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Six Tips to Combat Child Obesity

The most sobering statistics from the American obesity epidemic are those concerning children. According to the Centers for Disease Control and Prevention, over the last three decades, the rate of childhood obesity has more than doubled for preschool children aged 2-5 years and adolescents aged 12-19 years, and more than tripled for children aged 6-11 years. Today, about 35 percent of American children ages 6-19 are overweight or obese.

The culprit is clear. Children increasingly consume large amounts of processed and refined food. In particular, nearly 1/3 of American children eat fast food daily (a fivefold consumption increase since 1980), potentially resulting in about six pounds of weight gain per year, per child. Activity levels have also dropped.

Harvard endocrinologist David Ludwig, M.D., PhD., is the director of the Optimal Weight for Life program and Children's Hospital in Boston, which has helped over 5,000 children in the last 10 years. He was among the first researchers to identify the importance of the glycemic index, which assigns a number value to the rate at which the body converts a given food to glucose. Research confirms that foods that convert quickly - usually, ones made mostly of highly processed carbohydrates such as white flour and sugar - lead to weight gain. He has distilled that knowledge into a plan for parents called Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World. The paperback version was released April 21, 2008.

Can you summarize the advantage of using the glycemic index and glycemic load numbers when it comes to weight loss?
Basically, the more we know about biology, the less restrictive we have to be. As it turns out, unlike what some diets advocate, you don't have to get rid of all carbohydrates if you know that certain carbs are fundamentally better. That's a huge psychological advantage. Nobody wants to be deprived of a whole class of food.

How can people discover which foods have a low glycemic load?
They can go to There is also an abbreviated list in my book.

To help kids, you suggest as a first step cleaning out the home of unhealthy foods.
Yes, I call it protecting the home environment. Basically, if it does not support health, it does not come into the home. We encourage them to take all of the unhealthy, fake food out of the pantry and throw it into the garbage, and then shop to fill those empty places with healthy choices. Whatever money this costs will be more than recouped through better health and lower healthcare expenses.

But the fact remains that we live in a "fake-food world," as you put it, and you can't keep the kids home all the time. You discuss in your book six ways to change their behavior and guide them toward low-glycemic-load, healthier choices. Can you go through them?

I would be happy to.

  1. First, is praise. One expert in child obesity said, "Given how inexpensive it is, it's amazing that it is so rarely used." It is a wonderful parenting practice. Rather than criticizing your kid for eating the wrong thing, you can give positive feedback for eating the right thing.

  2. A powerful behavior change method is contingency management. In other words, "First this, then that." So you don't say, "You can't have dessert until you finish your vegetables," because that teaches kids to want dessert and hate vegetables. Instead, you simply say, "First we eat our dinner, then we eat dessert." So you are not valuing one more than the other, you are just telling the child about the proper order of things.

  3. Another is setting practical goals. No one can just "will away" 50 pounds. You need to set up practical, achievable goals, each one of which takes you further along the path to success. For a young kid, you might set a goal of going a day without junk food; for an older one, it might be two weeks without fast food. Then there is some small, nonmonetary reward at the end, like going to a movie or doing something else special with the parent. The goals should focus on behavior patterns, not pounds. The behaviors will drive the weight loss.

  4. I also suggest anticipating obstacles. Birthday parties might be a problem for young kids. Older ones might have trouble when friends go out for fast food. Anticipate these with your kid, and work with him to find ways to deal with them.

  5. I believe in empowerment. We have a saying that if a child helps cook it (or shops for it, or picks it from the garden), she'll eat it. Use meal preparation as an opportunity to spend quality time with your child, and help her develop an intimate relationship with the source of our sustenance.

  6. Finally, say no with love. If we can't say no to some things (that massive banana split), we can't say yes to others (good health).To do this, remember that you are saying no to the behavior, not the child. Set clear expectations and be consistent. And try to find as many ways to say yes as no - if you tell a child he cannot do something, ask him to name three things he would like to do as an alternative.

Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/ Fake Food World, by David Ludwig, M.D., Ph.D.

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