Author addresses overweight children

By Wanda A. Adams
Assistant Features Editor

CEDERQUIST: Wrote about weight problems of youth

But this is not just K.C.'s problem. It's her family's, too. And it is the problem of nearly one-third of children in this country, a considerable increase over their parents' generation, Cederquist says. In Hawai'i, a new study by the UH-Manoa and Brigham Young University indicates that 26 percent of public school children and 19 percent of private school children are obese — the medical term of being significantly overweight.

K.C. is the lead character in a series of vignettes that open each chapter in Cederquist's new book, a composite of many of Cederquist's patients. Not only does K.C.'s story serve to point up common issues and solutions or at least approaches, but it captures the readers, who soon begin rooting for this young woman, relating to her and wanting to know how things turn out.

Cederquist, a mother of three and a Virginia family physician who specializes in helping people with weight problems, said in a phone interview that she wrote the book because she realized that, while there are hundreds of weight loss books for adults, there aren't many aimed at children and their parents.

She has subtitled this book "A Family Guide," and designed it so that patients and their parents can employ the techniques she uses in her family practice.

In each chapter, she explores the issues brought up in the vignette, offers statistics to support her assertions, suggests ideas for how K.C., her parents, brother and friends can improve their eating and exercise habits, and ends with a summary of the chapter's key points. Appendices cover journal-writing, which she considers a vital tool, particularly for older adolescents; nutritional assessments of menu items from 11 national fast food chains, with lists of which dishes are better choices than others; a guide to reading food labels; and lower-fat recipes for dishes that young people like (including fish fingers, chicken nuggets, pizza and homemade potato chips).

In a telephone interview, Cederquist said the heart of her message to parents is to be accepting but not enabling, to be willing to take on the responsibilities that are theirs, and to consider the role their own attitudes and behavior may play in their child being overweight.

First, though, make sure your child really is overweight. Particularly when parents have issues about weightÊ— perhaps they were once overweight, or are uncomfortable with overweight people — they may over-react when a child's height hasn't quite kept up with their width. "A lot of kids go through growth spurts, and it's important that your first step be to take them to a physician who will plot them on the growth curve and determine whether they're truly overweight," she said.

If that is the case, Cederquist said, parents must find a balance between being too restrictive and too permissive. "Study after study has shown that if parents are too restrictive, saying you can't eat this and you can't eat that, then the child ends up binging and obsessed with food, and that really sets up long-term problems with weight," she said.

"It's really important that parents try to be accepting of their child and not to have weight be the thing their acceptance hinges on," she said. "It's not, 'I'd love you more if you lost weight.' It's 'We want the best for you, and we have decided as a family to live a healthier lifestyle to help you and all of us.'"

Parents should try to help young people become comfortable with their natural body type and their genetic inheritance, which may mean being short and rounded or having wider hips or a heavier 'okole. "Maybe you'll never have Janet Jackson abs — our family doesn't have that body type — but you can be a paddler like your Auntie Jean and get into dancing like Dad and I." The focus should be on what the child realistically can do and achieve.

And if you're not the person to introduce your child to physical pursuits, find him or her a sports mentor in the family, or a good coach and go to the games.

In her experience with parents, Cederquist has determined that it's key that parents agree between themselves that a) there is a problem, and b) this is how we are going to tackle it. It's very common — this happens at one point in K.C.'s story — for one parent to think a child's weight is a big deal while the other pooh-poohs it, she said. It's also key that parents take a broad view, assessing the family's eating and exercise patterns, and deciding to alter them as a group, even if that means Mom and Dad have to get out of their recliners and leave the potato chips behind.

"It really helps if parents are able to examine their own feelings. Sometimes people are really negative about the fact that their child is overweight and they don't want to admit it. They may feel a personal sense of guilt or failure; they may just really dislike overweight people or they may be overweight themselves," she said. "You never have to tell your child, but you can then become conscious of your own feelings and motivations and that alone will help you do something about them."

Equally important is knowing what can be controlled and what cannot. In the story of K.C., her parents make an effort to change the focus of family gatherings from eating to activities that involve some exercise, and they limit the amount of junk food that comes into the house, but her mom can't resist grilling her when she comes home from an outing with friends. The first two are positive moves, but the third only irritates K.C.

Just as they set rules on TV watching or computer use, it's appropriate for parents to decide what foods will be be available in the house and to set limits on serving sizes for rich foods or snacks, she said. But they shouldn't become food police, monitoring every bite.

K.C. experiences a couple of setbacks — eating too much pizza out with friends one day; binging on candy bars after a disappointment. Cederquist says it's important for parents to recognize that this kind of thing is going to happen. "The thing is, with childhood weight problems, we have the luxury of time. Most of the kids are still growing. Sometimes, they don't even have to lose weight, they just have to stop gaining and let their height catch up," she said. It's more important that children learn to deal with setbacks than that they never have them.

"You don't gain weight over your lifetime from eating a special meal or having a piece of birthday cake," she said. "You gain weight from everyday high-fat choices that you may not even realize you're making unless you take the time to read labels, educate yourself and learn what's better for you."