How to Cope with Excess Weight?



Excess weight has gradually become one of the most common and most challenging health problems of the 21st century. Prof. Dan Turner, Director of the Pediatric Gastro and Nutrition Institute at Shaare Zedek Medical Center, and Mrs. Ronit Dadosh, Clinical Dietician at Shaare Zedek, offer a number of rules and some advice on how to best cope with excess weight and how to lose it

Excess weight and obesity have become a 21st century epidemic, with statistics showing a constant rise in the numbers. We do not intend to discuss the social or esthetic implications of obesity or thinness. The world has advanced in that people are judged according to their deeds and their personalities, and it is best if we make the effort to accept ourselves as we are with love and confidence, irrespective of our external appearance. Nevertheless, obesity has gradually become one of the most common and challenging health problems of our times. And this is true of children as well: in the USA it is estimated that almost a third of the country's children are overweight. In Israel the numbers are lower, but are still rising consistently, with significant long-term health ramifications such as diabetes, high blood pressure and cholesterol, heart attacks, sleep and breathing disorders and fatty damage to the liver.

There are many reasons for this trend and they are largely related to changes in our lifestyle. We are engaged less in physical activity while sharply increasing our screen hours (computer, cell or TV). The change in diet is also dramatic – we are exposed to industrialized food ads, eat calorie-rich fast foods, drink sweetened drinks and tend to snack while watching TV. Although fats can be more or less healthy, the critical factor in being overweight and its many attendant diseases is less the fats and more an excess consumption of carbohydrates such as cakes, sugar, pasta, and sweetened beverages.

!For example, one study shows that removing the drinks machines from a school in the US led to a significant decrease in the students' weight with no other intervention whatsoever

The percentage of carbs in the western diet is significantly higher than the recommended amount (45-65% of all one's calories.) Studies prove that a Mediterranean diet based on fruit, vegetables, whole grains, legumes, olive oil, fish, minimal low-fat milk products and a little meat, protects one against excess weight and also helps prevent other diseases

Weight loss is expected when calorie consumption is less than the calories burned through physical activity. Achieving the ideal weight is challenging for us all but particularly for children and adolescents. With these ages one must act with sensitivity in order to maintain the child's healthy emotional state and self-confidence, which are no less – and probably more important – than his or her weight. Hunger should not be enforced. Their nutrition is vital for normal growth and development. It is often a realistic aim to maintain a current weight rather than fighting to lower it. As they grow taller, their weight effectively goes down. In any case, it is recommended to consult an experienced dietician and build a personal nutrition program for every child.

Do This! 

1. Increase physical activity. Adapt the activity to the child's preferences: cycling, swimming, running, walking, sports, etc. Fix set times for some intense physical activity at least three times a week.

2. Limit screen time to an hour or two a day.

3. Change your buying habits: don’t buy sweetened drinks, high-fat milk products, snacks and candies. What they don’t have at home, they don’t eat. Forbidding the eating of stuff in the house can just lead to secret eating, bingeing and unnecessary conflict.

4. Reduce the amount of carbohydrates in your general diet to the lowest recommended amount – 45-50% of all your daily calories. The rest of the calories should come from fats and proteins. The preferred type of carbs should be rich in fiber with a low glycemic index, like most vegetables, some fruits, quinoa and oats, and reduce starches like bread, pasta, sugar, rice and potatoes. 

5. Limit industrialized food and eating out. Fast food is rich in calories and less healthy.

6. Get into the habit of having one family meal per day. You too can then be a model of healthy eating while improving family bonding and shared experiences at the same time.

7. Define the eating place in your home and organized eating times. Best to avoid eating in front of the TV, computer or in the rooms. It is not recommended to miss meals or to limit the amounts children eat but rather direct them towards eating healthily, like eating fruit and vegetables instead of snacks in between meals.

8. Personal example is the key to success! If you eat in front of the TV you can't stop the children doing it!

9. Encourage the drinking of water or soda water instead of sweet drinks, which contain astonishing amounts of sugar. Some of the artificial sweeteners have also proven to be unhealthy.

10. Use smaller plates and serve smaller portions. Encourage them to drink a glass of water before the meal. Encourage them to eat slowly, chew well.

!Don't Do This

1. Don’t talk about weight in any sort of dramatic or extreme fashion. It is important to remember that in addition to the increase in obesity in adolescents, there is also an opposite trend, with an increase in eating disorders such as bulimia and anorexia. Bulimia sufferers often tend to be overweight and have guilt feelings and force themselves to vomit. Some anorexic patients began with excess weight and didn't know when to stop dieting, which was encouraged by society/peer pressure

 Don’t use the word "diet." It is a "change of habits for healthy eating," and for all the family too

3. Discuss and explain the issues calmly. Avoid comments about weight or amounts, like "can't you see you're overweight?" Do not compare children.

4. Warning! One word from a parent can damage the sensitive soul of a child. The sense of failure can lead to the opposite effect. To succeed we must give them positive reinforcement (but not through prizes). Give your children the genuine feeling that you care and support them. Sentences like "if you continue to stuff yourself you'll die early" do not help and can be easily flipped to something positive, like "when you lose weight you'll feel so much better with yourself because you'll be much healthier." "Let’s do it together because we believe that you can do it!"