Get Positive with Children

Health professionals and others have expressed alarm at the rising obesity rates in all segments of the population, including children and adolescents. In less than 30 years, the obesity rates for children and teens have doubled, and for children ages six to 11, they have tripled.2Much has been written about the probable short- and long-term consequences of this obesity epidemic.^{1, 2, 3, 4} Obesity increases risk of developing type 2 diabetes, high blood pressure, heart disease and many other health problems. Obesity increases the likelihood of emotional health problems, as well, including low self-esteem, negative body image and depression. Many overweight children can attest to the observation that they are likely to be the object of bullying and discrimination.

Overweight kids in your facility

Many health organizations have exhorted the fitness profession to make room for overweight people, including children, and create opportunities for more physical activity. Since overweight kids often avoid sports and other group activities, they may be more likely to join fitness-focused activities that offer individualized programs. Your fitness center may offer programs especially for overweight children, or you may see these kids in your regular classes and programs. It's not always easy for fitness professionals to relate to overweight people. Fitness professionals may have a tendency to patronize overweight people, or to make weight control the focus of every discussion. Here are some ideas for working with overweight children and adolescents. (Many of these ideas apply to overweight adults, as well.) Encourage kids and teens to develop a healthful lifestyle. Healthful means becoming more active; eating more fruits, vegetables and whole grains; and limiting junk food. Most children have a pretty good idea of what foods they could eat less of. Depending on the nature of your work, you might be able to hand out simple fact sheets on healthful eating, or refer your group to the food guide pyramid website (www.mypyramid.gov). Don't make assumptions. Don't assume that overweight kids or teens have joined your program to lose weight. They may just be there to have a good time. Stay within your scope of practice. If overweight children and adolescents ask you about dieting, refer them to a nutrition professional or healthcare provider. Never suggest dieting, unless you are a nutrition professional and can be sure that the dieting takes a healthy form. Otherwise, diets can backfire. Children and teens may begin restricting calories too severely or moving on to other dangerous methods of weight loss, such as using diet pills, laxatives, diuretics and other drugs, including cigarettes. Get medical clearance. While obesity increases the risk for many health concerns, this does not mean that all overweight people have health problems. If health problems are present, refer clients to their providers, or accommodate them to the same extent you would other clients with those problems. Don't deliver a lecture on weight loss, even if extra weight may be part of the problem. Keep an eye out for heat injuries. Overweight children have extra subcutaneous fat. This fat reduces the ability of the body to give off heat to the environment. You must help to prevent heat injury in all of your clients. Allow everyone the opportunity to reduce activity levels in the heat, to drink plenty of fluids and to rest as necessary to prevent heat illness. Be supportive. Promote an atmosphere of support and respect for all of the children and teens in your facility. Channel energy into fun activities and challenging workouts. Build team spirit and forbid teasing. Do not tolerate bullying behavior. References 1. American Academy of Pediatric. Prevention of pediatric overweight and obesity. Pediatrics 112(2): 424-430, August 2003. 2. Aronne, L.J. Classification of obesity and assessment of obesity-related health risks. Obesity Research 10: 105S-115S, 2002. 3. Centers for Disease Control and Prevention. Children and teens told by doctors that they were overweight - United States, 1999-2002. Morbidity and Mortality Weekly Report 54(34): 848-849, Sep. 2, 2005. 4. Ebbeling, C.B., D.B. Pawlak and D.S. Ludwig. Childhood obesity: Publichealth crisis, common sense cure. The Lancet 360: 473-482, 2002.