Don't put a child on a diet

Philip J. Goscienski, M.D.

September 2011

Childhood obesity rose from 4 percent in 1970 to more than 17 percent today. The consequences of overweight from toddlerhood through adolescence are more complex and more serious than anyone could have imagined 40 years ago.

Obesity leads to type 2 diabetes and more than a third of children born in 2000 will develop it by middle age according to the Centers for Disease Control. Its complications progress at a much more rapid rate than they do in persons who acquire the disease as adults.

Is the solution to put overweight children on a diet? Severe food restriction will cause children to react with behaviors that no parent wants to face. Experience with the low-carbohydrate ketogenic diet developed decades ago for the treatment of seizures should serve as a lesson. Those children became very creative in foiling the program. Further, there is no way that parents can regulate a child's food intake during school hours.

Fatigue and cravings will lead to abandonment of the diet in the majority of cases. These issues will certainly impair a child's classroom performance, a poor trade-off for a slowdown in weight gain or actual weight loss.

We should think of controlling weight gain in children in terms of a couple of years, not a few months, and guiding them to a permanently healthy lifestyle. The first step is to increase physical activity. Only about half of school-age boys engage in moderately intense physical activity four or more days per week. For adolescent females it is even lower and reaches a level of only about 25 percent among minority adolescent girls. Children who exercise regularly perform better in the classroom and have fewer behavior problems. They will also reach adulthood with stronger bones, a critical factor in the avoidance of osteoporosis decades later.

Family walks, biking excursions and physically challenging games cost nothing but time. The dividends go beyond fitness; they are memories for a lifetime.

In place of calorie-cutting try calorie substitution. Kids don't do the grocery shopping so there is no excuse for having sugary cereals, soft drinks and lots of ice cream in the home. There should always be fresh fruit and healthy nuts within reach in the kitchen and family room. Numerous studies show that kids will eat healthy food, even vegetables, if that's the only kind available.

Severely obese children should be evaluated by a physician and may need more aggressive diet management.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.