Rethinking Childhood Obesity - Keep It Simple!

by Regan Lawrence

December 2024

Almost a third of North Dakota kids are carrying excess body weight, according to North Dakotans' answers to a federal agency's survey. Obesity – what doctors call excess body weight – is a complex condition resulting from diet, activity level, and family health patterns. These extra pounds make kids more likely to have early-onset diabetes, develop heart problems, and another medical condition that causes breathing to stop during sleep, a diagnosis called sleep apnea. The extra weight can also strain joints enough to cause pain, further limiting kids' desire and ability to exercise. These conditions make childhood obesity an even bigger problem than just excessive weight.

Researchers have found that parents can make a big difference for their children by making small changes. One strategy, called the 5-2-1-0 approach and supported by the American Academy of Pediatrics, focuses on both diet and activity. Here's how it works: Aim for 5 servings of fruits and vegetables, with 1 serving roughly the size of the child's palm; 2 hours or less of screen time – which might be a big change for some kids – and 1 hour of physical activity, like playing outside, walking, or playing hockey. Finally, the "0" stands for eliminating all beverages that contain sugar, such as pop, juice, or special coffee drinks.

In addition to 5-2-1-0, doctors suggest keeping other changes simple, too. For example, if a family dines out three times per week, cutting back to once weekly will automatically cut back on calories. Replace chips and dip with fruits and vegetables for snacks. If fresh fruits don't fit the budget, fruits canned in 100% fruit juice can be a budget-friendly, non-perishable substitute. Ensuring there are no screens in the bedroom – except for homework – and no snacks after supper or in bed are other habits that will result in a healthier weight.

If these changes don't seem to work, primary healthcare providers are in a special position to detect and prevent unhealthy childhood weight gain when diet and physical activity aren't enough to nudge their weight into a healthier range. They can provide further counseling and education, information about medical weight loss options such as appetite-suppressing medications, and referral to specialists like registered dietitians and behavioral counselors who can help manage the more complex issues that sometimes come with obesity.

In summary, remember to try to keep it simple and start with small changes. Keep it simple with the 5-2-1-0 approach and trading sugary or salty snacks for fruits and vegetables. Try small changes like making sure kids get an hour of physical activity per day. Also, building these habits as a family will help make the whole family healthier.

About the Author

Regan Lawrence is a third-year medical student at the University of North Dakota School of Medicine & Health Sciences. She was selected as a Dickinson participant for the school's ROME program, or Rural Opportunities in Medical Education. The program includes teaching student doctors the importance of rural newspapers as a way to share health information. As a future healthcare leader, Lawrence has written this column to provide health information for her ROME community. The information is not for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed practitioner.