Preventing Childhood Obesity New York

Excess weight gain in children is not limited to a certain age or gender; it can start anywhere from infancy to the late teen years.

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As parents, we share the goal of providing the best possible lives for our children. Over the past few generations, however, providing the best possible life seems to come with a downside: excess weight. Family Power: 5 Simple Rules for a Healthy-Weight Home is about changing that. Its goal is to help our kids grow up to be lean and healthy adults. Excess weight gain in children is not limited to a certain age or gender; it can start anywhere from infancy to the late teen years. We must take steps to prevent our children from becoming overweight or to help them achieve a healthy weight if they are not at one now. It is never too late. By taking a close look at what scientists have found out about the weight management strategies that work for kids and combining them with the tips, strategies, and experiences of families that have been using them, Family Power shows you how to make a healthyweight home.

You Are Not Alone
Over nine million American children over the age of six are the adult equivalent of obese. Over the past thirty years, the number of overweight two- to five-year-old kids in the United States has more than doubled. The number has more than tripled for children six to eleven years of age and for adolescents twelve to nineteen years of age over the same three decades. Researchers estimate that about 30% of children are either at risk of overweight or overweight. The Institute of Medicine, a respected group that advises the government on health issues, describes childhood overweight as an epidemic. And while it often is not reported this way, experts agree that the solution lies in approaching the problem from every possible angle. The problem of overweight children is not just a North American problem—it is happening all over the world. Researchers who looked at the rates of overweight in European thirteen-year-olds found the highest numbers in three very different countries: Finland, Ireland, and Greece. Excess weight in children has even become an issue in countries where children never had problems, including China. A 2003 study conducted in Beijing, China, found that 28% of boys and 14% of girls were significantly overweight.

What Is a Healthy-Weight Home?
A healthy-weight home is one in which everyone who lives there has a lifestyle that encourages them to be at a weight that is right and healthy for them. This means children and adults, including those who are very thin and those who are rather heavy. A healthy-weight home is not about being on a diet. It embraces meals and snacks that focus on wholesome, nutritious foods and it includes treats. Activity plays a vital role. Because parents create the home for their families, they are the “change agents” that make a healthyweight home happen. This is done by surrounding the family with the 5 Simple Rules, using a style that will make them last. Experts agree that the main reason for this global trend lies in our kids’ lifestyles—processed foods are replacing wholesome, lessprocessed foods; fast food is widely available; and the need to be active as part of daily life is declining. This lifestyle is nobody’s fault. It is simply the course that our world has taken. Understanding the whys behind the trend is important, however, because it points us to the solutions. And when it comes to making a difference in the weight of our children, there are many strategies to take. How many and which ones depend on your lifestyle.

Making the Science Work for You
Childhood overweight is a complex issue. A number of factors are involved, from eating too many calorie-loaded foods to spending too much time in front of televisions, computer monitors, and video games. To add to the complexity, the definitions used to define excess weight in children are different from those for adults. We will explain this in chapter 1. Several prestigious organizations, including the Institute of Medicine, the U.S. Surgeon General, and the American Heart Association, have reviewed the scientific studies on the development and treatment of childhood obesity and have issued recommendations. While valuable, these recommendations are generally meant to influence public policy, guide health care professionals, and create awareness about the issue. It is not always easy to translate the recommendations into “What can or should I be doing for my family?” That’s why we’ve written this book. Weight Watchers, as the largest provider of weight-loss services in the world, is concerned about the growing rate of overweight children and is committed to helping discover safe, lasting solutions. No one has more experience: since 1963, Weight Watchers has helped millions of people all over the world lose weight. With its science-based approach and talent for translating medical recommendations into practical advice that works in the real world, Weight Watchers is uniquely qualified to tackle this issue. This book provides you with the latest scientific information (a complete list of references is at the end of the book) that you can use to manage the weight and health of your entire family, including those who are underweight, overweight, or at a healthy weight now. But knowing and doing are two different things. Family Power goes beyond providing scientific information to bring you into the lives of the people who are taking the information and weaving it into their family’s life. The first part of the book lays the groundwork, providing the big picture behind the 5 Simple Rules. It starts by taking a look at how excess weight is defined in children and how it is very different from overweight in adults. Weight-loss recommendations for kids are also quite different from those for adults, so we include the current guidelines for children as well. One chapter looks at the science of changing behavior and how to increase the odds for success. This is followed by a chapter that explains the basics of weight management and why kids are not miniadults. The chapter shows that while the basic equation of calories in/calories out applies to everyone, changing the results of the equation are very much different for children. This leads into the 5 Simple Rules and the science that they come from. Finally, the roles that parents play in creating a healthy-weight home are defined. Throughout part one we include answers to the questions that parents often ask—everything from “Should I weigh my child?” to “What is the difference between a snack and a treat?” With the background in place, part two goes into the whys and hows of making the Rules a part of family life. By focusing on each of the roles that all parents play—role model, provider, enforcer, protector, and advocate—the 5 Simple Rules are consistently reinforced. This is the magic that makes them work. The focus in part two is on the tips, strategies, and experiences of families who have taken on the task of weight management and are seeing success. Besides getting an in-depth look at many families who are using Family Power now, part two also has the advice of the coaches who have worked with these families and many, many more. The book ends with some of the issues and challenges that many families may face as they work to create a healthy-weight home. From nontraditional family structures to having an unsupportive spouse, answers are given to often-asked questions on how to handle these situations, including how to get extra help if and when it is needed.

Kids Can Be More Successful Than Adults
When it comes to weight and children, there is good news. Kids have an energy advantage over adults. Unless they are older teens, kids are still growing and that takes energy (also known as calories). Children are also more responsive to being active than adults when they are given the opportunity. Because of this, children are likely to be able to achieve and sustain a healthy weight with fewer rules than most adults. In fact, living in a healthy-weight home—a home in which all family members live a lifestyle that supports nutritious eating and regular physical activity—can make a big difference in stopping and/or reversing the pattern of weight gain that leads to obesity. Making small, consistent changes in a few key areas rather than following a structured, low-calorie diet and strict exercise regimen is a realistic approach to both reducing excess weight in children and enhancing the health of all family members. Family Power shows you how.

EXPERT PORTRAITS
Family Power has been a team effort that includes weight-loss experts, pediatricians, coaches, and, most important, families. Throughout the book, we include portraits of some of the people who are behind Family Power. We hope that by getting to know them, you will feel comfortable and confident that following the 5 Simple Rules is right for your family.

Karen Miller-Kovach, M.S., R.D.
As Chief Scientific Officer for Weight Watchers International, I am committed to helping those who want and need to lose weight. Weight Watchers has always taken a science-based approach to its programs and services. My job is to know the science and, if it does not exist, to help create the studies and trials that will give us the answers we need.

The 5 Simple Rules
Rule #1: Focus on wholesome, nutritious foods. Rule #2: Include treats. Rule #3: Aim to keep nonhomework screen time at two hours (or less) a day. Rule #4: Try to be active an hour or more a day. Rule #5: The Rules apply to everyone in the home. The Weight Watchers approach includes the four pillars that are known to provide lasting weight loss in adults: 1. Making wise food choices 2. Being physically active 3. Developing positive thinking skills 4. Living in a supportive environment While the Weight Watchers approach has been developed and extensively studied in adults, it has not been rigorously evaluated in children. The fact is, none of the popular weight-loss methods have, so any recommendations about their use in children and adolescents are based on the assumption that what’s right for adults is appropriate for kids. Weight Watchers does not encourage children to join its program, and no child under the age of ten can become a member. For those between the ages of ten and seventeen, membership in our meetings-based program is available only with a doctor’s referral, which is required to ensure that a health care professional who knows the child and the family has made an assessment and believes that the type of program that Weight Watchers provides is a good fit for that child. Access to the subscription weight-loss service on WeightWatchers.com is only available to adults. Recognizing that popular adult-based programs had not been adapted and carefully studied in children and adolescents, Weight Watchers took on the challenge, resulting in the Family Power pilot project and this book. Since we were interested in exploring the impact parents have on the weight of their children, we developed a family-focused pilot program that called on parents to take the science-based recommendations that have been proven to affect children’s weight and incorporate them into the eating and activity patterns of their homes. Rather than launch the pilot in a traditional clinical trial, we wanted to try it in the real world. In 2003, Weight Watchers joined forces with Pediatric Healthcare Alliance, a large pediatric group practice in Tampa, Florida, to pilot the family-focused approach. In 2005, the pilot was expanded to include the Orlando, Florida, and Seattle, Washington, areas, with more planned in the future. To learn more about the project, log on to www.weightwatchers .com/family.

Lane France, M.D.
I am a pediatrician, heading a large group practice in Tampa, Florida, the Pediatric Healthcare Alliance. For years, I have been concerned about the problem of weight gain in children. I have seen many children in my career. Over the years, my patients have become heavier and heavier. I have made it a practice to talk with each and every parent and child about the importance of eating a nutritious diet and getting more physical activity. I am passionate and persistent about this problem. Excess weight gain is one of the biggest problems in pediatrics today, and this is the first generation of children who may not live as long as their parents do. Reversing excess weight gain in our children is going to take a long time. Consider how much time it took to motivate people to take action to stop smoking, buckle up seat belts, and use helmets for bicycling and skating. The saying goes: “It takes a village to raise a child.” I feel that it indeed does take a village to tackle the growing problem of children who are too heavy. Weight gain in children is not the fault of parents, schools, pediatricians, or any one group, so it cannot be stopped through the actions of just one person or group. One day, I realized that my efforts might be more effective and reach more children if I involved the community. Knowing that Weight Watchers shared my passion, we joined together. The Pediatric Healthcare Alliance patients were the first to learn about Family Power. Our doctors joined together to let parents know that they have the power to change their children’s weight. Several (you’ll meet two in chapter 13) joined the pilot program and spoke to the families you’ll meet. These are families just like yours. They come from all walks of life, but share the goal of helping their children to be as healthy as they can be. They are helping each other by creating a village of support to make a difference in their families’ lives. My goal is to work together with the movers and shakers of the community to help our children. I invited other pediatricians to collaborate with me and tell children and their parents about healthy weight. We formed a committee composed of a member of the school board, a reporter from our local paper, a nurse, several doctors, and a community leader to brainstorm ideas for getting the community involved. Since television has a big influence on parents and children, I am also talking with our local television personalities to get them on board. The environment in all areas of the community has to change. Towns need trails, parks, and outdoor space for children to play in. I believe that schools should take treats out of the cafeteria and return physical education to the daily schedule. I also believe that parents have to turn off the television, the computer, and video games and promote exercise instead of sedentary activities. Family meals are essential. Let’s work together to help children reach a healthy weight and to prevent children from gaining too much weight in the first place. The problem is preventable as long as parents, schools, medical professionals, and leaders in the community recognize that something can be done if they work together. Kids and parents can’t tackle the problem on their own. They need the help of the community, and every person helps.

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