By Drs. Sally Robinson and Keith Bly

In the past 20 to 30 years, the number of overweight children has doubled. Almost one child in five is considered overweight. Obesity can lead to risk factors for heart disease, such as high cholesterol and high blood pressure, sleep apnea, orthopedic problems, liver disease, asthma, as well as low self-esteem and depression. The likely cause of the increase in the number of overweight children is the same as that for the rise in adult obesity: overeating and lack of physical activity.

Here are suggestions to help your family start a program to improve eating habits and increase physical activity.

• Focus on gradual changes in both eating and exercise patterns, rather than enforcing immediate changes.
• Encourage your child to exercise. Make physical activity part of your family’s daily routine. Children should exercise for at least one hour every day. Include exercise when planning family activities, such as biking, hiking or washing the car.
• Limit the amount of time spent watching television and playing video games. 
• Supply healthy snacks, such as yogurt, fruits and vegetables, to help your child learn to make healthy food choices.
• Give your child water or juice rather than soda or other drinks high in sugar. 
• Provide balanced meals when eating at home and limit the number of times that your child eats fast food per week.
• Let your child help you plan and prepare meals. If your child helps decide what’s for dinner, she will gradually learn about nutrition and may be more willing to try new foods.
• Avoid using food as a punishment or reward. For example, don’t offer dessert as a reward for finishing a meal. This teaches your child that sweets are more valuable than other foods.
• Encourage your child to eat slowly and eat together as a family, if possible. Try to make mealtime a time for sharing what your child did at school that day.
• Don’t force your child to eat if he or she is not hungry.
• Involve the entire family, rather than just focusing on an overweight child, when it comes to changes in eating habits and physical activity.
• Be supportive and let your child know that he is OK no matter what he weighs. Your child may realize that he has a weight problem and, therefore, needs your support and acceptance.

The goal of promoting a family eating and exercise program is to get healthier, rather than to reduce your child’s weight. Children should not be put on restrictive diets because they need calories to develop properly, but changing eating and exercise patterns helps children “grow” into their weight without adding extra pounds.
Dr. Sally Robinson is a pediatrician in the division of children’s special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email