“How should we help our son lose weight?”
My son is 8 years old and my doctor considers him obese. He's 110 pounds. We never really realized that this could be a problem until now, because both me and my husband are a little overweight. How can we help our son lose weight?
6 Answers
Most of the children in this age have slow growing and easily gain weight. Sports and restrictions of carbohydrates helps. Better that the whole family get on a low-carb diet and more activities to support your sun.
Obesity is a medical condition were excess fat is stored in the body (in adipose tissue). Obesity is becoming a major health problem not only in the USA but also globally. In the United States over 50% of adults and over 25% of children are obese/overweight. Obesity increases risk factors such as type 2 diabetes, hypertension, fatty liver disease, sleep apnea, cardiovascular and colorectal diseases, irregular menstrual cycle and many other medical problems.
excess fat is stored in the body deep in side the body (viscera) or superficial (subcutaneous). It may be distributed in two forms. Central or Android (apple shape) or Gynoid (pear shape) obesity. Central obesity (apple shape) is when fat is deposited on the abdomen, trunk and neck. This form of obesity is common in men. Abdominal girth is much bigger in central or Android obesity. It is also true that abdominal (central) obesity is worse than the gynoid (pear shape) obesity because it exports insulin resistance, leading to metabolic syndrome, type 2 diabetes, high blood pressure, fatty liver disease, hyperlipidemia, sleep apnea and others. The Gynoid (pear shape) obesity is when fat is distributed in the hip and thigh area. This type of obesity (Gynoid) is more common in women though some men will have it as well. The gynoid obesity is not as strong as the Android obesity in causing obesity related morbidities such as insulin resistance (metabolic syndrome) as the abdominal girth is not increased to the degree of the Android obesity.
The majority of obesity whether it is Android or Gynoid are caused by lack of regular physical activity, wrong diet and excess calorie ingestion. Few cases of obesity are as a result of hormonal imbalances and genetic abnormalities. Some of the hormone causes of over weight can be thyroid hormone deficiency, excess cortisol, insulin resistance, leptin abnormalities etcetera. Obesity (overweight) due to hormonal imbalances will follow the Android or central obesity form of body fat distribution. In cortisol excess for example, the fat distribution is more prominent on the trunk and neck.
There are also rare genetic abnormalities that can cause obesity such as Prader Will syndrome, Bordet Biedl syndrome, downs syndrome, leptin deficiency, MC4 defect, psuedohypoparathyroidism and much more. These genetic disorders are beyond the scope of our discussion at this time.
The human history has been so successful that we have evolved into a complex and affluent modern society. From the days of scarcity ( hunter and Gatherer) we have evolved into a wealthy society with plenty of food and endless festivities. during the days of food scarcity in the era of hunter and gatherer society a thrifty gene evolved for our survival. The thrifty gene helped as gain more weight during plenty (hunting season) and we used the body fat to survive during scarcity when there was little prey to hunt. The thrifty gene was able to store more fat by creating insulin resistance during the seasons of plenty. Those calories were used during the time of scarcity. The thrifty gene was therefore a survival gene in that era. The people who had the thrifty gene faired better than the people with out the thrifty gene. AS we became affluent the thrifty gene was no longer needed, and instead it be became a liability. It continued to unleash the epidemics of obesity leading to the metabolic syndrome mostly through insulin resistance.
Suppose we all go to the Kalahari desert to become hunter and gatherers or we go to some poor countries where there is food scarcity, regardless of the thrifty gene our body fat will melt in a matter of time. It is therefore important to appreciate that wrong diet (high carbohydrate and high saturated fat), excess calorie intake and lack of daily regular exercise are driving most of our obesity and its co-morbidities. It is therefore important to remember that nutrition is the hallmark of the maximum expression of the gene. The more food we have the more maladaptive genes will express, leading to more medical problems which were not common before.
In some cases medications for appetite suppression may be indicated on individual basis. Specially in adolescent and adults persons with obesity appetite suppressing medications can be tried if diet and exercise fail. Such medications are stimulants (such as Adderall), phentermine, belviq, qsymia, contrive, Topamax, metformin, (Naltrexone+welbuterine), HCG (150-250 units daily injection for 40days), Saxenda 3.0 mg, Victoza and more others can be tried as indicated. If every thing fails and if obesity either severe or morbid and are signs of comorbidity, bariatric surgical intervention should be entertained seriously.
Psychological and emotional counseling is very important for life style modification. Good counseling would facilitate life style modification. Change is not always easy. For a change to be successful the mind needs to be receptive of the change. That is, the mind need to accept the change to make the process easier. With out emotional psychological readiness weight loss program will not be effective.
In young children weight loss may not be the preferred step. Since young children are growing halting weight gain will be sufficient. If they do not gain any weight as they grow they will slim out nicely compared to adolescents and adults who have no more future potential left for growth.
Going back to your question, your son most likely gaining excess due to wrong diet (high carbohydrate, high saturated fat) excess calorie ingestion and lack of daily regular physical activity like the majority of over weight and obese people in the USA, though there could be a slim possibility of hormonal imbalance. It is therefore very important that you see your son's doctor for proper evaluation. You should ask him to run some tests to rule out hormonal imbalances and check for any genetic conditions. If his weight gain is due to hormone problems, things will improve with correcting the hormone imbalance.
The most important issue is to recognize that wrong diet, excess calorie intake and lack of regular (daily) physical activity are the overwhelming causes of the overweight/obesity epidemics in the USA. So I encourage you to look in to this issue. Healthy balanced diet with bigger portions of vegetables and regular daily structured physical activity should be intensified to maintain an ideal body weight. You should see a good nutritionist to give you a nutritional guide. Provide your son with healthy diet, limit calorie intake with out restricting growth and daily structured physical activity. Create partnership with a good nutritionist and your doctor and you as the leader of the team. If he still continues to gain more weight despite all endeavors, ask your doctor for appetite suppressing medications if indicated. Discuss these issues with you doctor and listen to his expert advice and work as a team.
Good luck
excess fat is stored in the body deep in side the body (viscera) or superficial (subcutaneous). It may be distributed in two forms. Central or Android (apple shape) or Gynoid (pear shape) obesity. Central obesity (apple shape) is when fat is deposited on the abdomen, trunk and neck. This form of obesity is common in men. Abdominal girth is much bigger in central or Android obesity. It is also true that abdominal (central) obesity is worse than the gynoid (pear shape) obesity because it exports insulin resistance, leading to metabolic syndrome, type 2 diabetes, high blood pressure, fatty liver disease, hyperlipidemia, sleep apnea and others. The Gynoid (pear shape) obesity is when fat is distributed in the hip and thigh area. This type of obesity (Gynoid) is more common in women though some men will have it as well. The gynoid obesity is not as strong as the Android obesity in causing obesity related morbidities such as insulin resistance (metabolic syndrome) as the abdominal girth is not increased to the degree of the Android obesity.
The majority of obesity whether it is Android or Gynoid are caused by lack of regular physical activity, wrong diet and excess calorie ingestion. Few cases of obesity are as a result of hormonal imbalances and genetic abnormalities. Some of the hormone causes of over weight can be thyroid hormone deficiency, excess cortisol, insulin resistance, leptin abnormalities etcetera. Obesity (overweight) due to hormonal imbalances will follow the Android or central obesity form of body fat distribution. In cortisol excess for example, the fat distribution is more prominent on the trunk and neck.
There are also rare genetic abnormalities that can cause obesity such as Prader Will syndrome, Bordet Biedl syndrome, downs syndrome, leptin deficiency, MC4 defect, psuedohypoparathyroidism and much more. These genetic disorders are beyond the scope of our discussion at this time.
The human history has been so successful that we have evolved into a complex and affluent modern society. From the days of scarcity ( hunter and Gatherer) we have evolved into a wealthy society with plenty of food and endless festivities. during the days of food scarcity in the era of hunter and gatherer society a thrifty gene evolved for our survival. The thrifty gene helped as gain more weight during plenty (hunting season) and we used the body fat to survive during scarcity when there was little prey to hunt. The thrifty gene was able to store more fat by creating insulin resistance during the seasons of plenty. Those calories were used during the time of scarcity. The thrifty gene was therefore a survival gene in that era. The people who had the thrifty gene faired better than the people with out the thrifty gene. AS we became affluent the thrifty gene was no longer needed, and instead it be became a liability. It continued to unleash the epidemics of obesity leading to the metabolic syndrome mostly through insulin resistance.
Suppose we all go to the Kalahari desert to become hunter and gatherers or we go to some poor countries where there is food scarcity, regardless of the thrifty gene our body fat will melt in a matter of time. It is therefore important to appreciate that wrong diet (high carbohydrate and high saturated fat), excess calorie intake and lack of daily regular exercise are driving most of our obesity and its co-morbidities. It is therefore important to remember that nutrition is the hallmark of the maximum expression of the gene. The more food we have the more maladaptive genes will express, leading to more medical problems which were not common before.
In some cases medications for appetite suppression may be indicated on individual basis. Specially in adolescent and adults persons with obesity appetite suppressing medications can be tried if diet and exercise fail. Such medications are stimulants (such as Adderall), phentermine, belviq, qsymia, contrive, Topamax, metformin, (Naltrexone+welbuterine), HCG (150-250 units daily injection for 40days), Saxenda 3.0 mg, Victoza and more others can be tried as indicated. If every thing fails and if obesity either severe or morbid and are signs of comorbidity, bariatric surgical intervention should be entertained seriously.
Psychological and emotional counseling is very important for life style modification. Good counseling would facilitate life style modification. Change is not always easy. For a change to be successful the mind needs to be receptive of the change. That is, the mind need to accept the change to make the process easier. With out emotional psychological readiness weight loss program will not be effective.
In young children weight loss may not be the preferred step. Since young children are growing halting weight gain will be sufficient. If they do not gain any weight as they grow they will slim out nicely compared to adolescents and adults who have no more future potential left for growth.
Going back to your question, your son most likely gaining excess due to wrong diet (high carbohydrate, high saturated fat) excess calorie ingestion and lack of daily regular physical activity like the majority of over weight and obese people in the USA, though there could be a slim possibility of hormonal imbalance. It is therefore very important that you see your son's doctor for proper evaluation. You should ask him to run some tests to rule out hormonal imbalances and check for any genetic conditions. If his weight gain is due to hormone problems, things will improve with correcting the hormone imbalance.
The most important issue is to recognize that wrong diet, excess calorie intake and lack of regular (daily) physical activity are the overwhelming causes of the overweight/obesity epidemics in the USA. So I encourage you to look in to this issue. Healthy balanced diet with bigger portions of vegetables and regular daily structured physical activity should be intensified to maintain an ideal body weight. You should see a good nutritionist to give you a nutritional guide. Provide your son with healthy diet, limit calorie intake with out restricting growth and daily structured physical activity. Create partnership with a good nutritionist and your doctor and you as the leader of the team. If he still continues to gain more weight despite all endeavors, ask your doctor for appetite suppressing medications if indicated. Discuss these issues with you doctor and listen to his expert advice and work as a team.
Good luck
Control his diet, may see a nutritionist and physical activity
Stuart Jay Brink
Endocronologist (Pediatric)
Most 8-year-olds who are overweight or obese don't buy their own food and snacks, so key will be to determine what you are offering and what is available at home for meals and for snacks. Much more water is always a great model to help you as parents with your weight, but also to demonstrate this option for your child. Paying particular attention to the amounts of carbohydrates (cereal, pasta, bread, potatoes, fruits/juice, candy) is another great idea to consider. Decreasing size of plates helps to decrease simple excess portions as well. If you don't know how to get started, then sitting down with a pediatric dietician/nutritionist recommended by your PCP or pediatrician is another good option. And, of course, in addition to cutting total grams of carbohydrates/sugar intake and perhaps also saturated fat/total fat intake, increasing daily activity/cutting down on time on the phone/computers/television can only help the process. If not already done, then blood vitamin D levels (goal should be >50 ng/ml levels optimally), as well as lipids (total cholesterol goal <170, HDL goal >50, LDL goal <100, nonHDL cholesterol goal <100, triglyceride goal <84). The more these are abnormal, the greater the current risk as well as future risk. Overall end goal is to decrease current and future risks of diabetes, high cholesterol, high blood pressure, osteopenia/osteoporosis (and maybe also cancer) that is all reflected with excess weight, excess carbs.
Stuart Brink, MD
Stuart Brink, MD
Increase his physical activity. Discontinue the consumption of junk food or fast food. Discontinue drinking sugar-containing beverages or sodas. Take a nutritionist consult together as a family. Change your diet at home.
Children should drink about 3 glasses of milk per day. Everything else should be water. Appropriate serving size for your child is the size of his fist. 1 serving protein: meat, 1 serving carbohydrates and then 2 servings of vegetables would be ideal - please see choosemyplate.gov. Also, he should get 1 hour of exercise everyday in addition to gym class.
