As stated previously, the best way to significantly affect the prevalence of obesity is to become aware of obesity and then prevent obesity.
Starting with the earliest of ages, parents should know that both bottle- and breast-fed infants can be overfed, although overfeeding is more common in infants fed by bottle. Parents need to respect their child's appetite and to understand that it is not necessary for an infant to finish every bottle. Breast feeding and delaying the introduction of solid foods may decrease the risk of future weight problems. Skim milk can safely replace whole milk after two years of age.
Food should not be used as comfort or reward. Children should not be offered sweets as a reward for finishing a meal, as this places a higher value on dessert foods and may make desserts more desirable to them. Family meals should be oriented toward a healthy diet. Parents should limit the amount of television that a child is allowed to watch and should encourage active play in its place.
When a child does develop obesity, a serious and conscientious attempt to treat it should be undertaken.
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Components of a Successful Weight Loss Plan
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Component
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Comment
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Reasonable weight-loss goal
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Initially, 5 to 10 lb, or a rate of 1 to 4 lb per month.
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Dietary management
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Provide dietary prescription specifying total number of calories per day and recommended percentage of calories from fat, protein and carbohydrates.
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Physical activity
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Begin according to child's fitness level, with ultimate goal of 20 to 30 minutes per day (in addition to any school activity).
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Behavior modification
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Self-monitoring, nutritional education, stimulus control, modification of eating habits, physical activity, attitude change, reinforcements and rewards.
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Family involvement
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Review family activity and television viewing patterns; involve parents in nutrition counseling.
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Establish target goals for weight loss in children
Weight loss goals should be reasonable and should allow for normal growth and development. Weight loss goals should initially be small, so that the child doesn't become overwhelmed or discouraged. Using small incremental goals are ideal, with 1 to 4 pounds per month initially until there is significant behavior modification.
Teach weight and diet awareness to children
The overweight or obese children should maintain a food record to aid in dietary evaluation and management. The food journal should include not only the type and quantity of food eaten, but also where it was eaten, the time of day and who else was present. In most cases, the journal will not be accurate in figuring total calories consumed but will be useful in reviewing problem foods and eating patterns.
A straightforward dietary regimen or plan should be offered, keeping in mind that 3,500 calories must be eliminated by diet and exercise to lose 1 lb. It is necessary to obtain a specific calorie-per-day recommendation from a health care professional that follows guidelines for percentages of fat, protein and carbohydrates. Dietary fiber is also important, as fiber increases satiety and displaces fat in the diet. Educational nutrition books that describe the nutritional contents of foods and food exchange lists should also be utilized.
Encourage physical activity in children
Exercise is necessary to burn excess caloric intake and to maintain a weight loss curve. Exercise will also aide to use stored body fat and develop more skeletal muscle mass. Exercise is an essential part of any weight management program.
Initial exercise recommendations should be small and exercise levels should be increased slowly. This slow, ‘small step' approach will allow for more goals to be accomplished and further aide in developing self esteem. A reasonable goal is 20 to 30 minutes of moderate activity per day, in addition to the exercise the child may get during the school day.
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