“Our heath care cost have grown along with our waist line”, said Jeff Levi, PhD, executive director of Trust for America’s Health. “The obesity epidemic is a big contributor to the skyrocketing health care costs in the United States”.

Childhood obesity rates have more than tripled since 1980. The states with a higher obesity rate are those in the South, including Alabama, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia; they all have a prevalence of 30 % or more. That means that out of 100 children, 30 meet criteria for obesity. Concerning and sad statistics.

The latest CDC obesity data also indicates that none of the 50 states achieved the Healthy People 2010 goal of reducing obesity prevalence to 15 % or less.

Pediatricians use Body Mass Index (BMI) to asses obesity in childhood. It is an easy, fast way to determine who is at risk during the yearly health supervision visit. Reviews of data from pediatric patients indicate a clear correlation between BMI and lower socioeconomic status, based on parent’s education and family income. But, why is this happening, contrary to what history teaches us?

About 500 years ago, wealthy individuals were the ones showing a distension of their waistline. Looking at European history, those who were rich and powerful could afford more food, and being fat was a sign of prosperity. Today, the economic crisis is causing the opposite effect: food prices for nutritious foods are expected to go up and eating healthy is going to be more difficult to afford. These days it is less expensive to go out for a hamburger and fries that to make the effort to prepare good food at home. It is also faster and it takes less work.

Parents today must make an effort to increase the quality of the food they give to their kids and make sure they are getting enough exercise. And don’t forget about portion size. The only way for parent to ensure their children’s future health is by taking control of their eating habits now. If we give it enough time Health Insurance Companies are going to start paying attention to the correlation between childhood obesity and the development of chronic health problems later in life. I believe they are already aware and considering what to do next. The only feasible solution will be to charge more to those at risk, that is, those who’s BMI is outside of what is considered normal.

At our office we run a Nutrition Management Program for kids. I have observed how difficult it is to maintain good eating habits when the whole family already has an increased BMI. I have also decided to intervene earlier, when the child is starting to cross percentiles in the wrong direction. It is then apparent that loosing or maintaining weight is a lot easier and, since the results of a diet plan are seen faster, the whole family is more likely to participate.

Exercise is at the other side of the equation. After all Energy Intake = Energy Expenditure, if we want to avoid accumulation of fat tissue. Studies have demonstrated a clear correlation between obesity and the presence of a TV set in the child’s bedroom. Remember when you used to walk 3 miles to school over 1 foot of snow?

What are we supposed to do?

My advice is to consult your doctor in order to identify where the main obstacle to good health is. We all know the list, but it is crucial to create a priority and tackle one difficulty at a time. It is reassuring to observe how some intervention, even a small one, makes an impact in the child’s weight when it is early enough. When the “to do” list is too long everybody gets discouraged and it is more improbable to delay doing anything.

Don’t forget to ask your pediatrician what your child’s BMI is at a well-child visit. That is the time to discuss eating issues. Sick visits tend to be quicker, the main concern being to identify and treat what is wrong.

Don’t feel embarrassed if you fail. It is important to keep trying and attend follow-up appointments to reinforce what you have learned and share difficulties you may encounter. It takes about 1 year to go through the process of changing eating habits. Just keep going. Never give up.

Marta Katalenas M.D.

About the Author

Dr. Katalenas

Dr. Katalenas is a pediatrician and owner of The Pediatric Center of Round Rock and the author of the book "The Step Up Diet: From Scratch… The Quality, Quantity, and Timing Solution to Childhood Obesity", a guide to healthy cooking and eating for busy families.