Unlimited Access. Try it Today! Your First 10 Days Always $0.99
Lifestyle Maryland Family

What's up, doc? Weight-loss diet for 9-year-old

Q: How do I know if I need to put my child on a weight-loss diet? What is appropriate for a

A: Interestingly, 20 years ago, there was little interest in weight loss in a 9-year-old child. It was assumed that this was the “husky” age and that he would slim down with the impending start of pubertal height gain. We have regrettably learned that is too often a false assumption.

You begin with a visit to your health care provider to document the true weight, weight percentile, height percentile and the Basal Metabolic Index (BMI) — a weight for height marker — all adjusted by age and sex. You also need to look at the rate of weight gain over the past few years. Together you will then discuss the BMI percentile that best reflects the extent of obesity. If the BMI is above the 85th percentile for age, we are dealing with an “overweight” child. If it is above the 95th percentile, we are dealing with an “obese” child. A child with a BMI above the 99th percentile is “severely obese,” and aggressive intervention is indicated — as in, beginning yesterday!

It will help to take with you a three- to five-day diet diary of true intake, serving sizes, snacks, desserts, sugar-based beverages and frequency of eating meals away from home. Be sure to include what grandparents and aftercare providers are offering. Family history of obesity, family lifestyle and the child’s sleep history also play major roles. Include a summary of physical activity, interests and local options to improve exercise. Your provider may begin with a behavioral motivation interview, allowing you and your family to acknowledge areas of concern and options for realistic intervention.

If obesity is confirmed to be a concern, the whole family must commit to a supportive lifestyle change. Keys to success include eating all meals as a family at least six days a week, eliminating high-sugar snacks and drinks, getting more than nine hours of sleep a night, reducing “screen time” of video in any form to less than one hour a day and getting television out of the child’s bedroom. Try to provide more than one hour a day of aerobic strenuous exercise — walk to school and the park, ride bikes in safe areas, sign up for weekend and after-school sports or dance activities.

You and your provider will set realistic weight-loss goals, and weight/progress checks should be held at least monthly at the beginning. If there is limited or no success, there are multi-specialty programs in the area to provide more aggressive team approaches. Children are not candidates for weight-loss surgery until at least the midteens. Failure to address early childhood obesity greatly increases your child’s risk for early type 2 diabetes, hypertension, lipid abnormalities and literally dozens of other preventable concerns.

Dr. Alan M. Lake, Maryland Pediatric Group in Lutherville
Chairman, Maryland Academy of Pediatrics Taskforce on Childhood Obesity

Copyright © 2015, The Baltimore Sun
Related Content
  • Fighting obesity with good nutrition
    Fighting obesity with good nutrition

    As The Sun recently noted, the Centers for Disease Control and Prevention issued a report explaining that obesity rates in the nation have declined ("Tide may be turning on U.S. childhood obesity — CDC," Aug. 6). Hooray! But if you look beneath that shiny veneer here in Maryland, you'll...

  • Raising kids in the world of texting, tweeting and tagging
    Raising kids in the world of texting, tweeting and tagging

    Meredith Long's twin daughters were 11 years old when they started to use Snapchat, then moved on to Kik Messenger and ooVoo. When they turned 12 and got their first cellphones in December, they expanded to Instagram.

  • The positive side of kids and technology
    The positive side of kids and technology

    When Alison Brennan was in college, she had a telephone in her dorm room — but she rarely used it to call home. “I called my parents after 11 on Sunday nights, when the rates went down,” the Towson resident says with a laugh, recalling the not-so-distant past, when...

  • Training young athletes in the offseason
    Training young athletes in the offseason

    Maybe basketball just ended and the kids don’t have another activity until the pool opens this summer. Maybe your daughter is excited about her first season of soccer — which doesn’t start until September. Or maybe your son just gave up on baseball, leaving a void of...

  • Shaving cream pie fight
    Shaving cream pie fight

    The Center Ring Circus School attempts to break the record for the largest shaving cream pie fight.

  • They're never too old for picture books
    They're never too old for picture books

    Editor's note: This week, we're introducing a new regular contributor to Life & Travel. Paula Willey of the Baltimore County Public Library will explore and recommend books for young readers.