Step By Step: Kids Trimming Down
• NOTES from Part 6 •

Pediatrician — Stewart Gordon, MD

Children sometimes endure traumatic emotional experiences because of their weight. Brandie Hunt underwent verbal abuse because of her weight. But, now Brandie is reaping the benefits of tackling her weight problems.

At the tender age of 9, Brandie had to learn how to live with being taunted about her weight. The mean and ugly treatment lingered throughout high school. “They would walk behind me in the hall and they would make noises. They would make elephant noises. They would make hippo noises. When I would get on the bus, people would scream, oh, the bus is going to fall over. The bus is going to fall over. It was one thing after the other. The more they made fun of me the more I would eat and the bigger I would get. It was just a vicious, vicious cycle.”

Brandie believes her problems began when her dad didn’t understand the difference between child and adult size portions, and insisted she eat everything on her plate. Her unhealthy relationship with food got worse as she got older. “If something would upset me I would go to the pantry. If we had a bag of Doritos, I’d go get the Doritos and I’d go sit in my room and turn on the T.V. and I’d eat the whole bag of Doritos instead of sharing my feelings, instead of sitting down and talking with my mom. As I got older it became Oreos and milk, cold double-stuffed Oreos and milk. If my boyfriend had broken up with me, I’d go to the store and get a bag of Oreos, get the milk and eat Oreos, the whole bag.”

As Brandie gained weight, so did her parents. Her mother would often help her finish up over-sized plates of food. The excess weight caused Brandie a lot of discomfort in her physical education classes. “They wanted you to run. I couldn’t run. The teachers didn’t like it. We had the president’s physical fitness awards. And, you had to do sit-ups. I couldn’t lift my shoulders off the ground.”

Brandie survived elementary, middle and high school, despite being bullied, and having very few friends. But, tragedy continued to follow her. She lost her father to kidney failure that was apparently related to his type one diabetes. And, then came more bad news for Brandie. Only one year after her father’s death, she was diagnosed with Type Two Diabetes. She was only 19-years-old. “I balled like a baby. That was the worse news anybody could give me.” Brandie consulted with her physician and a registered dietitian about losing the weight, but her efforts were short lived. By the time she was 23, 5-foot-3 Brandie had climbed to 245 pounds. Her doctor, Endocrinologist Joel Silverberg tripled her medication. “The reason her medication was increased was to reduce her risk of complications associated with diabetes, including heart disease, circulation problems, eye and kidney problems, 10 and 20 years down the road.” Like many diabetes suffers, Brandie still felt fine and she hadn’t allowed her weight to interfere with her career aspirations. By then, she was a nurse surrounded by other health care professional. They offered Brandie a world of support in conquering her problem. She also sought professional help from registered dietitian, Davie Frick. Within a year, Brandie lost 70 pounds and is still losing weight. The young nurse credits Davie with giving her all of the information and support she needed, when she needed it. She says Davie accepted her as she was, and only wanted to help. However, Davie gives Brandie all the credit. “She got up in the morning ad she ate right and she exercised. It’s just you making up your mind. And, every person is different in that aspect as far as what it takes. And, with Brandie, she just decided to get her life together at that point.”

Brandie’s doctor, Joel Silverberg wants her to lose another 25 pounds by simply eating healthy and exercising. And, she’s optimistic that will get her off medication she has been taking for seven years, medication she feared she would be taking for life. Her doctor likes her chances. “With exercise and weight loss, we reverse a condition called insulin resistance which is a factor in most patients. If she continues on that path, she won’t have to take the medication, but she will always have that monster in her closet. If the weight gain came back, the insulin resistance and diabetes would come back.”

Parents, these are not the kinds of risks you want your children saddled with as they grow older. They may not have diabetes. In fact, they may not suffer any ailments at all. But, they are certainly at risk. Remember any movement helps.

Federal health officials and those of us working in local clinics and hospitals are watching some very disturbing trends. Two-thirds of our adult population is already overweight. And, if we can’t break this cycle, most of our children will be overweight in a few decades. Take a look at the map from 1991 provided by the Centers for Disease Control. The darkest blue indicates that from 15 to 19-percent of the population in those states was obese. The lighter blue shows that from 10 to 14 percent of the population was obese. And the lightest blue indicates that less then 10 percent of the population was severely overweight.

There was no data available for the states in white.

Now lets see what happens 11 years later in 2002.

There is an alarming situation for the three states in red. More than 25 percent of the population is obese. The tan indicates that from 20 to 25-percent of the population is obese in more than half of our states. And, at least 15-percent of the population is obese in all the rest of the states.

Psychologist — Denise Sellers, Ph.D.

Many of you are making plans and working toward living a healthier lifestyle. But, some of you parents may feel unsure about how far you should go in encouraging your children to stick with the program. Generally speaking, the more personal responsibility you give your children, the faster they will understand their role in attaining and maintaining their physical well-being.

This means letting go enough to allow them to master their program themselves. The sooner the child can “set” and “abide by” his or her own limits, the better. It’s important that you as parents “not” take control of your child’s actions. Remember, you are the coach, not the controller. If the child has a bad week, don’t blame yourself. Rather, help lead her back on course. In the same vein, you can’t take credit when the child reaches her goal. It’s entirely her accomplishment. As is true of any coach, when the team drops the ball, it’s not the coach’s fault. And, when the team scores, it wasn’t the coach who threw the winning ball. That said, there are many issues that come along with independence.

Coping with failure

We all become familiar at one point or another with the features of failure. When your child doesn’t reach a goal, it’s important to work with her to access the situation realistically by evaluating her goals. Was the goal too difficult? Was there something going on in the child’s life that made the goal difficult to attain? Take a look at the big picture. Never look at the child as a failure and move forward by establishing new, easier goals.

Though I’ve told you, the child has to ultimately be responsible for sticking with the program; you as parent have to set restrictions.

Restrictions

If things aren’t progressing the way you hoped, the time will come when you should reflect on the household rules you made and whether or not you enforced them. It’s up to you as parents to initiate, model and monitor the restrictions.

Positive reinforcement

I want to stress the importance of positive reinforcement. When was the last time you said something positive to your child. When did you say something negative? I’ll bet you could have rephrased the negative comment to make it affirming, upbeat and encouraging. That’s something we all need to work on as parents.

Healthy choices

Your children will always have an easier time taking on responsibility and becoming more independent when they know they have healthy choices available to them. Remind children of their options. For example, let them know they can rake the leaves, vacuum the carpet or spend half and hour riding their bike. Or you may want to let children know they can’t have ice cream for dessert, but there is an array of other choices that are also sweet as well as delicious...things like strawberries, sugar-free and fat-free yogurt and watermelon. Having choices in every aspect of the program strengthens everyone’s commitment and sense of control.

Both parents and children, as you embark on changing your lifestyle, you need to be prepared.

Backsliding

There will be times when you backslide, but to different degrees. I have a list of definitions to help you deal with those situations.

• First, there are lapses or slips. Your child may engage in an old, unhealthy behavior once during a typical week, eating a fast food meal for example, or spending an entire day on the couch. If this happens, remember, this can be a planned treat.
• Then there is the relapse. Your child allows unhealthy behavior to surface three times within a single week. It’s time to become a little concerned.
• And, then there is the collapse. An unhealthy behavior happens every day of the week. It could either involve eating unhealthy food or failing to exercise.

The relapses are definite areas of concern. During these times, you need to sit down with a pen and paper and list the things that you can control that may have contributed to the relapse or collapse. Maybe you didn’t limit television time. Or maybe you slipped yourself and bought some unhealthy snacks.

Then, you need to list changes you can make at home to promote maintaining healthy habits.

Remember parents. It won’t do much good to make these lists if you don’t follow through on the changes you need to make. And, finally parents, and children...by now, you know I believe in making lists...writing things down.

Differences between normal and overweight people

I have some comparisons between things overweight and normal weight people do. This list will give you some things to think about, observe and hopefully change. First the things overweight people do:

• skip breakfast
• sit at desks all day
• snack too much on junk food
• always take the elevators or escalators
• walk around with drinks or food
• feel physically tired at the end of the day
• head for the sofa and t.v. to relax
• eat a large dinner late in the evening
• over-exert during rare exercise sessions
• eat midnight snacks
• stand impatiently at traffic lights and bus stops
• drink soft drinks when thirsty
• stand impatiently in store lines
• sit in one position for hours
• eat fast food three or four times a week

That’s while normal weight people

• eat a healthy breakfast
• get up every thirty minutes for two or three minutes of moderate activity
• schedule mid-morning and mid-afternoon snacks that are healthy for them
• take the stairs
• eat at the dinner table
• go for a walk or ride a bike to reduce stress and unwind
• eat a moderate dinner in the evening
• exercise moderately most days of the week
• sleep soundly because of a regular exercise schedule that helps reduce stress
• shift weight from side to side at traffic lights and bus stops
• drink water when thirsty
• do toe raises or shuffle their heels forward while waiting in store lines
• feel hungry when they wake up
• stretch at their desk frequently
• eat fast food only once every couple of weeks

Parents, it takes time and determination to go from an unhealthy to a healthy lifestyle, but, the rewards are worth it. Occasionally, children will become defiant or depressed while trying to make the transition from one lifestyle to the other. If you detect this behavior I suggest you contact a professional.

Registered Dietitian — Heidi Schumacher

Parents, you should teach your children that all three meals are essential in maintaining a healthy lifestyle. And, better yet, make a habit of preparing all three meals for the whole family.

Children often see their parents skip breakfast because you “don’t leave enough time” to eat in the morning. Some parents even think skipping meals will help them eat less and lose weight. Skipping meals, especially breakfast, is similar to asking your car to run without gasoline. Eating throughout the day is important to keep both your body and mind functioning properly. People who skip meals actually find it harder to lose weight than those who eat frequent small meals and snacks. Our bodies need us to “break the fast” in the morning.

Going long periods without eating such as sleeping all night and then skipping breakfast, and possibly even lunch, negatively affects our metabolism. It causes our bodies to actually slow down and burn less calories. The result is that we don’t lose weight and may even gain unwanted pounds.

Skipping meals can also make us eat far too much when we finally do eat. We tend to overeat or load up on high calorie snacks to hold us until our next meal. Studies also show that children who eat breakfast do better in school!

A healthy breakfast

A healthy breakfast should include protein such as eggs or egg substitutes, low fat cheese, peanut butter, low fat milk or yogurt.

You should also have a complex carbohydrate, such as bread, grains and cereal. When shopping for cereals, make sure you compare sugar and fiber content, looking for no more than 5 grams of fat and 15 grams of fiber. Oats is a great cereal for meeting this requirement.

Other healthy breakfast meals include low fat cheese toast, peanut butter on a bagel, fruit and skim milk, and an egg with whole wheat toast.

Breakfast does not have to consist of traditional breakfast foods. Eat a turkey sandwich or peanut butter and jelly sandwich on whole wheat bread.

Either will provide you a complex carbohydrate and a protein. Try an English muffin with ricotta cheese and salsa or a tortilla with beans and low fat cheese.

If there just isn’t time to sit-down for breakfast or you have a child who just doesn’t seem to get going in the morning, consider some breakfast meals that you can take with you. A bag of dry cereal or a low fat breakfast bar might work, or a small bagel or English muffin with peanut butter. You could also hand him a small carton of juice or a smoothie made with skim milk or yogurt and fruit to get in a serving of fruit.

Sometimes parents it’s helpful to prepare a pitcher of fruit beverages to have stashed in the refrigerator to grab on the run. Be creative! And remember your kids will probably do what they see you do. Sharing breakfast is a great time to not only eat together, but also give your kids some encouragement for the rest of the day.

Exercise Physiologist — Melinda Sothern, Ph.D.

Parents, it’s important to make sure your children are comfortable with what ever body type they inherited from you. And, body type is hereditary. While specific training can alter some aspects of your shape and posture, it can’t change everything. This means, some children may never appear as lean as others with different genetic profiles. However, they can always work to stay in good shape.

Some kids have denser, heavier muscles and bones. Their muscles are composed of more thick fibers called “fast twitch” that can generate lots of power over a short period of time. They have fewer “slow twitch” type fibers which generate less force, but can go for long periods. Their body types are better designed for activities requiring strength and power such as football, baseball, martial arts, boxing, wrestling, weight lifting, shot put, discus, long jump, ice skating, ice hockey, water polo, sprinting events in track and field, swimming, springboard diving, gymnastics and tumbling.

Others have a more average type frame. They will have about an equal amount of fast twitch and slow twitch muscle fibers. These people tend to do well in all types of middle-distance and moderate-intensity activities such as swimming, dancing, or brisk walking. They are also well suited for individual sports; martial arts, tennis, archery, bowling, sailing, golf, softball, hiking, snorkeling, scuba diving, water skiing and middle-distance field events.

Some children have body types that are more suited to do long distance events such as basketball, soccer, football, ice hockey, field hockey, track and field, long distance runs, pole vaulting, marathons and triathlons. Note, these are moderate to vigorous intensity exercises that take long durations of time. That’s because children with this body type have more slow-twitch fibers. It is important for kids to do all kinds of exercise, no matter what their body type. Keep in mind that all activity burns calories and improves overall health.

And, parents, children may need your encouragement in some areas. They will naturally gravitate to the sport that is more inline with their body type. For example, girls with large frames and heavy bones are more likely to excel in sports requiring strength and endurance such as volleyball, baseball and basketball. That’s while boys with small frames will do well in martial arts, gymnastics and soccer. It’s fine for kids to have their favorites. But, you should expose them to as many activities as possible, in settings that are both nurturing and inviting.

As your children get settled into an exercise routine, it’s easy for them to get bored. That’s when you may want to steer them toward cross-training. There are four basic types of cross training.

Cross-Training

1. Continuous cross-training is a regimen where you alternate endurance activities such as jogging and swimming. You do them at a consistent pace, at a specified period of time, from three to five times per week.
2. For interval cross training, the child gravitates among a variety activities, with periods of rest in between them. For example, the child may run very hard for one lap, walk easily for two laps, jog moderately for one lap, run very hard for one lap, and so on. The rate of intensity varies from very high to very low.
3. Fartlek cross-training is a more casual version of interval training, that’s typically done outdoors and on roads and trails. Children casually decide which routine they want to pursue based on how they feel at the time, or the lay of the land. They may run up a hill for ten minutes, walk on a level surface for five minutes, slowly jog downhill on flat land for 15 minutes, or whatever they feel like doing.
4. Circuit cross-training includes both strength and endurance exercises. Children move from one station to another, alternating between strength exercises like stomach crunches, to aerobic exercises like marching or running in place.

Parents you want to encourage your children to experiment with all these forms of exercise to see what works for them. See which programs appear too challenging, which ones leave your children feeling happy or sad; whether they sweat too profusely or their ankles, knees, or other joints hurt. Respond to the trouble areas, shortening programs, giving children more time to rest, more water.

The amount of sleep a child gets can also be a major factor in how well he or she handles an exercise routine. Once your child is settled into a formal exercise routine, he or she will often be challenged to stay on course. Trips to visit relatives during the holidays or summer vacations will interfere with your schedule. Plan stops at play grounds or parks in advance. If you are staying in a hotel with a pool, take advantage of it. Ask about exercise rooms. Take trips to zoos that will force you get out and do some enjoyable walking. If it’s a winter trip, try to get in some skiing, sledding or even just get out and build a snowman. If your children complain about having to stay active, remind them that they will feel sluggish if they do not exercise while on vacation. And, it will be much harder for them to get back into their routine when they get back home.

• NOTES from Part 6 •
Home • Information • Biographies

LPB Home

LEGAL DISCLAIMER: This information is for general information purposes only and does not address individual circumstances. It may not be right for you and should not be relied upon in making decisions about your health. Always consult your doctor for medical advice.