Child obesity expert explains why epidemic isn't going away anytime soon

“The difficulty really comes in that once adolescents are obese, they more than likely will remain obese into and through their adulthood. There is no easy fix. It takes time, hard work and a drive to change habits that have been established for a long time,” said Garry Sigman, MD, a pediatrician and obesity expert at Loyola University Health System and associate professor of pediatrics at Loyola University Chicago Stritch School of Medicine.

The physical implications of obesity are vast and dangerous. It is a major risk factor for numerous health problems, including cardiovascular disease, skin problems, orthopaedic abnormalities, diabetes and cancer. Just as scary are the psychological and emotional impact obesity will have on children and adolescents.

“Obesity in children can lead to a feeling of inadequacy and isolation. Even as young as 5 years old, children can be stigmatized by their peers. This can result in depression or suicidal ideation, especially among adolescent girls. Since food can be comforting, the child may turn to or may already have turned to food to feel better. This is a very circular problem and so when dealing with obesity the whole child – mind, body and soul – needs to be addressed as well as the environment,” Sigman said.

In working with children, Sigman has found that a child’s environment and social-cultural factors play an even larger role than genetics in their development of the disease.

“Genetics do play some role in whether a child will become obese, but the dramatic numbers and steady increase that we have seen can’t be attributed to genetics alone,” Sigman said. “What’s happening is our lifestyle is not only causing more people to become obese, but the BMIs of a larger part of the population are higher. So, even those who are not genetically prone to the disease are becoming obese."

Some nongenetic behavioral risk factors for children include:

Mother who is obese or diabetic

Mother who smokes

Bottle-feeding on a schedule vs. breast-feeding on demand

Too much screen and sedentary time

Not enough sleep

Portion size of food

Unhealthy snacking, including where, when and what a child eats

Not getting enough physical activity

Not eating enough healthy foods, including fruits and vegetables

Many of these factors are linked to a common feature in the lifestyles of today’s youth – too much screen time. According Sigman, there is a direct correlation between collective time youths spend in front of a screen and the number of patients who are obese.

“Unsupervised TV watching is terrible for kids. It has a hypnotic effect that causes us to move less and burn fewer calories. Eating in front of the TV is made worse by  ads for food that make people of all ages have the desire to eat more, even if  not hungry,” Sigman said.

We move more when we are reading a book or even playing a video game, so both pastimes are better than watching TV, Sigman said. Getting away from the screen and really moving are integral to battling the obesity epidemic and need to be priorities of both parents.

“Parents need to limit their children to two hours of screen time at home a day,” Sigman said. “This needs to be a rule and one that’s enforced. It’s time consuming for parents and it’s a lot of hard work, but it really could be a factor in whether you have a healthy child or not."

Screen time also affects a child’s sleep, which is another risk factor for obesity. Sigman said there should be no television in a child’s room. And close to bedtime, there should be limited access to computers, cell phones, video games, iPods, etc.

“Children and adults need less stimulation before bed to allow their bodies and their minds to wind down before going to bed. It’s important to include downtime into a child’s schedule to ensure a child is getting enough sleep,” Sigman said. “In addition to screen time, parents should limit a child’s vigorous exercise and loud music close to bedtime."

Sigman gives a 3-step plan for parents to start limiting their child’s screen time.

Plan it. Make a daily schedule for your kids and be sure to include active after-school play time. Don’t forget time for homework.

Model it. If you are sitting on the couch watching TV, so will your kids. So find ways to be active as a family.

Enforce it. Make the planning and the enforcement of it a priority. Plan it together. Look for alternatives to screen time, such as working on a project together, playing a game, taking a walk or even cleaning the house.

“It’s important for kids to be more active and take responsibility. So why not include cleaning or picking up as part of the daily family schedule? Everyone needs to contribute to make the family function. Kids need to learn at an early age that mom and dad are not servants,” Sigman said. They learn that if everyone is expected to pitch in, he said.

Still, Sigman believes it goes beyond the family to whole communities making changes to really make a dent in the epidemic.

“We need to create safe places for kids to play outside. Safety is a real issue for parents,” Sigman said. “Though organized sports are wonderful, they aren’t for all kids. Kids need free play. They need to be able to run and ride their bikes, but if there aren’t sidewalks or safe playgrounds, kids are stuck inside on a computer or in front of the TV."

Provided by Loyola University Health System