Childhood Obesity: Common Misconceptions

Everyone, it seems, has an opinion about obesity. Some may insist that they know what causes it. Or they might have a dozen or more suggestions on how to conquer it. Yet even though it seems that our culture is obsessed with diets and a belief that you can never be too thin, there are more than enough myths and misunderstandings about childhood weight to go around. Unfortunately, some of this misinformation can get in the way of your child succeeding in his own weight-loss efforts.

To help you and your youngster get on the right path toward normalizing his weight, let’s separate fiction from facts. See if you believe in any of the following misconceptions, and then read what the truth about them really is:

“My child and I deserve the blame for his weight problem.” Not true. Thanks to the media and many high-profile diet gurus, many overweight children and adults believe that obesity occurs in people who are self-indulgent or weak-willed. With those kinds of attitudes so prevalent, no wonder that there’s so little empathy and support for individuals who need to lose weight. However, the facts are that no one is to blame for your child’s obesity. Children gain excess weight for a variety of reasons. Some have a tendency to be obese because it runs in their families. Others may not make the best selections of foods or portion sizes, often because healthier choices aren’t available or perhaps because their parents or grandparents put too much food on their plates. Throughout you’ll find descriptions of other culprits and contributors to your child’s weight problem that should remove self-blame. Once you understand the causes of obesity a little better, you and your child will be able to manage his obesity more effectively and realistically.

“My child’s weight problem needs a quick fix.” Yes, you and your youngster may wish for an instantaneous solution for losing his excess pounds, and there are plenty of diets in bookstores that promise fast results. But let’s face it—there are no easy answers to weight problems (or to most other things in life). Obesity is not a problem that can be resolved overnight or even in a few weeks. (If you’ve ever tried to lose weight yourself and keep it off, you know that’s the case.) In fact, some of the most popular quick fixes, from diet pills to herbal teas, may be hazardous to your child’s health. Many of the “natural” supplements that teenagers might be attracted to, as well as the near-starvation diets

that are promoted in newspaper ads and popular magazine articles, are risky and in some cases, even potentially deadly. Where should you turn instead? Working with your child’s pediatrician and using plans and programs that are based on credible, scientific evidence offers the best chance for safe and long-term weight-loss success.

“My overweight child will ‘grow into’ the excess pounds that he has.” Youngsters normally gain weight throughout childhood. It’s a necessary part of the growth process. But some parents tell their pediatricians that their overweight children will outgrow their weight problems. However, that’s not something you can count on. In fact, depending on your child’s eating habits and activity level, he is just as likely to continue to gain weight, not lose it, as he grows. Don’t depend on routine growth spurts to compensate for his weight problem.

“My child may seem overweight according to the growth charts, but our entire family is ‘big boned.’ So I don’t think he has a weight problem at all.” Pediatricians often hear parents say, “We’re not worried about our child’s weight. Everyone in our family is big, and we’ve always been like this.” In truth, you need to keep your focus on the growth and body mass index charts. If your child’s weight exceeds the normal range for his age and height, he meets the definition of being overweight or obese. It’s not something that you can rationalize away. There are certain metabolic or hormonal (endocrine) imbalances that often get blamed for weight problems. However, they are responsible for less than 1% of the cases of childhood obesity. Yes, hypothyroidism (a deficit in thyroid secretion) and other rarer and more severe genetic and metabolic disorders (eg, Prader-Willi syndrome, Turner syndrome, Cushing syndrome) can cause weight gain (and in some cases, other severe problems such as hearing and vision impairments). You should certainly speak to your child’s pediatrician about these concerns and a have a complete medical evaluation performed. But because these syndromes are uncommon, they account for very few cases of obesity. More likely, your child’s excess weight is associated with poor eating and activity habits, as well as certain other issues.

“Because my child is heavy, he actually needs to eat more food to stay healthy.” Based on this belief, many families may give bigger portions to the heavier children because of their size. Nothing could be more counterproductive. You need to rely on the growth charts and your pediatrician’s advice and make sure that your child is consuming portion sizes that allow him to maintain an average weight.

Last Updated

8/20/2015

Source: A Parent's Guide to Childhood Obesity: A Road Map to Health (Copyright © 2006 American Academy of

Pediatrics)  

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1 switch to fat-free or low-fat (1%) milk They have the same amount of

calcium and other essential nutrients as

whole milk, but fewer calories and less

saturated fat.

make half your grains whole grains To eat more whole grains, substitute a whole-grain

product for a refined product—such as eating whole-

wheat bread instead of white bread or brown rice instead of

white rice.

foods to eat less often Cut back on foods high in solid fats, added sugars,

and salt. They include cakes, cookies, ice cream,

candies, sweetened drinks, pizza, and fatty meats like ribs,

sausages, bacon, and hot dogs. Use these foods as

occasional treats, not everyday foods.

compare sodium in foods Use the Nutrition Facts label

to choose lower sodium versions

of foods like soup, bread, and frozen

meals. Select canned foods labeled

“low sodium,” ”reduced sodium,” or

“no salt added.”

drink water instead of sugary drinks Cut calories by drinking water or unsweetened

beverages. Soda, energy drinks, and sports drinks

are a major source of added sugar, and calories, in American

diets.

balance calories Find out how many calories YOU need for a day

as a first step in managing your weight. Go to www.ChooseMyPlate.gov to find your calorie level. Being physically active also helps you balance calories.

enjoy your food, but eat less Take the time to fully enjoy

your food as you eat it. Eating

too fast or when your attention is

elsewhere may lead to eating too

many calories. Pay attention to hunger

and fullness cues before, during, and after meals. Use

them to recognize when to eat and when you’ve had

enough.

avoid oversized portions Use a smaller plate, bowl, and glass. Portion out

foods before you eat. When eating out, choose a

smaller size option, share a dish, or take home part of

your meal.

foods to eat more often Eat more vegetables, fruits, whole grains, and fat-free

or 1% milk and dairy products. These foods have the

nutrients you need for health—including potassium, calcium,

vitamin D, and fiber. Make them thebasis for meals and snacks.

make half your plate fruits and vegetables Choose red, orange, and dark-green vegetables like

tomatoes, sweet potatoes, and broccoli, along with other

vegetables for your meals. Add fruit to meals as part of

main or side dishes or as dessert.

choose MyPlate10 tips to a great plate

Making food choices for a healthy lifestyle can be as simple as using these 10 Tips. Use the ideas in this list to balance your calories, to choose foods to eat more often, and to cut back on foods to eat less often.

United StatesDepartment of Agriculture Center for Nutrition Policy and Promotion Go to www.ChooseMyPlate.gov for more information.

10 tips

Nutrition Education Series

DG TipSheet No. 1

June 2011USDA is an equal opportunity

provider and employer.

Healthy Eating

Get your child on the path to healthy eating.

Focus on the meal and each other. Your child learns by watching you. Children are likely to copy your table manners, your likes and dislikes, and your willingness to try new foods.

Offer a variety of healthy foods. Let your child choose how much to eat. Children aremore likely to enjoy a food when eating it is their own choice.

Be patient with your child. Sometimes new foods take time. Give children a taste at first and be patient with them. O�er new foods many times.

Let your children serve themselves. Teach your children to take small amounts at first. Let them know they can get more if they are still hungry.

Cook together. Eat together. Talk together. Make meal time family time.

U.S. Department of AgricultureFood and Nutrition Service

FNS-451October 2012

USDA is an equal opportunity provider and employer.

1 cup 1½ - 2 cups

½ cup of fruit?½ cup mashed, sliced, or chopped fruit½ cup 100% fruit juice½ medium banana4-5 large strawberries

½ cup of veggies?½ cup mashed, sliced, or chopped vegetables1 cup raw leafy greens½ cup vegetable juice1 small ear of corn

2 year olds 3 year olds 4 and 5 year olds What counts as:

1 ounce of grains?1 slice bread1 cup ready-to-eat cereal flakes½ cup cooked rice or pasta1 tortilla (6” across)

1 ounce of protein foods?1 ounce cooked meat, poultry, or seafood1 egg1 Tablespoon peanut butter¼ cup cooked beans or peas (kidney, pinto, lentils)

½ cup of dairy?½ cup milk4 ounces yogurt¾ ounce cheese1 string cheese

1½ cups

1 cup 1 - 1½ cups1 - 1½ cups

3 ounces 4 - 5 ounces4 - 5 ounces

2 ounces 3 - 5 ounces3 - 4 ounces

Protein Foods

2 cups 2½ cups2 cups

Food group

Vegetables

Fruits

Grains

Dairy

Daily Food Plan Use this Plan as a general guide.

Make half your grains whole

Choose low-fat or fat-free

These food plans are based on average needs. Do not be concerned if your child does not eat the exact amounts suggested. Your child may need moreor less than average. For example, food needs increase during growth spurts.

Children’s appetites vary from day to day. Some days they may eat less than these amounts; other days they may want more. O�er these amounts and let your child decide how much to eat.

Some foods are easy for your child to choke on while eating. Skip hard, small, whole foods, such as popcorn, nuts, seeds, and hard candy. Cut up foods such as hot dogs, grapes, and raw carrots into pieces smaller than the size of your child’s throat—about the size of a nickel.

Healthy Eating

There are many ways to divide the Daily Food Plan into meals and snacks. View the “Meal and Snack Patterns and Ideas” to see how these amounts might look on your preschooler’s plate at www.choosemyplate.gov/preschoolers.html.

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Youth Physical Activity:T h e R o l e o f F a m i l i e s

Being physically active is one of the most important steps to being healthy. Families play an important role in helping youth learn to be active and stay active throughout their lives.

How Does Physical Activity Help?•Builds strong bones and muscles.1

•Decreases the likelihood of developing obesity and risk factors for diseases like type 2 diabetes and heart disease.1

•May reduce anxiety and depression and promote positive mental health.1

How Much Physical Activity Do Youth Need?•Childrenandadolescentsshoulddo60minutes(1hour)ormoreofphysicalactivitydaily.2

■ AerobicActivities: Most of the 60 or more minutes per day should be either moderate- or vigorous-intensity aerobic physical activity. Vigorous-intensity physical activity should be included at least 3 days per week.◦ Examples of aerobic activities include bike riding, brisk walking, running, dancing, and playing active

games like tag, soccer, and basketball.■ Muscle-strengtheningActivities:Include muscle-strengthening physical activity on at least 3 days of the week

as part of the 60 or more minutes.◦ Examples of muscle-strengthening activities for younger children include: gymnastics, playing on a jungle

gym, and climbing a tree.◦ Examples of muscle-strengthening activities for adolescents include push-ups, pull-ups, and weightlifting

exercises.

•Some activities may address more than one category at a time. For example, gymnastics is both muscle-strengthening and bone-strengthening. Running is aerobic and bone-strengthening.

How Physically Active Are Youth?•Among 9th–12th grade students, only 11% of girls and 24% of boys said they were physically active at least 60

minutes per day.3

•Among 9–13 year olds, only 39% said they participated in organized physical activity.4

•In 2007, only 30% of 9th–12th grade students said they attended physical education classes every day.5

•Activities should be age-appropriate, enjoyable, and offer variety.2

■ Bone-strengtheningActivities: Include bone-strengthening physical activity on at least 3 days of the week as part of the 60 or more minutes.◦ Examples of bone-strengthening activities include hopping, skipping, jumping, running, and sports like

gymnastics, basketball, and tennis.

•In 1969, 41% of students walked or biked to school. By 2001, only 13% of students walked or biked to school.6

•Among 9th–12th grade students, 35% reported watching 3 or more hours of television per day.5

Is My Child’s Aerobic Activity Moderate or Vigorous?•When your child does moderate-intensity activity, his heart will beat faster than

normal and he will breathe harder than normal. On a scale of 0 to 10, where sitting is a 0 and 10 is the highest level of effort possible, moderate-intensity activity is a 5 or 6.■ Examples of moderate-intensity activities include brisk walking, hiking,

rollerblading, skateboarding, bicycle riding, baseball and softball.

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•When your child does vigorous-intensity activity, her heart will beat much faster than normal and she will breathe much harder than normal. On a scale of 0 to 10, vigorous-intensity activity is a 7 or 8.■ Examplesofvigorous-intensityactivitiesincludesoccer,iceorfieldhockey,jumpingrope,oractive

games that involve running.

What Kinds of Activities Are Appropriate for My Child?•It is important for youth to participate in activities that are safe and good for their growth and development.

Younger children like to move between short bursts of activity followed by short periods of rest. Adolescents do more structured and longer activities than younger children. For example:■ For aerobic physical activity, younger children like to run, jump, or play tag for short periods of time and

then take a break. Adolescents can run for longer periods of time.■ For muscle strengthening activity, younger children enjoy active play such as gymnastics, playing on a

jungle gym or climbing a tree. Adolescents may start a structured weight-lifting program.

What Can Families Do To Get and Keep Their Children Active?Youth learn a lot about physical activity from their families. Family members who enjoy physical activity can help children enjoy physical activity. Caregivers play a very important role in determining youth participation in physical activities—how much, how often, and what type of physical activity. Caregivers can also help youth balance non-active time periods (watching TV, using the computer, or talking on the phone) and physical activity.

ModelPositivePhysicalActivity:•Lead an active lifestyle yourself.•Make family time physical activity time.

■ Build physical activity into your family’s daily routine. Take a walk after dinner together or do housework or yard work together.

■ Uselocal,low-cost,orfreeplaceslikepublicparks,baseballfields,andbasketballcourts to be active.

■ Attend family nights or other physical activity events at your child’s school or local community centers.

■ Be active whenever possible. Walk or ride bikes to school or the bus stop instead of riding in a car. Parents of young children can enjoy the walk or bike ride, too.

■ Include physical activity breaks in events such as long car trips, vacations, or visits to relatives or friends. Bring along beach balls, kites, jump ropes, or other items that can be used for active play.

HelpChildrenBeActiveWithTheirFriends:•Instead of watching television or playing video games, encourage your children to be

active with their friends by playing tag, basketball, or by riding bikes.•Give your children toys that encourage physical activity like balls, kites, and jump ropes.•Make special events physical activity events, such as activity-based birthday parties or

other group celebrations.•Encourage your children to join a sports team or try a new physical activity.

EncouragePhysicalActivityforYouth:•Help youth participate in team or individual sports, as well as in noncompetitive activities

such as bicycling, hiking, jogging, and swimming.•Be positive about the physical activities your children engage in and encourage their

interest in new activities.•Help children be physically active by taking them to and from activities and events or helpingthemfindotherwaystogetthere.

•Encourage children to talk about how physical activity makes them feel and how much fun they have when they are active.

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Limit“ScreenTime”(timewatchingTV,playingvideogames,orusingthecomputer):•Know how much screen time you and your children are getting and then set limits for the

entire family.■ The American Academy of Pediatrics (AAP) states that children 2 years or older

should spend no more than 2 hours a day watching TV, playing video games, and using the computer.7

•Do not use screen time as a reward or punishment for your child.•Turn commercial breaks into activity breaks when watching TV. Do jumping jacks, push-

ups, or crunches or run in place during commercial breaks.•Turn off the television during mealtime and homework time.•Put the TV and computer in common areas like the living room instead of your child’s

bedroom.

PartnerWithYourChild’sSchool:•Find out what physical activities are offered at your child’s school.•Talk to the principal or write a letter to the district superintendent if you think there should

be more physical education at your child’s school.•Become a member of the school health advisory council or the Parent Teacher Association

(PTA).•Encourage the school to implement a comprehensive school physical activity program.

This includes quality physical education, recess, before- and after-school physical activity clubs, walk- and bike-to-school programs, and school staff wellness programs.8

•Help organize special events like walk-, dance-, or bike-a-thons, walk- or bike-to-school day, or a walking school bus.

•Volunteer to help with after-school physical activity programs or sports teams.

Where Can I Find Additional Information About Youth Physical Activity?•U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for

Americans. Washington, DC: U.S. Department of Health and Human Services; 2008. Available at: http://www.health.gov/paguidelines.

•Centers for Disease Control and Prevention. Healthy Youth! Physical Activity. Available at: http://www.cdc.gov/HealthyYouth/physicalactivity/.

•Centers for Disease Control and Prevention. Making Physical Activity a Part of a Child’s Life. Available at: http://www.cdc.gov/physicalactivity/everyone/getactive/children.html.

•Alliance for a Healthier Generation. Good Health Starts at Home. Available at: http://www.healthiergeneration.org/uploadedFiles/For_Parents/ParentResourceBook.pdf.

•National Association for Sport and Physical Education. Teacher Toolbox, Physical Activity Calendars. Available at: http://iweb.aahperd.org/naspe/template.cfm?template=teachers_toolbox.html

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Be Active and Play, 60 minutes, every day!

References1. U.S. Department of Health and Human Services. Physical activity guidelines advisory committee

report. Washington, DC: U.S. Department of Health and Human Services; 2008.2. U.S. Department of Health and Human Services. 2008 Physical activity guidelines for Americans.

Washington, DC: U.S. Department of Health and Human Services; 2008.3. Centers for Disease Control and Prevention‘s National Youth Risk Behavior Surveillance—United

States, 2007. Unpublished data.4. Centers for Disease Control and Prevention. Youth Media Campaign Longitudinal Survey, 2002.

MMWR 2003;52(33):785-8.5. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2007.

MMWR. 2008;57(No.SS-4):1-131.6. McDonald MC. Active transport to school: trends among U.S. schoolchildren, 1969-2001. American

JournalofPreventiveMedicine 2007;32(6):509-16.7. American Academy of Pediatrics. Committee on Public Education. American Academy of Pediatrics:

Children, adolescents, and television. Pediatrics 2001;107(5):1043-8.8. National Association for Sport and Physical Education. Comprehensive school physical activity

programs position statement. Reston, VA: National Association for Sport and Physical Education; 2008. Available at: http://iweb.aahperd.org/naspe/pdf_files/CSPAP_Online.pdf.

U.S. Department of Health and Human ServicesCenters for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health PromotionDivision of Adolescent and School Health

www.cdc.gov/HealthyYouth

August 2009

PhysicalActivity

Apples • Bananas • Grapefruit • Lemons • Oranges • StrawberriesCantaloupe • 100% Apple Juice • 100% Grape Juice

Dark Green Leafy Lettuce • Broccoli • Potatoes • CornButternut Squash • Red Pepper • Garbanzo Beans • Zucchini

Brown Rice • Rolled Oats • Popcorn • Whole-Wheat FlourWhole-Wheat Spaghetti • Bulgur • Whole Rye • Quinoa

Lean Cuts of Beef, Pork, Chicken • Eggs • Black Beans • LentilsSoy Beans • Almonds • Walnuts • Haddock • Salmon • Shrimp • Tuna

Fat-Free or Low-Fat (1%) Milk, Yogurt, Cheese Calcium-Fortified Soy Milk

Walking • Jogging • Biking • Hiking • Tennis • Basketball Soccer • Swimming

Avoid oversized portions.

Make half your plate fruits and vegetables.

Drink water instead ofsugary drinks.

Enjoy your foodbut eat less.

Switch to fat-freeor low-fat (1%) milk.Make at least half

your grains whole.

Compare sodium, sugars, andsaturated fats in foods

and choose thefoods with lower numbers.

Use ChooseMyPlate.gov forhealth tips and resources.

Determine how many calories you should consume per day using SuperTracker.usda.gov

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EAT THE MYPLATE WAY

Be active your way.

United States Department of Agriculture

Center for Nutrition Policy and PromotionAugust 2013

Select your daily food plan on ChooseMyPlate.gov. Use it as a guide

to building a healthy plate.

USDA is an equal opportunity provider and employer.

HOW TO FILL MY PLATE

GET STARTED!