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Controlling diet and physical activity can help obese and overweight children lose weight

About 15 percent of American children aged 6 to 19 years are overweight, and the percentage of black and Hispanic children who are overweight is even higher. Excess weight in children is due primarily to poor eating habits and inactivity, according to Jennifer Greaser, R.N., M.S.N., of the Centers for Disease Control and Prevention, and John J. Whyte, M.D., M.P.H., of the Agency for Healthcare Research and Quality. In a recent article, they recommend that children eat at least five servings of fruits and vegetables a day, engage in moderate physical activity for at least 60 minutes on most days of the week, and limit their TV viewing and computer activities to no more than 2 hours a day.

Because children are still growing, weight loss is usually not recommended, and clinicians and parents should first strive to maintain a child's baseline weight. Weight loss of no more than 1 pound per month is recommended in children aged 2 to 7 years who have a secondary weight-related complication such as high cholesterol or high blood pressure. Weight loss should be considered for children aged 7 years and older if the child's body mass index (BMI, ratio of weight to height) for age is 95 percent or greater or if the child is at risk for becoming overweight (BMI-for-age of 85 to 95 percent) and has secondary complications.

Several barriers prevent children from eating a healthy diet and exercising regularly. These include unsafe neighborhoods that relegate children to inside TV viewing and video games; time spent alone after school, during which children tend to engage in sedentary activities while eating foods high in fat and sugar; and low socioeconomic status that makes it harder for families to provide nutritious foods and pay for sports activities. Finally, children who eat excessively or when they are not hungry may be suffering from an eating disorder, which is often related to depression or stress.

See "Childhood obesity: Is there effective treatment?" by Ms. Greaser and Dr. Whyte, in the September 1, 2004, Consultant, pp. 1349-1353.

Reprints (AHRQ Publication No. 05-R011) are available from AHRQ Publications Clearinghouse.

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