The incidence of obesity in children is increasing rapidly. According to recent studies, 20% of American children aged six to eleven are significantly overweight. While there are no statistics available on the occurrence of childhood obesity among Jews, anecdotal evidence, combined with the fact that so much of Jewish ritual and tradition focuses on food and eating, would suggest that the incidence of childhood obesity among Jews is at least as high as that among the larger American society.

Parents of overweight children have legitimate reason for concern. In addition to a myriad of medical problems it causes later in life, obesity condemns children to social rejection and low self esteem during the most pivotal years of their psychological development.

These parents often feel overwhelmed by intense emotions, such as anxiety, frustration, shame and guilt. In order to successfully meet the challenge of obesity in children, parents need to first understand what causes this disorder and then what they can do to help their children overcome it.

WHAT CAUSES CHILDHOOD OBESITY?

There is no single factor which leads to obesity in children. It is caused by any one or combination of the following:

  1. Biological factors. Just as with adults, hormonal imbalances in the body can cause a child either to overeat or metabolize food too slowly. In addition, some medications prescribed for children could have the undesired side effect of causing weight gain.

  2. Parental modeling. If one or both parents are overweight, then children have a poor example being set for them 24/7. Children tend to imitate their parents. While they do not copy all of their parents' behaviors, they almost always emulate those behaviors we would most want them to avoid.

  3. Inadequate exercise. As academic standards rise in our ever increasing competitive society, the opportunities for children to engage in physical exercise diminish. Television, video games and other passive forms of entertainment also reduce the time today's children are active. With so little exercise, even moderate overeating can result in childhood obesity.

  4. Poor nutrition. In our fast paced world, fast food has become a staple instead of an occasional indulgence. Families with two working parents often need to rely on take-out food regularly in order to maintain their busy lifestyle. While these meals may be tasty and convenient, they also add many more calories and much less nutrition than traditional home cooked meals. In addition, the tidal wave of advertising aimed at children, stimulates their appetite for food with high sugar and fat contents.

  5. Psychological factors. Some children use food as a tranquilizer to calm their fears and anxieties. Others use food to comfort or soothe hurt feelings from childhood abuse or trauma. Still others overeat as a way of passively defying their parents' attempts to control their behavior. Finally, some children use food to ward off depression or to suppress angry feelings that they cannot express openly.

WHAT PARENTS SHOULD NOT DO

Although they are usually well intentioned, parents often engage in misguided strategies to help their children which only backfire and make matters worse.

Take Reuven's mother, for example. She saw him piling on the pounds when he was only 11 years old. Determined to help him, she launched a program of brow beating, harping and plain old fashioned nagging to convince him to join a weight control program. Her efforts succeeded in alienating Reuven, lowering his self esteem and crushing his confidence. And he never did lose any weight. Today, 17 years later, a still much overweight Reuven looks back and identifies his mother's attitude and approach as having contributed much more to the problem than to a solution.

WHAT PARENTS CAN DO

  1. Consult your pediatrician. The first thing you need to do is rule out any biological factors which may be contributing to your child's obesity. Only after your pediatrician has eliminated these causes as possible considerations should you look for behavioral or environmental solutions.

  2. Set a proper example. "Do as I say; not as I do," is as ineffective in dealing with childhood obesity as with any other childhood behavioral problem. If your eating is out of control, trying to curb your child's appetite would be like driving with your food on the gas pedal and the brake at the same time. You will get nowhere fast, while wasting a lot of energy.

  3. Help support healthy lifestyle choices. Be sure to provide plenty of healthy snacks to your child and limit the availability of unhealthy foods at home. Teach your child the basic principles of good nutrition. For example, it is not how much you eat that counts, but rather how much of which foods. In addition, encourage your child to engage in active recreation that is both fun and aerobic. Exercise should not be a burden if you hope to make it an integral part of your child's daily schedule.

  4. Foster dietary autonomy. Weight monitoring and weight loss must become your child's responsibility and not yours. Once you care more about your child losing weight than he or she does, you have lost the war.

    The way to get your child to take charge of his or her eating is by giving more choices, not less. For example, "Which salad would you like for lunch?" is much more helpful than, "Don't take another piece of bread. You've had enough already."

  5. Focus on positives. Punishment, criticism and disapproval are the most ineffective methods of modifying childhood behavior, even though they are widely used by parents today. What is much more helpful is to positively reinforce good behavior with praise, approval and compliments. Try to catch your children making healthy choices and verbally reward them.

    Comments such as, "I was so proud of you today when you took fruit for snack," or "I know it was not easy for you to turn down the dessert Grandma offered you tonight," or "I'm so happy that you took advantage of the nice weather this afternoon to ride your bike," go a long way towards supporting your child's motivation to lose weight as well as boosting his or her self esteem.

  6. Alleviate stress. Since food is so often misused as a source of emotional comfort and soothing, try to identify and eliminate as many sources of stress in your child's life as possible. If the dynamics of your family life are generating too much hostility at home, seek marital or family counseling. If your child is lacking social skills, is overly fearful and anxious, or is having difficulty getting past some stressful event, arrange to have your child meet with a child specialist who can help your child learn the necessary coping, emotional or social skills.

    Finally, as with so many childhood disorders, obesity is not something that can be overcome quickly or easily. In time, however, with patience, understanding and a realistic plan, you can succeed in helping your child adopt healthier behaviors and attitudes about food, eating and exercise.