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Healthy Weight Center

Weight Loss in Children

03/12/2009

Question:

I need information on dietary recommendations and weight loss for a 10 year old girl. I am a school nurse and need to have this info available to me. Thanks

Answer:

Obesity is defined as a body mass index (BMI)above 30, or a weight for height (as plotted out on the growth chart) of greater than the 95th percentile. Many children are overweight (a BMI greater than 25), but not frankly obese. These overweight children should be counselled to maintain their current weight until they "grow into it" in height. If the child has finished growing, then it is appropriate for him/her to lose weight until the BMI is close to 20.

Obese, especially dangerously obese children should be counselled to lose weight. The chance that he/she can grow into a seriously high weight is unlikely. I generally recommend 5 lbs or less of weight loss per month. This should be achieved with a moderate calorie restriction, focusing on maintaining the intake of highly nutritious foods (especially vegetables and fruits) and avoiding fried, overly fatty (fatty meats and cheeses), and overly sweetened foods.
 
I ask the children to avoid eating at all for the 3 hours before they go to bed. If they do snack during the day, it should be of a low calorie and nutritious food. Stressing that even healthy food can lead to excess weight is important - the chld needs to learn to push away the plate when satiety is reache, and not keep going for any reason.

Exercise is the other key component to weight management and health. A minimum of 3 hours per week, spread on at least 3 different days, and of fairly vigorous type is key. If the child is seriously obese and is not able to exercise at this level safely, then using swimming or walking is a good place to start. Even in the absence of weight loss, regular strenuous exercise will help the obese child be more healthy.

Discussing the reasons why people eat may also be helpful. Food should be used for nourishment only - not boredom, or filling other needs. The older adolescent may be able to grasp this concept, but not the younger teen. Joining a group that is dedicated to weight loss, such as weight watchers can be very helpful. That organization does a lot of education and can provide support and motivation. The American Dietetic Association has a website which you may visit for further information.

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Response by:

Caroline Mueller, MD
Assistant Professor
College of Medicine
University of Cincinnati