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Posted by Dr. Claire McCarthy February 10, 2014 08:09 AM
Time and time again, when I tell parents that their young children are overweight, they look at me like I'm some sort of deranged zealot and say, "It's just baby fat. He'll grow out of it."
If only it worked out that way.
Sometimes it does. Certainly years ago when infant mortality was high, and when we were all much more active, a little extra weight didn't hurt and possibly helped. But times have changed. Medical care has come a long way--and we are way less active. These days, baby fat turns into kid fat, which turns into teen fat, which turns into adult fat--with all the health consequences adult fat brings.
The New England Journal of Medicine recently published a study that underlined this problem. Researchers followed nearly 8000 youth from kindergarten in 1998 to 8th grade in 2007. They found that those who were overweight when they entered kindergarten were four times more likely to be obese by the time they were in 8th grade. In fact, three-quarters of the overweight 8th graders were either overweight or nearly overweight when they were 5. Another interesting finding in the study: the biggest jump in the number of obese kids in the study happened early, between 1st and 2nd grades.
If we are going to fight childhood obesity, we are going to have to start with fighting baby fat.
I am getting remarkably nowhere in my practice when it comes to helping my overweight patients. I talk and talk with them and their families. We talk about specific changes they can make, like cutting out juice, or walking to school, or joining a sports team--we agree together on something they think is feasible. I have them come back to see me in a few months...and with remarkably few exceptions, their weight isn't any healthier. Some have made the lifestyle changes we talked about--but most haven't, at least not all of them.
Habit is a powerful thing, I know. But there is more at play here. Parents don't like to make their kids unhappy by taking foods and drinks they like away from them--especially their young children (who are most likely to throw tantrums, and least likely to understand your rational argument). They don't like to make them be active, either, when the kids complain. And parents really do seem to believe that it's not a big deal, that the kids will thin out when they get older. They just think I'm wrong.
I can't tell you how much I wish I were wrong. Or how much I wish I had a crystal ball to show them. Maybe we need something like the ads the FDA is putting out to show teens what they will look like when they are older if they smoke. Maybe if parents could see their cute chubby preschoolers as obese adults with diabetes, they'd rethink the Capri Sun.
Please, parents, do whatever you can to keep your babies and young children at a healthy weight. Breastfeed, if that's possible. Be sure your baby is hungry before you give her another bottle. Don't give juice. Have family dinners, and consider baby-led weaning. Serve fruits and vegetables (and eat them yourself). Don't overdo the screens. Take your child to the park and otherwise start them early on an active lifestyle. And please: listen to your doctor.
It's little stuff--but it will make a really big difference.
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About MD MamaClaire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »
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