Fat Children

Exactly what being overweight is is difficult to measure and even harder to define. Causes may be many and specialists all have different ideas and approaches to the subject. However, there are some general points which can be made to help parents who think their child may be becoming fat, or is fat already, or who have a weight problem themselves and are anxious that their child may follow suit.

The first is that prevention is better than cure and it is probably easier to help a tubby child slim down in the pre-school years when parents still have greater control over what is eaten, eating habits are not as fixed and the child is distracted from food with less difficulty. Later, when a pattern of eating too much and being fat is established, it can be very hard to change.

So at what point should you begin to watch your child’s weight? Start by seeing that your baby does not get too fat because this will make him more prone to respiratory illnesses and he may be slower to do things like turning over, sitting up, crawling and walking just because too many rolls of flesh make it more difficult. Most fat babies grow into normal-weight children and it is only a small proportion of them, about one in ten, who are still fat when they start school. Include a good range of fruit and vegetables, cereals and small servings of high-protein foods. Distract the older baby with finger foods and smaller quantities of spoon foods at meal and snack times. Usually rolls of fat start to disappear during the second year when the child learns to walk, becomes more active and able to do more, and is usually less interested in food. For these reasons parents should always let a child’s appetite dictate how much he eats and not try to force or coerce him into eating more.

Probably the best way to prevent a child becoming fat is to teach good eating habits in the early pre-school years. This means eating a wide range of different foods and not just a very few favourite items – many fat children are also extremely fussy about what they eat, sticking to just a narrow range of foods, and have a tendency to dislike fruit and vegetables. Offer pieces of fresh fruit or raw vegetables instead of crisps, cakes or sweets as edible treats or mid-morning or supper snacks.

It is very important for you to teach your child that eating is something that happens at specific mealtimes and to give only a drink in between meals to the child who is overweight. Continual nibbling will also make children likely to refuse the more nutritious food you offer at mealtimes. Teach your child to drink water right from the start and keep very sugary drinks like Cola, lemonade or sweetened squashes for special occasions. If a child stays fat after the first year of life, or after being normal suddenly becomes fat and gets into the habit of eating sugary, high-fat, high-calorie snacks and drinks, his risk of growing into an overweight teenager and adult is greater. If a child is fat at seven he has an almost 50% chance of continuing to be fat into adult life.

Why do some children become or stay fat? We do know what makes them fat – taking in more energy from food than is needed so that extra energy is stored as body fat. But even at that point the matter becomes complicated because all children sometimes eat more than they need – so why do some stay slim and others become fat? Obesity runs in families, so a child with two fat parents has a much higher chance of becoming fat himself. Whether this is because of some inherited tendency to obesity or because families share similar eating habits and attitudes to physical activity is uncertain: probably both factors are involved.

A pattern of eating more than is needed may begin for various reasons – perhaps the child is very difficult and the parent finds giving food is one of the only ways of comforting or appeasing him. This may be true at night as well as during the day, so that a baby or child with sleep problems gets offered far more night feeds or drinks. A parent who cannot show affection except by handing it out on the end of a spoon may put great emphasis on feeding, and in turn a child may try to please a parent by eating everything offered. Parents can also overfeed to compensate for guilt because they feel inadequate about some other aspects of their relationship with the child.

How to Tell if Your Child is Fat

Look at your child when he is next running around naked or with a swimming costume on with other children of the same age – at bathtime, on the beach, at the swimming pool or simply in the back garden. If he looks very fat, especially round the thighs and abdomen, in comparison with other children, then almost certainly he is overweight. Think about the clothes you buy for him – do they always have to be two or three age sizes bigger because the waist will never do up or the sleeves are always too tight? The waist in particular is a good guide because tall but slim children may need bigger age sizes because of their height, but in their case the waist invariably needs taking in to fit properly.

Parents with weight problems themselves can often have trouble recognising or acknowledging a child’s problem – if you are not sure, ask a couple of trusted friends for their opinion, but phrase the question so that it allows them to answer honestly. ‘You don’t think John is any more than big for his age?’ may get a different response from, ‘l am not sure if I should be concerned about John’s weight – tell me truthfully what you think?’

Weight adjusted to height charts are a good guide, though children who consistently take in more calories than they need tend to be taller than average as well. However, a GP may simply be able to decide whether your child is too fat by looking at him.

Helping Children to Lose Weight

Many parents do recognise, at various stages, that their child is getting a bit tubby and solve the problem without professional help by just cutting down on high-calorie foods and drinks like biscuits, cakes, puddings and sweets, keeping their child busy to take his mind off food and encouraging more exercise. For parents who recognise that their child is continually and persistently gaining more weight than other children of his age, the pre-school years are still a time when they can more easily adjust their child’s eating habits before he becomes seriously overweight. These are some simple rules to follow:

If your child is already into the habit of nibbling at whatever he wants between meals, then putting these five rules into practice will demand energy and determination. Children who are accustomed to having whatever they want to eat at almost any time will need to be encouraged in the mealtime habit – for example, by making sure they are hungry and by providing appealing but nutritious food. They also need to be distracted from their usual continual nibbling by being kept busy and occupied. This may be particularly hard for parents who are not, for whatever reason, in the habit of spending much time supervising their child’s day.

Tubby two-year-olds will probably slim down naturally as long as you do not try to encourage or force them to eat more than they want – if you have a demanding new baby, resist the temptation to palm off the older child with food for the sake of a bit of peace. Instead, plan a few distractions in advance which do not involve eating. By three years, children enjoy having friends round and visiting other homes, though you usually have to go too. Playing with other children is both distraction and exercise and, if the other child has good eating habits and is a normal weight, then sharing mealtimes can set a useful example. Enlist the help of sympathetic friends or relatives to keep your child busy – if you have a weight problem yourself it may be very hard to ask for help initially, but good friends with the same age children can be very supportive.

Professional help may sometimes be hard to come by – if your child is fat do not be tempted to ignore the problem because your doctor takes the view that it is ‘puppy fat’ which will disappear of its own accord. If your GP is unsympathetic try asking for a referral to see a hospital-based or community dietitian or see your health visitor at the clinic. Special clinics do exist in some large hospitals but are not widespread for children – if your GP is unable to tell you of the nearest one you can ring the dietitian at your district hospital or the regional health authority.