The treatment of an overweight child should focus on the entire family. The eating and exercise habits of the entire family nearly always need to be improved. Efforts to treat the child without addressing the lifestyle of the parents and other members of the family living under the same roof are likely to fail. Targeting only the child for treatment may stigmatize the overweight child and can be counter-productive and even harmful.
- The eating and exercise behavior of the parents will be the most important influence on the behavior of the child over the long term. Parents must see themselves as important role models in the areas of healthy eating and regular physical activity.
- The environment in which the child lives may need to be evaluated and changed.
- Questions for evaluating physical activity:
- Does the child walk to school?
- Can the child safely play outdoors? If so, how much time does he or she spend outdoors?
- Does the child receive physical education that involves plenty of physical activity at school each day?
- Are after school and weekend recreation programs available that emphasize physical activity?
- How much TV, videos, or computer games is the child doing each day?
- Does the child have unlimited access to TV? Is the TV in the child's bedroom?
- Questions for evaluating diet:
- Does the child have his or her own money to spend on food? If so, what food is being purchased?
- What foods and beverages are readily available to the child at school? At home? In the community?
- How often does the child eat out each day? What food choices is he or she making?
- Parents may need guidance in choosing and cooking foods low in fat.
- Families may need to learn what an appropriate portion or serving size is for adults and children and how many servings from each food group should be eaten over the course of an entire day.
- Parents may need different approaches for managing problem foods. Some programs treat candy, desserts, sweets, cakes, cookies, and soda and ice cream as "red light foods" that may not be consumed more often than 3 or 4 times a week. It may be necessary to stop bringing red light foods into the house.
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