SAN FRANCISCO — Preventing and treating overweight in children begin with good advice to parents—no force feeding, don't use food as a reward, and get active as a family.
That's how Michelle L. May, M.D., a family physician in Phoenix, Ariz., advises families in her practice.
It only takes a minute or two during a well-child visit, and it gives parents permission not to make their child eat everything on his or her plate, Dr. May said at the annual meeting of the American Academy of Family Physicians.
“We know that we have an obesity epidemic in our population, and we are seeing this more and more in children,” Dr. May said.
While body mass index (BMI) is not calculated in children younger than 2 years, physicians should calculate BMI, in addition to height and weight, in all children aged 2–18 years. And Dr. May advocates that BMI should be added to the vital signs at the top of every chart.
The Americans in Motion toolkit, available from AAFP online at www.aafp.org/x22874.xmlwww.cdc.gov/growth
Physicians need to decide on a treatment approach for children who are at risk for or are already overweight, she said.
The advantage in treating overweight children is the chance to work with the entire family, she said. In many cases, there are multiple family members with the same problem and addressing the child's overweight could motivate other family members to take action.
Treating childhood overweight also requires physicians to be nonjudgmental and open, said Dr. May. These children have likely been teased about their weight at school or by friends and don't need to be criticized by their physician too.
Dr. May said she tries not to focus on weight as the problem, especially since children can grow into their weight. Instead, she focuses on interventions. For example, instead of counseling a child to lose weight, she will talk about increasing activity as a way to improve cholesterol.
Physicians also need to let parents know that children are born with the instinctive ability to know when and how much to eat. Counseling parents in this area should start right away, she said. Force feeding an infant a bottle can lead the child to associate food with comfort, Dr. May said.
And letting parents know that infants will take in the proper amount of food on their own takes the pressure off the parents, she said.
The same is true as a child gets older and is self-feeding. Parents should be careful not to heap praise on their child for finishing all of his or her dinner or coerce their child to eat all the food on the plate.
Dr. May is the author of “Am I Hungry? What to Do When Diets Don't Work.”