My son is obese. How can we help him?

bathroom-scaleQ: I took my child to the GP due to a chest infection and as part of the examination he weighed my son and indicated that he thought he was overweight and that I should take steps to address this. I was a bit annoyed because I had not taken my son to see him for an assessment of his weight. However, I see his point that he might be thinking of my son’s well-being. To be honest I know I am quite overweight myself and I think he was intimating this also. I suppose hearing all the campaign ads on TV I am worried about the problem for my son and I don’t want him to have health problems. Also, I am not totally sure where we are going wrong. He does like his food and treats but I did not think he ate much more than other kids of his age. Also, I don’t want him to make him feel self-conscious or feel bad about being fat.

A: Being overweight is a very sensitive issue and getting information that you might be overweight can be difficult to hear. This is even the case if this information comes from a health professional who has a responsibility to give people feedback about their health. It can feel much worse to get this news about your own child because as a parent you can feel to blame for your child being overweight and that it somehow it reflects on your parenting. However, it is good that you get this information earlier rather than later so you can take steps to address it.

Childhood obesity is a growing problem that predicts serious future health problems unless it is changed. Eating and exercise habits can become established in early childhood and these can be harder to change when children are older. In Ireland we are facing an almost epidemic increase in obesity rates in recent years. The Growing Up in Ireland study in 2011 showed that almost 20 per cent of nine-year-olds were overweight and a further 7 per cent obese – these are alarming rates.

You are also not alone in being surprised by the fact that your son might be overweight. As a culture we have become out of touch about what being normal weight is, as so many of our peers are overweight that it has almost become normal. Collectively, our dietary habits have deteriorated, our portion sizes have increased and our levels of physical activity have decreased. You can easily see this in the changing eating habits of children.

Whereas in the past, sugary drinks, chocolate and crisps were rarely consumed by children, now they are almost daily habits for some. In addition, children are walking less and been driven places more and engaging more in passive activities such as computer games and less in physical activities such as sport or even walking. These changes have crept in slowly over the years but are now habitual in many homes.

Take time to reflect on your family’s eating habits and activity levels
I would encourage you to treat the visit to your GP as a positive event and see it as a “wake-up call” that inspires you to take action. The first step is to take stock of your son’s and your family’s eating habits and lifestyle. Make a note of what you are all eating and how much activity you are taking. It can help to keep a food and activity diary for a few days which will help you spot any bad habits that might have evolved.

Educate yourself about healthy eating and the calorie intake and nutritional content of foods. Many people are surprised by just how little the recommended daily calorie intake is for adults and children and how high the calorie content is of some common foods. There are lots of excellent online guides to making nutritious healthy family meals on a budget – simply search online.

Focus on family goals of health and fitness
In my work with parents it is always best to tackle these problems as family together. Rather than changing things just for your son, try and make positive lifestyle changes for the whole family. In addition, don’t focus on negative goals such as “losing weight” or “going on a diet”.

Instead focus on positive goals of getting more healthy as a family. Sit down together and plan how you are going to try new and interesting healthy foods together and how you are going to do more physical activities together. See it as your family project for the year ahead.

Make small significant changes
Remember you don’t have to start out with big lifestyle changes, and some simple small changes in routine can make an enormous difference. For example, arranging it so that you walk to school with the children will really increase your level of physical activity. Or setting a rule that you only have “treat foods” at the weekend could drastically reduce your intake of high sugar foods. Or having fixed meal times and reducing snacking outside these can help everyone be more clear about what they are eating.

There is some excellent family advice on the government health website, which makes suggestions for healthy family meals, portion sizes and how to make positive family lifestyle changes. You may have noticed the associated “Tackling obesity one step at a time” national campaign in the media, which includes memorable steps such as saying no once in the shop to treats, so you don’t have to say no all week when the treats are in the house!

Dr. John Sharry, Irish Times Newspaper, February 2014. John writes in The Irish Times Health+Family every Tuesday.