One third of American children are overweight or obese, a health risk that increases the odds of heart disease, diabetes, and other killers. Need more convincing that being overweight threatens children's health? A report just out from the federal Centers for Disease Control and Prevention says that 20 percent of American teenagers have abnormal cholesterol levels.
Given these dismal numbers, the public-health folks are doubling down on efforts to prevent and treat childhood obesity. Earlier this week, the U.S. Preventive Services Task Force recommended for the first time that all children be screened for body mass index, as my colleague Katie Hobson reported. And first lady Michelle Obama is about to launch her own intiative against child obesity, emphasizing "common-sense, innovative solutions."
Parents have to be deeply involved if a child with a serious weight problem is going to lose pounds and keep them off, according to Daniel Kirshenbaum, a clinical psychologist who is clinical director of Wellspring Academies, a residential weight-loss program for children and teenagers. That means parents also have to change their french-fry-scarfing, couch-potato ways. "You gotta strap on a pedometer, eat a very low-fat diet," Kirschenbaum says. "The parents have to do it in parallel with their kids."
There is good help out there, but finding an antiobesity program that works for children can be tough. Researchers have found that just telling kids to lose weight can do more harm than good and that an educational session or two with a pediatrician or nutritionist doesn't spark long-term change. Even just using the word "diet" can backfire; teenagers told to diet actually gain more weight than teens who are encouraged to live more healthy lives.
So what works to help kids lose weight? The USPSTF analyzed research on children's weight-loss programs. It reported in Pediatrics that the weight-loss programs that worked best for kids were "medium- to high-intensity comprehensive behavioral interventions." The programs provided more than 25 hours of treatment over six months, including nutrition counseling, behavior-change strategies, coping skills, and relapse prevention. One program cited, Bright Bodies at the Yale School of Medicine, provides a weekly education program for parents and kids, plus twice-weekly exercise sessions.
Here's now to find a behavioral intervention program weight-loss program for children:
- Ask your pediatrician for a referral and check with nearby universities to see if they have a program with more than 25 hours of sessions in six months. Several universities offer the Smart Moves program, which is the basis for Bright Bodies.
- Look for a cognitive behavioral therapist who provides individual or group sessions for childhood obesity through the Association for Cognitive and Behavioral Therapy. CBT is a short-term form of therapy focused on changing behavior.
- Consider a summer camp that uses cognitive behavioral therapy and involves parents in the process. The Wellspring Camps and Camp La Jolla are two examples. You don't want a "fat camp" where kids are starved and forced to exercise. You want a program that teaches kids how to live a healthy, active life.
Intensive programs like these are not only scarce but can also be expensive. Health insurance may pay for cognitive behavioral therapy, but residential camps run more than $1,000 a week, with insurers reimbursing a fraction of the cost, if that. The USPSTF recommendations may help push insurers toward better coverage, but until then, parents who need a comprehensive program for their child are faced with financing it out of pocket.
Fortunately, there are inexpensive things parents can take to help their children lose weight, or just live healthier. These constitute a good first step. If these don't work for your family and child, cognitive behavioral therapy or a comprehensive program would be next on the list.
- Have everyone in the family get 60 minutes a day of fun physical activity; limit screen time to 2 hours a day; eat a low-fat diet; and have the family eat meals together as often as possible. Check out the "We Can" childhood obesity prevention program from the National Heart, Lung, and Blood Institute for practical advice.
- Find a low-cost support group for parents and kids like Take Off Pounds Sensibly or Weight Watchers. Members share their tips for adding more activity to the day and eating better.
- Check out a book geared towards teens, like Weight Loss Confidential by Anne Fletcher. It gives teenagers' experiences and feelings a voice, while providing practical information for parents.