Treatment of Childhood Obesity

Obesity treatment programs for children and adolescents rarely have weight loss as a goal. Rather, the aim is to slow or halt weight gain so the child will grow into his or her body weight over a period of months to years.

Early and appropriate intervention is particularly valuable. There is considerable evidence that childhood eating and exercise habits are more easily modified than adult habits. Three forms of intervention include:

Physical Activity – Adopting a formal exercise program, or simply becoming more active, is valuable to burn fat, increase energy expenditure, and maintain lost weight.
Diet Management – Fasting or extreme caloric restriction is not advisable for children. Not only is this approach psychologically stressful, but it may adversely affect growth and the child’s perception of “normal” eating. Balanced diets with moderate caloric restriction, especially reduced dietary fat, have been used successfully in treating obesity. Nutrition education may be necessary.
Behavior Modification – Many behavioral strategies used with adults have been successfully applied to children and adolescents: self-monitoring and recording food intake and physical activity, slowing the rate of eating, limiting the time and place of eating, and using rewards and incentives for desirable behaviors.

Obesity is easier to prevent than to treat, and prevention focuses in large measure on parent education. In infancy, parent education should center on promotion of breastfeeding, recognition of signals of satiety, and delayed introduction of solid foods. In early childhood, education should include proper nutrition, selection of low-fat snacks, good exercise/activity habits, and monitoring of television viewing. In cases where preventive measures cannot totally overcome the influence of hereditary factors, parent education should focus on building self-esteem and address psychological issues.