Dealing with obesity in children

• If you feel your child is gaining too much weight, start making meaningful, lasting lifestyle changes immediately

I was waiting to interview the head of an upmarket kindergarten when a particularly plump child arrived. As the mother turned to go, the headmistress took a quick glance at the lunchbox contents and politely asked the mother to take it away.

As the bewildered mother left with the sausages, the teacher told me: “I can’t allow such things. Come in a month’s time, and you won’t recognise the child.”

She said childhood obesity was directly linked to what kids ate, and she had the responsibility of ensuring that no child entrusted to her was smothered in fat — with good cause.

Nairobi psychoanalyst Eunice Olawo says obesity affects the self-concept of a child, with preteens and teenagers being the main victims.

According to Olawo, traumatic experiences like loss of a parent through death or separation affect children emotionally, and since many children don’t have good coping mechanisms, they turn mainly to junk foods to fill the vacuum.

In addition, obese children suffer cruelty through teasing and are subjected to ridicule, which leads to low self-esteem.

“These children withdraw to a corner. If they lack teachers’ and parents’ support, then they are doomed,” she says, adding that the child is intimidated right from home, where he or she is teased by the househelp, in the school bus by fellow pupils, and in the classroom by teachers, and “even during PE”, presumably because the obese child tends to be clumsy and less agile than fellow pupils.

Says Olawo: “This child is stuffed with negative feedback on his or her body image, shattering their self-esteem.”

Sadly, Kenyans hardly see obesity as a concern because many parents consider it a sign of good health, she says. And yet obesity has serious implications for the child’s health.

Diabetes, heart disease and asthma are just some of the diseases associated with obesity, and which are causing early deaths.

American parenting expert James Dobson blames childhood obesity on high-fat junk food.

“And even when healthy foods are consumed, kids are not exercising the calories off. Between television, car pools, computer games and just hanging out at the pizza parlour, kids just don’t run and jump like they used to do,” he laments.

Although this describes the American situation, things are no different in fast-urbanising Kenya, where chips and sausages have replaced traditional health foods like sweet potatoes and simsim paste.

Chicago paediatrician Robert Andersen has an even longer list on why children are becoming obese.

In his 2006 book, Raising Fit Kids, he lists less exercise, eating too much, less emphasis on physical education, and too much screen time. Although a small percentage of obesity has genetic and hormonal origins, most obese children are victims of eating too much of the wrong food, he says.

So, how do you measure obesity?

According to Andersen, the current objective criterion for diagnosing obesity stipulates that the child must have a BMI greater than that of 95 per cent of children of the same age and sex — the “95th percentile”. He adds: “BMI is the number that expresses the relationship between a person’s weight and height.”

You get your child’s BMI by dividing the weight in kilogrammes by (height in metres times height in metres). Andersen says BMI charts are a crucial aid in evaluating a child who is overweight or obese.

Parental support for the overweight or obese child is paramount. “If you feel your child is gaining too much weight or doesn’t look the right size, act immediately. Start making some meaningful, lasting lifestyle changes,” he suggests.

Andersen offers a raft of guidelines to keep kids off the slippery slope to obesity. Prospective mothers should take care of their healthbecause babies born to overweight mothers are more likely to be overweight, he says.

So, “To give a child the best possible start, a mother-to-be should establish healthy eating habits and weight before conception — and continue throughout pregnancy,” says Andersen.

Two, breastfeed exclusively for four to six months at least, because studies show that breastfed babies are at less risk of obesity.

Three, give water instead of fruit juice. “Many toddlers and older children suffer obesity partly because they became ‘juice-aholics’ as infants,” says the doctor.

Four, wean the baby on strained vegetables before fruits in order to suppress the sweet tooth that predisposes to obesity.

Finally, regular exercise to burn surplus calories is paramount.

dkweyu@nation.co.ke