Getting your kids to eat healthily from an early age will help them avoid the health problems associated with obesity, writes SHEILA WAYMAN
‘A MOMENT on the lips but a lifetime on the hips” is one of those trite sayings trotted out by dieters. However, there’s no denying that excess weight is hard to shift and we would be better off not overeating in the first place.
But all the statistics show that when it comes to overweight and obesity, the prevention message is failing miserably in Ireland – even for the youngest in our society.
The national longitudinal study, Growing Up in Ireland, found that one in four three year olds is overweight or obese, as is the case also among the nine year olds it is tracking.
The study also shows that parents are poor judges of whether or not their child is overweight, which means often the problem is not being identified and nothing is being done about it.
Some 54 per cent of parents of overweight children and 20 per cent of parents of obese children report that they are “about the right” weight for their height.
As a result, Growing Up in Ireland recommends that the height and weight of children should be routinely measured when they visit their GPs.
It also suggests that public health teams, who already do vaccinations and dental and optical checks in school, could also check children for overweight/obesity.
Parents should take matters into their own hands and track their children’s weight, says Dr Donal O’Shea, consultant endocrinologist and director of the weight management clinic at St Columcille’s Hospital, Loughlinstown, in Co Dublin.
He recommends putting children on the scales once or twice a year to check they are “in the right ballpark” – the normal weight for your child’s height can be calculated on the internet.
“There is a very rough rule of thumb – from the age of four to 14, a kid should be half their age in stone, roughly, but height is important.”
He believes it is time Irish people developed life-long weight awareness because the “head-in-the-sand approach we have taken up to now is clearly not working”.
If your child’s weight is a cause for concern, you need to do something about it.
SEEK PROFESSIONAL HELP
If you are worried about your child’s weight, go to your GP for a formal measuring of height and weight. While the problem is probably due to more calories being consumed than expended, metabolic causes, such as an underactive thyroid, may need to be excluded through blood tests.
A GP may refer you to a dietitian, or you can find a qualified dietitian yourself through indi.ie, the website of the Irish Nutrition and Dietetic Institute, where you search by county and speciality.
Dr Mel Bates, a GP in Fairview, Dublin, believes a lot of parents are concerned about their children’s weight and feel guilty about it but do not seek help. When he notes, visually, that a child has a weight problem, he dreads mentioning it because he knows the upset it is likely to cause.
“No matter how gently we broach it, mothers look crestfallen, guilty and upset, partly with good reason. They realise they do have the power, but for a whole variety of reasons they don’t use it or else they don’t fully appreciate it.”
Other parents have a complete lack of insight. “They don’t see it as a problem and they wonder why I am ‘scarring their child psychologically for life’ by actually mentioning it in a consultation when they came in with a sore ear.”
It is GPs’ responsibility to bring it up, he adds, but it is never an easy conversation.
LOOK TO YOURSELF
More often than not, an overweight/ obese child will have at least one parent with the same problem. Parents are a child’s most influential role models, so they really need to sort themselves out first by reviewing their dietary and exercise habits.
Eat more fruit and vegetables, avoid junk food, re-examine portion sizes and look carefully at liquids being consumed – anything other than water can pile on the weight by stealth.
"Your example is most important – what are you eating as a parent?" says Dr Eva Orsmond, who runs a number of private weight-loss clinics and advises participants in the current RTÉ series of Operation Transformation.
When she started out, she used to take children on their own but soon realised it was totally the wrong approach.
“A child is not overweight or obese by their own choice,” she says. Cases of obese children “are very near to what I call child abuse”.
Last July, two doctors suggested in the Journal of the American Medical Associationthat morbidly obese children should be considered endangered and removed from their homes.
Now Orsmond will not take on a child as a client unless a parent is also prepared to attend, to follow the eating programme and change their lifestyle.
“Going on a diet as a family is not going to work long term. The diet will come to an end – obviously it needs to be permanent.”
Parents need to look to themselves first, agrees Marie Campion of the Marino Therapy Centre, which specialises in treating eating distress and eating disorders.
But “we cannot blame the parents” and she is critical of public health campaigns that create anxiety and achieve nothing in addressing the root causes.
There are no quick fixes, she says. Anxiety and stress drive people to overeat, so these are issues that need to be looked at.
Parents need to enjoy being with their children more. Get them off the screens and go for a walk or run with them, “not for the purpose of losing weight but for the purpose of moving and having fun together”, she advises.
“We are creating a generation of children who do not feel good enough and then they start to emotionally overeat – they eat because of stress and become overweight and isolate themselves,” Campion says.
ACT NOW
The big advantage of early intervention is that children generally do not need to go on weight-loss programmes because they are going to grow. They just need to hold their weight steady and combine healthy eating with a reasonable level of activity.
“Parents are responsible for pretty much everything that goes into a kid’s mouth up until the age of 12 ,” says O’Shea.
If they have not instilled good eating habits into their children during those formative years, bad habits will persist in teenage years.
Orsmond says the hard work has to go in at the time of weaning babies, when it is essential to introduce different tastes gradually and ensure they become accustomed to a wide variety of food.
She sympathises with parents trying to change teenagers’ eating habits. “They have so many other issues at that age. I feel it is really sad if you have a teenager struggling with weight.”
Recently she saw a 14-year-old girl at her clinic who weighed 108kg (17 stone). “We should not let it get to that level but should address the issue earlier,” Orsmond says.
ENCOURAGE EXERCISE
Children need to be physically active for at least 60 minutes every day. Inactivity is a vicious circle for overweight/ obese children because the less they exercise, the more likely their weight is to increase, and carrying excess weight makes them less inclined to exercise.
“Be aware that your overweight child faces real obstacles to being active – be understanding, be positive, and make changes together,” says David Egan of Red Branch, a charity that promotes healthier lifestyles for young people.
They may be very self-conscious about their weight and if they want to avoid activities such as swimming, respect that, but help them find activities they enjoy.
Red Branch’s new website, parents forhealth.org, advises on how to help turn around your overweight child’s lifestyle.
Sport also encourages children to focus on fitness and see their bodies as “instruments” to be looked after.
CONCENTRATE ON WELLBEING
Parents are often terrified of bringing up the subject of weight with their children, for fear of giving them issues for life.
But an eating disorder such as anorexia, says Orsmond, “has a totally different pathology as a start point. A very small percentage of overweight/obese people would become anorexic – it is very unlikely.”
The focus should always be placed on health and wellbeing as opposed to size and appearance, says Ruth Ní Eidhin, a spokeswoman for Bodywhys, the Eating Disorder Association of Ireland.
“No matter what their weight, young people need to be encouraged in terms of developing a healthy body image, which is about how they perceive themselves rather than their actual weight,” she explains.
“They need to understand that their physical appearance is not reflective of other values like their worth as a person or friend.”
Campion recommends concentrating on other things in life because an indirect approach can help, rather than obsessing about food and weight.
“Measuring your daughter’s waist is only telling her she’s not good enough, she’s a number, it is not creating a happy person,” she says. “If you make yourself happy, you never will be overweight.”
While somebody who is very underweight is really telling us they cannot cope with emotional issues, somebody who is very overweight is telling us they are not listening to their body, she adds, “and often they are eating what is really eating them”.
HOME TRUTHS: 'I DO WORRY ABOUT THE AMOUNT OF RUBBISH HE CONSUMES AND THE EXAMPLE IT IS GIVIING TO HIS BROTHER'
Caroline cannot remember a time when she did not feel dissatisfied with her body shape, always thinking she should lose at least a stone.
“However, it never upset me enough to do something long-term about it. I did try to eat less from time to time, but my willpower is not great!”
Now, aged 47 and with a body mass index (BMI) of 26, she knows she continues to be overweight – a BMI of 25-29 is classed as overweight, anything 30 or over is obese. But she is reassured that she has lost a few pounds over recent years rather than putting them on.
However, she is concerned that she has passed on her “sweet tooth” and let her two children develop bad eating habits.
“My youngest son is certainly one of those one in four nine year olds who is overweight,” she admits. “He has been chubby from day one, even though he was breastfed for over a year.”
She now feels she is trying to get to a place where, if you were to ask for directions, the classic jocular response applies: “I wouldn’t start from here.”
Children’s habits are hard to break, especially at a time when you want to start giving them greater independence, she points out. And nobody wants to make a child self-conscious about how they look by explaining they need to lose weight.
“My basic philosophy would have been moderation in all things and I have tried to avoid ‘demonising’ foods, believing it only makes them more desirable.
“I do buy biscuits and crisps – although I never keep fizzy drinks in the house, always insisting they are for special occasions, such as meals out and parties.”
The trouble is, she explains, that “treats” seem, slowly but inexorably, to have become a much more frequent part of her children’s eating.
Her eldest son, who is in first year at secondary school in south Dublin, is relishing the new-found freedom to buy sweets, fizzy drinks, crisps or sometimes chips as he travels home independently.
“I am not unduly concerned about his weight, but I do worry about the amount of rubbish he consumes and the example it is giving to his younger brother.
“He gets a limited amount of pocket money, but sweets and crisps are relatively cheap,” she points out. “There is no point in saying he can only have the money if he doesn’t spend it on this stuff as how could I police that?
“All I can do is try to appeal to his intelligence and explain the importance of not eating too much junk food – although, perhaps, the more I go on about it, the more likely I am to drive him towards it!”
Talk by Minister for Children Frances Fitzgerald of restricting new fast-food outlets from opening in close proximity to schools, as they do in the UK, makes sense to her.
“I know some people regard this as ‘nanny state’ stuff and that it is up to parents to do their job. But my son buys chips on the way home from school at least once a week – and he would not do that if he was not passing the takeaway every day.”
Caroline feels like a rabbit trapped in the headlights – believing she should be doing more to avert weight issues for her sons going into adulthood.
“I have not looked for any professional advice because I feel if only I could get my act together – and that applies to my own weight too – the solutions are obvious, so I don’t need anybody to tell me what to do.”
The trouble is, she points out, knowing and doing are two different things.
Meanwhile, she clings to the hope that her sons’ keen interest in sport, with gradual changes to household eating, will spare them a lifetime of weight problems.
*Name has been changed
- Some 54% of parents of overweight children and 20% of parents of obese children report that they are “about the right” weight for their height
