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My Child is Obese:
What Can I Do to Help Her?
by Gwenn Schurgin O'Keeffe, MD, FAAP
Dear Dr. Gwenn:
"My daughter is 6 years old and obese, weighing 106 lbs. That is well above the 90 percentile line for her age. We have had her to her pediatrician and to a specialist for lab work. All the results came back in normal range. We have been struggling for over a year to get her weight under control but she keeps gaining. We do not eat out and I limit all sweets and fried foods. My son who is nine eats the same food and is normal weight for his age. We encourage her to play outside and try to walk around the block everyday. But since she is so overweight, she tires easily. HELP! We do not know what to do. Her teacher and principal at her school have also contacted us about her increased weight and they are concerned. She seems to have a ravenous appetite constantly. We cannot find clothes to fit her now, because she has outgrown the 14/16 girls that we last bought. If you could please give me some advice I would greatly appreciate it."
~ RP
Dear RP:
Thank you for writing in. I first want to commend you for taking this problem so seriously. Many parents have trouble acknowledging that their young child is overweight and being able to do that is most certainly the first step for helping your daughter.
I find it useful to not look back but look ahead. Many factors lead to your daughter's current weight but those are not as important as what steps you tackle to help her get to a normal weight. She has a fast metabolism and growth on her side. That will give her an advantage in tackling her weight problem as opposed to an older teen or adult whose growth has already stopped.
If you look at a growth curve, she clearly needs to lose weight but given she is growing you'll also see that over time her current weight becomes more appropriate. So, in addition to shedding some pounds, helping her exercise more and eat more appropriately to maintain her weight will help her health considerably. So, don't feel you need to get all the weight off at once.
You are wise to address this now because the longer a person is overweight the more problems they have as adults including high blood pressure, back problems, cholesterol problems, diabetes and heart disease. I'm glad you started with you pediatrician and a specialist because sometimes medical problems cause weight gain. It is important to check a child's thyroid, cholesterol, triglycerides and blood pressure when overweight.
Now that medical problems are ruled out, the focus needs to be on healthy living: learning to eat healthy and act healthy. Embedded in this goal needs to be the message of moderation. None of us are 100% healthy and part of being a child is learning how to balance having a sugary of fatty treat with a healthy lifestyle. It can be done!
For exercise, encouraging her to play and get active is wonderful but you need something a bit more intense to help turn this around. Many local gyms and YMCAs have exercise and weight loss programs for kids. A personal trainer could be fun for her, too.
Don't forget hydration as part of nutrition. Kids sometimes mistaken thirst for hunger so make sure she is drinking enough water. You can get her flavored water instead of juice if she needs something sweeter. For food, the goal is moderation and balance. What I'd suggest is a positive reinforcement chart for food. See if you can get her to work with you on eating healthy during the school week and then on weekends be a bit more flexible and allow her to have some of her favorite foods. Sometimes allowing a sweet a day helps kids not crave them. You can find desserts that don't break the calorie bank such as Jello with low fat whipped cream, low fat pudding, 100 calorie pack cookies. And, go out to eat as a family once in a while. Learning to eat out is important for healthy living in general.
Finally, you'll be more successful if the focus is on getting healthy and not just weight issues alone. One way to accomplish this is counseling to rule out emotional issues and work on self-esteem. Keep an eye on TV and computer time and find ways for her to interact with other kids in an after school program if your schedule allows.
As you embark on this path with your daughter, expect set backs with the successes. Find something each week to applaud your daughter for - a new activity, walking longer, trying a new food. The more positive you are, the better she will feel and the more successful you'll be in helping her become healthy - and stay that way for a lifetime.
© 2005 - 2006 Pediatrics Now. All rights reserved.
PEDIATRICS NOW™ is a trademark of Pediatrics Now
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About the Author
 Pediatrician, Dr. Gwenn Schurgin O'Keeffe, MD, is a board-certified pediatrician and Fellow of the American Academy of Pediatrics. Dr. Gwenn is an experienced columnist, educator, and practicing pediatrician. Dr. Gwenn strives to write as if she were talking to a parent. As a parent herself, she knows how important it is to obtain information but also understand how precious little time parents have to find that information on the internet. Pediatrics Now was developed to fill that gap and provide a bridge between the parenting and pediatrics worlds.
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