rudd Center further brings to light the stigmatization of large children in the following article.
http://www.obesityaction.org/magazine/oacnews7/Childhood%20Obesity%20and%20Stigma.pdf

The NAAFA Child Advocacy Toolkit shows how Health At Every Size® takes the focus off weight and directs it to healthful eating and enjoyable movement. It addresses the bullying, building positive self-image and eliminating stigmatization of large children. The CATK lists resources available to parents, educators or caregivers for educational materials, curriculum and programming that is beneficial for all children. It can be found at:
http://issuu.com/naafa/docs/naafa_childadvocacy2011combined_v04?viewMode=magazine&mode=embed

[crimminy]

10:46 PM on 03/14/2012

I read this thinking, why does this say something and nothing at the same time. Then I looked up Phil Lempert and saw he has partnered with Con Agra foods, as a spokesman for the company. Obesity is an issue because of many of the products from Con Agra, including Manwich, Parkay, Banquet Brown N. Serve, Peter Pan, Crunch N Munch, Reddi-wip, Slim Jims Chef Boyardee etc... many of these processed foods with ingredients that contribute to obesity. Children need to be eating fresh fruits and vegetables, so his "reinforcement and praise" recommendation won't work when corporations are promoting quick snacks/dinners with highly processed foods. The economy is in bad shape, which means more and more parents are stressed, and having to both work, having less time to shop for fresh ingredients and buying more processed foods. So Mr. Lempert, you could have easily rewritten this to talk about shopping the perimeters of the market, serving organic foods, and offering simple and easy recipes.