Obesity in children - support for families

Introduction

Weight problems are common among children in Australia.  At least one in four school-aged children in Australia are overweight or obese. If you think your child may be above a healthy weight, they should be correctly assessed by a health professional as their weight could be causing other health problems. Your local GP/paediatrician will be able to measure their growth and level of development and provide advice.

Younger children, unless very overweight, should not actually lose weight, but grow into their weight.  Deliberate weight loss in children can affect growth and development. Check with your GP if your child is in the healthy weight range.

Talking to children about their weight can be difficult. Tips for talking about weight with children include:

• focus on healthy behaviour changes. Remind them about positive changes
• get the whole family involved. Children are best able to make changes when they feel well-supported, not “targeted”
• unless advised by a health professional, focus on health/healthy lifestyle, rather than weight loss
• avoid labelling people as fat, chunky or obese. Use phrases like: “not a healthy weight for their age” or “above average weight”
• help improve your child’s self-esteem. Praise them, give compliments and encourage qualities not related to their appearance
• avoid negative-sounding comments like: “don’t you think you should…” or “you shouldn’t be having that.” Children interpret this as nagging and are less likely to do what you want them to do
• be mindful of negative commentary about your own body
• if your child makes an unhealthy food choice, don’t make a big deal. Wait until the right time to talk about what they could have done differently
• encourage children to talk about any bulling or teasing about their weight and encourage self-esteem in other areas
• avoid fad diets. They can lead to disordered eating, poor self-esteem and more weight gain overtime.

The main factors that can influence weight for children are their food intake and physical activity. Parents can support their kids to make healthy choices by providing suitable foods and drinks in the home, discussing healthy options for outside-the-home, and being a healthy role model.

Changing your lifestyle to achieve a healthy weight isn’t as hard as it may sound. Your family can reach healthy goals by changing a few unhealthy habits.  Goals should be small, realistic and involve the whole family.

Tips for a healthier lifestyle:

• limit screen time to less than two hours per day. For younger children, keep screen time to under one hour per day
• eat together once a day as a family and turn off devices
• spend at least 60 minutes outside every day (playing or being active)
• choose water as your main drink: fruit juice, cordial and soft drinks should only be occasional treats
• eat breakfast every day
• swap all full-cream dairy foods for low-fat options
• eat more fruit (two serves/day), vegetables (5 serves/day) and nutritious snacks
• do not skip meals. Eat at regular times (three main meals + 2-3 optional healthy snacks per day) - this will regulate appetite
• limit takeaway food and high-fat snacks
• use low-fat cooking methods
• learn how to read food labels (e.g. look for products with less than 10g of fat per 100g)
• encourage your teen to eat slowly and chew food well
• aim to fill half the plate at main meals with salad or vegetables. If your child says they don’t like vegetables/salad, do not substitute with other foods
• plan your shopping list around healthy meals. Avoid high-energy snack foods such as chocolate, potato chips, lollies, and sweet biscuits regularly
• choose whole grain-based breads, pasta and breakfast cereals, as they are more filling than processed white varieties
• don’t keep unhealthy food choices in the house
• include regular, portion-controlled treats once or twice per week: this gives a balance between good nutrition and overeating
• when dishing out dinner, aim for ½ plate of vegetables or salad, ¼ protein (i.e. red meat, fish, chicken) and ¼ carbohydrate (i.e potato, rice or pasta)
• children do not need adult sized meals.

Physical activity is important for a healthy lifestyle.  Exercise helps growth and muscle development, while also keeping your child’s bones, heart and lungs strong and healthy.

The Australian guidelines for physical activity are:

• one hour of physical activity per day: moderate/vigorous physical activity - this means children are “huffing and puffing”
• less than two hours of screen time per day.

Physical activity can be incidental, adding up across the day, or organised like sport. Both forms promote a healthy weight; however, ‘lifestyle’ exercise is usually easier to stick to longer term. 

Tips to increase physical activity include:

• encourage time outdoors each day for play. Children need to be set-up to play outside. Put out basic play equipment and start by playing a game with them
• make exercise fun (map games, twister, hide and seek)
• encourage outside play: try running, chasing, playing outdoors, scooting, skateboarding, bike riding and going to the park
• organise activities around the house e.g., a ball in the backyard
• pack a healthy lunch and go out for the day - have a picnic at the park and take a ball to kick around, or go on a family bush walk
• try some extra “incidental activity” like walking to and from school, doing household chores and walking up stairs
• offer pocket money for active jobs like walking the dog, washing the car and gardening
• put up a basketball or netball hoop
• buy inexpensive play equipment such as totem tennis, badminton or a skipping rope
• make the most of daylight savings and go for a regular, family walk
• on warmer days, visit the beach or swimming pool.

If your child has been advised to lose weight, the whole family can make some small changes. Children need support to lose weight – they can’t do it without you. If everyone in the family makes healthy food choices and is more active, then it is easier to be consistent. 

Things to Consider:

• the food you offer and the brands you buy make a huge difference to you and your child’s health. Consult with your dietitian when making new, healthy food choices
• children learn from your example. When you make changes, they are more likely to copy you. That’s why it is critical for parents/carers to model healthy behaviours
• kids may not be motivated to lose weight. Never rely on willpower alone; instead, change the environment for everyone
• ensure children are living in a healthy environment. Keep tempting food such as cakes, biscuits, soft drinks and chocolate away from the house and stock up with healthy foods and snacks
• implement family rules about how much screen time each person has every day, ensuring it is limited to less than two hours a day
• to encourage activity, do things together as a family such as walks, bike rides or picnics on the weekend.

The length and the quality of your child’s sleep can affect their weight, and vice versa.

Sleep and weight are strongly connected in children - not getting enough sleep can change how hormones work, leaving you more likely to have a bigger appetite and gain weight.

Getting extra sleep can often help children who are obese to lose weight. Generally primary school-aged children need a lot of sleep – often more than you think!

If you are not sure what time your child should go to bed:

• work out what time they need to get up in the morning, so they have enough time to sit down and eat breakfast and do other essential things before starting the day. Then, count back between 10 and 12 hours.

Things to consider:

• daily exercise helps sleep. It is best to avoid rigorous physical activity within one hour of sleep time
• encourage your teen to be consistent with sleep and wake up time. Adolescents should not stay up too late or sleep in, even on weekends
• having a set way of doing things every night helps kids get to sleep. For example, the routine might be dinner, bath, books and bed
• it also helps if kids sleep in their own bed
• to avoid daytime naps, encourage your child to stay off the bed during the day
• children should have a period of time to wind down before bedtime with a shut-down of all electronic devices. Screen time should stop at least one hour before bed time
• do not have a television, game console, or computer in the bedroom
• as a family, talk about the need to develop better sleep habits and put some strategies into action
• often kids resist going to bed and can be disruptive at bedtime. It’s important to stay low-key and calm. If children get up, persistently take them back to bed.

If you have concerns about your child’s sleep, speak with your doctor. It is particularly important to talk to your doctor if children are snoring or sound like they are having difficulty breathing when asleep.