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To rid kids of fat, first banish word 'fat'

Parents search for ways to get their children to lose pounds without developing a complex.

By ALICIA ULFERTS
Published April 8, 2007

	Nursing student Ashley Howe checks Jalen Facyson's body mass index at a KidShapers class at All Childrens Hospital's conference center in St. Petersburg. The program's goal is to get children and their families to eat healthier and exercise.
[Times photos: Bob Croslin]

ADVERTISEMENT Registered dietitian Melanie Newkirk measures Jalen's height and weight. The 12-year-old has found that he likes healthy foods like broccoli, collard greens and bananas with sugar-free yogurt.

Lori Estes spent nearly two years searching for a program to help her stepdaughter develop healthy eating habits and an appreciation for exercise.

It took that long, Estes said, because she wanted to be sure the program didn't lead to the unintended consequences so many parents fear when talking to their children about weight.

"As a parent, if you don't handle it correctly, you can send a child into patterns of anorexia or other bad eating," Estes said.

It's a problem more parents face as studies and statistics continue to chart the increase of overweight and obese children: how to get children to develop a healthy relationship with food and exercise when all around them are images both of the dangerously overweight and the dangerously underweight.

When it comes to being overweight, the numbers are staggering: An estimated 25-million children 17 and under are obese or overweight, about a third of the population for that age group, according to Census Bureau data and a 2006 study published in the Journal of the American Medical Association.

That's leading more pediatricians to diagnose children with type 2 diabetes and high blood pressure, ailments traditionally associated with adult populations.

The enormousness of the problem, and its potential to drive up already high medical costs, led the Robert Wood Johnson Foundation to commit $500-million this month to the study of childhood obesity.

And Gov. Charlie Crist called on the Legislature last month to require physical education classes every day for elementary school students to help fight the growing problem.

At the same time, the fashion industry is coming under fire for allowing alarmingly thin models to strut the catwalks of New York, London, Madrid and other fashion capitals. Last year, Spanish officials banned from fashion shows models who have a body mass index, or BMI, of less than 18 after two South American models died of complications of anorexia nervosa.

BMI is a common measure of body fat that is based on height and weight. Anything below 18.5 is considered underweight, 25 and over is overweight and 30 and over is obese.

That juxtaposition is why Estes took her time researching programs that could help 12-year-old Shianne eat healthier foods without using the term "diet" or leading the sixth-grader to believe she had done something wrong and was being punished.

She, Shianne and Shianne's mother found the answer in KidShapers, a weight management and fitness program for families at All Children's Hospital. Shianne lives with her father and stepmother Estes, but frequently stays with her mother. So both women attended the eight-week program with Shianne.

"Now if she wants a snack, I frequently find her sitting in the kitchen reading labels," Estes said of the program's impact on Shianne.

Dr. Mark Cavitt, a child psychiatrist, helped develop the program and a screening questionnaire the hospital uses to determine whether families really are ready for the challenge.

When it comes to approaching a child who has or is developing a weight problem, Cavitt says the best thing to do is deal with what is very frequently a factor in the child's overeating: the diet and exercise habits of the entire family.

"It really is about what the family does," Cavitt said. "You're not singling out the child or adolescent but are saying, 'We have a problem,' " Cavitt said.

There's no downside to the entire family eating healthier foods, taking note of portion size and getting out as a group in the evenings for a family walk or bike ride. That not only takes the pressure off the overweight child, but also allows him or her to emulate the good eating habits of the parents, Cavitt said.

"Start making lifestyle changes as a family," Cavitt said.

That's what KidShapers emphasizes, said program dietician Sarah Krieger. Children must be referred to the program by their physician, and one program leader works with the parents while others work with the children, she said.

"The No. 1 thing is we do not use the word 'diet,' " Krieger said. "We really just focus on making small behavior changes," she said.

For example, one child might promise to try two different fruits or vegetables each week. For another child, a change may be the agreement to eat breakfast at home instead of asking for fast food.

That's how Jalen Facyson, 12, discovered that he liked bananas with sugar-free yogurt. He was surprised by how many healthy foods he learned to like in the program.

"I love broccoli. I love collard greens," the St. Petersburg fifth-grader said between fitness tests last month on his last night in the program. "I really like walking a lot."

That's music to Krieger's ears, because it's so hard to tear children away from television, computer or video games and get them moving.

A survey conducted by the Kaiser Family Foundation in 2005 found that children spend an average of 6 1/2 hours every day watching television or using computers and other electronics.

"We call that screen time. Technology has really increased the sedentary lifestyle," Krieger said.

Points for parents

AVOID USING WORDS LIKE "DIET" OR "FAT." Instead, use words like "healthy" and "fun" when talking about food and exercise.

GET EVERYONE INVOLVED. Preparing healthy meals together and then going for a walk or bike ride can be great family time and is healthier than watching television together.

BE A GOOD EXAMPLE. Don't eat too much - or too little. Don't obsess about your weight or anyone else's. Get involved in a sport or other physical activity. Learn to appreciate health and your children will, too.

[Last modified April 7, 2007, 18:05:31]