By Christine L. Williams, MD, MPH

With any medical problem, it is important to educate yourself about the condition itself. As a parent, this gives you a better idea of the factors that contribute to the problem, how it affects your child’s health, and what expert opinions are as to the best course of treatment and follow-up.

Medical Problems

Some of the medical problems that can affect overweight children include high blood pressure, high blood cholesterol and triglycerides, low levels of “good” HDL-cholesterol (that helps keep arteries “clean”); early stages of fatty liver; elevated insulin levels; type 2 diabetes; orthopedic problems; polycystic ovary syndrome or other menstrual problems; and sleep apnea. Several of these problems increase risk of premature heart disease in adult life. All of these medical ailments improve with weight control or weight loss, and worsen as overweight becomes more severe. There are many sources of excellent information available from leading health organizations and others. Some of the best of these are listed at Helpful Resources for Parents of Overweight Children.

Emotional Concerns

Of equal concern are emotional problems that can result in negative social consequences. For many overweight kids, psychological and social problems are the most troubling. Overweight children are at increased risk of low self-esteem and sometimes depression. In addition, they may be less popular than others and excluded from activities by children their age. Teasing and name calling are common, too. Parents who were overweight as children or teens rarely forget the hurtful ridicule they experienced when they were young, and don’t want their own children to go through the same thing.

Healthcare Providers

There are medical and health professionals who are trained to help the parents of overweight children with initial evaluations and plans for treatment and follow-up. These include your child’s health care providers, registered dietitians (RD’s), psychologists, and physical fitness specialists and trainers.

School and Community

Almost all children eat lunch at school, where they spend a large part of every day most of the year. An increasing number eat breakfast, lunch, and a snack at school, which makes it vitally important that schools provide the healthiest school-food program possible. What is more, for many children, physical education (“gym”) at school is the only moderately vigorous exercise they get all week. Unfortunately, many schools have cut programs so that a large number of kids have gym only once or twice a week.

Health and nutrition education is also a vital part of a child’s education and many schools teach the fundamentals. Children, like adults, need to learn the basics of body care: how to eat a healthful diet; how to maintain good hygiene; the importance of regular exercise; how to avoid accidents, injury, and violence; and why to avoid tobacco and dangerous drugs.

Parents can help by getting involved in their child’s school. Find out about the school nutrition and physical education policies. Does the school have a “healthy snack” policy? Volunteer for any committees involved with nutrition and physical activity in the school. Review the usual cafeteria menus and a la carte items sold. Arrange for a dietitian to speak to the PTA about healthy nutrition for children. Look for innovative ways to increase the amount of physical activity children get at school, such as a morning running club, an afternoon jump rope club, “cheerleading 101,” or even just a music CD to accompany a 3-5 minute “transition” time of stretching/moving exercises to get the children settled down when they arrive in class.

Communities also play an important role in supporting healthy nutrition and policies and practices regarding physical activity. For example, the concession stand at the town swimming pool could stock a variety of healthier snacks and beverages. Sidewalks, good lighting and safe well-equipped playgrounds all promote an active lifestyle for children. Community picnics and dinners can involve dietitians to help plan “lighter,” healthier fare.

Christine L. Williams, MD, MPH is professor of Clinical Pediatrics, and director of the Children's Cardiovascular Health Center in the Department of Pediatrics and Institute of Human Nutrition at Columbia University, College of Physicians and Surgeons.