Saturday, February 13, 2016

Does my child need help losing weight?

Lauren Falini, an exercise physiologist, talks about why it can be hard to admit that your child has a weight problem, and how she works with families to help a child lose weight.

Does my child need help losing weight?

We welcome Lauren Falini, a bariatric exercise physiologist at Nemours Alfred I. duPont Hospital for Children in the weight management program, as a new regular contributor to the Healthy Kids blog. She specializes in fitness testing and exercise prescription for adolescents receiving weight loss surgery. She also focuses on exercise counseling for obese children and their families. She talks today about how she works with families to help a child lose weight.


A recent national poll found that parents are much less likely to recognize that their own child has a weight problem. But when you consider that 68 percent of adults and 32 percent of children are overweight or obese, is this perception really surprising?


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Some parents may perceive being overweight as the norm — and may think the normal weight child looks too skinny. To them, it may no longer stand out that their child is overweight at all. Being overweight is hard for adults, no one wants to think their child is overweight or that their child’s weight could be a health problem. And many parents think their kids will outgrow it, or that they’ll go on a diet and start exercising more when they’re teenagers.


Consider this scenario: “Michael” is a typical 10-year-old who lives with his mom, dad, and 6-year-old younger sister. Michael loves to play soccer, video games, and is in a robotics club after school. His mom and dad are both overweight and his dad has type 2 diabetes. Michael decides not to play soccer this year — not because he doesn’t enjoy it, but because, “I am not as fast as the other players and I get tired.”


Michael gets home from school and does his homework, then plays video games until dinner. After dinner he watches a movie, then gets ready for bed. Sounds like what goes on in many households, doesn’t it?


As an exercise physiologist at Nemours/Alfred I. duPont Hospital for Children’s Weight Management Clinic, I see everyday how being overweight can affect many parts of kids’ lives — their health, what they believe they can do, their self-esteem, and how difficult it can be to make friends.


So, continuing this scenario, let’s suppose that Michael’s pediatrician referred him to our Weight Management Clinic. Michael’s first visit is with a physician, who assesses his health, history, and creates a plan for him. When I see Michael, we talk about what he’s done in the past for exercise, what he likes and doesn’t like to do for exercise, and what exercise options he has. On a follow-up visit, we discuss what has worked, what has not worked, and change our plan as needed.


After meeting with someone like Michael, here’s what goal-setting could look like:

  • He agrees to exercise for one hour a day after school, before dinner, and in place of video games. He can choose one of the following to increase his cardiovascular fitness:
  • Ride a bike.
  • Walk outside, with a running interval every 5 minutes. We suggest making it fun and getting his sister involved by having races with her.
  • Play a dancing video game or do a dancing exercise video.
  • He plans to play soccer on the weekends with his parents, sister, or friends to get ready to play soccer on a team again.

Seems manageable for Michael and his family, right? It’s these kinds of small, incremental changes in kids’ day-to-day routines that can have a big impact on their health overall.


If you think or aren’t sure if your child might be overweight, talk to your child’s primary care doctor. The doctor will be able to tell you if your child is overweight by measuring height and weight, and looking at growth charts for children. Talk to your doctor to figure out next steps and determine whether your child would benefit from a weight management program.


And remember — you’re not alone in this. Lots of kids in the United States are overweight. But there are simple solutions to change behaviors and help get kids – and their families – started on the path to healthier living.


Read more from the Healthy Kids blog »

About this blog
Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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