By Lauren Bernstein and Paula Rovinsky

Kids and weight: It's got to be a family thing

Adults know how hard it is to lose weight, but imagine how hard it can be for kids.

Kids are under the control of adults, who can unknowingly sabotage efforts to maintain a healthy weight. What chance does a child who is trying to lose weight have when a time-pressed parent decides that dinner is pizza or a hamburger and fries, or when a well-meaning grandparent offers a plate full of freshly baked cookies?

Before you can expect your kids to change their eating habits, look at your own. Kids learn by example, so if you want them to eat healthy foods and to exercise, you have to set the example.

When it comes to managing kids' weight, it's got to be a family thing. Studies have shown a family-centered approach to weight management is the most effective way to long-term success in managing weight and developing a healthy lifestyle. So unless the family environment changes, weight loss isn't going to happen.

The family needs to understand what it is about their lifestyle that's not allowing them to reach their goals. They need to understand the basics of healthy meals and snacks. Learning to read labels and determining proper portion size for the age of the child are important.

Incorporating more physical activity into their daily lives has to be a priority. And they have to understand the emotional aspects of food. If food is love, how much love is doled out at home?

The why of eating
It's not just what we are overeating that is packing on the pounds but why we're overeating. Do we eat when we're nervous or bored? Do we turn to food to soothe hurt feelings? Do we mindlessly eat when we watch television? We can break the chain of overeating if we understand why we are doing it. A lot of the emphasis on childhood obesity has focused on schools. A number of schools have eliminated candy and soda machines and now offer healthier choices such as salad bars in their cafeterias. Those are good steps. But to help the one out of three children in the United States who is overweight or obese, we have to take a hard look at what's going on at home.

Losing weight and keeping it off takes time and effort. That's an especially hard lesson for time-crunched parents who are juggling work, kids, home and community. But with planning, understanding and limit setting, it can be done successfully.

Having a plan
Robert Wood Johnson University Hospital Rahway runs a weight-management program for kids and adolescents. The program focuses on nutrition, exercise and the behavioral aspects of eating and food. We start by telling parents they are the gatekeepers and have to be vigilant in their roles. After all, they are the ones who are buying the food, stocking the shelves and making the meal decisions. Adults, not kids, decide whether the refrigerator holds fruit and vegetables or cheesecake and ice cream.

We also talk about meal-planning and preplanning. If there are a few meals made ahead in the fridge and freezer, there is no need to grab a pizza or hamburgers after a hectic day. Failing to plan, we tell them, is planning to fail. The advantages of planning are enormous. Parents know the ingredients of food made at home and can control the portion sizes. They can supplement entrees with salad, raw vegetables and plenty of fruit.

Compare that to those so-called economy meals that feature large portions of calorie-laden fries and sugary fountain drinks. If parents have to go the fast-food route, we talk about making better selections, such as salads and ordering smaller portion sizes.

The program is more about building awareness than anything else. We talk about "mindful eating," or being more aware of not only what we eat, but how much of it we are eating and why we are eating.

We live in a society of giant portions and empty calories. One of our most eye-opening exercises is showing kids what a portion of meat or pasta really looks like. We show them what a portion of ice cream — a tennis ball — looks like compared with a so-called "medium" portion at an ice cream store, which can add an extra 500 calories to daily caloric intake. Our weight-management program is one day a week for two months. In that time, we know children are not going to shed all their excess weight. Our program is not a rigid diet. Instead, we give kids and their parent knowledge, insights and tools.

Perhaps one of the most important lessons we teach is setting an example. The "do what I say, not what I do" philosophy of parenting is not going to help kids get off the couch and walk. When it comes to healthy meals and snacks, exercising daily and breaking the cycle of mindless eating, it has to be a family thing.

Lauren Bernstein, MS, RD, is a registered dietitian and certified diabetes educator. Paula Rovinsky, RN, is a registered nurse and Reiki master. They lead Shapedown, a weight-management program for children and adolescents at Robert Wood Johnson University Hospital Rahway. More information about the program is available by calling (732) 499-6109.

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