Rapid Weight Gain

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Sometimes children gain weight more rapidly than expected.  Parents are understandably concerned, in view of our society's epidemic of obesity and eating disorders.  But most parents know that labeling a child as “overweight” is not usually helpful.

In fact, new onset of rapid weight gain is generally not an immediate health risk.  Is your child going to develop diabetes or hypertension next year?  Probably not … However, the weight gain may be a “red flag” for unhealthy lifestyle habits.  Families can have a dramatic influence on their children’s long-term health, by using the “red flag” as an opportunity to teach healthy life habits.  These habits will stay with the child, long after he has begun living on his own.

There are several interventions that families can follow to assist in appropriate weight gain, while participating in a normal life and a regular diet.  In fact, these guidelines can be healthful for all family members to follow; there is no need for one child in the family to be singled out.

1.  Exercise:  Participation in supervised vigorous activity is beneficial.  Noncompetitive activities like dance or karate are just as helpful as organized competitive sports.  Participation in one sport or another in every season, year round, is a good idea.  30 to 60 minutes per session, three times per week, is a reasonable start.

2.  Juice:  Limit total juice intake to 6-8 ounces per day; limit soda to twice a week.  (Diet soda is probably not harmful in limited amounts, but regular consumption may perpetuate the desire for sweet foods.)  Water is a better alternative.  16 ounces per day of milk (such as skim milk) is usually sufficient; more than 24 oz. is unnecessary.

3.  Water:  Insure adequate water intake.  Some kids have trouble telling the difference between hunger and thirst.  So when they’re thirsty, they eat, taking in unnecessary calories.  I suggest drinking some water every hour.  It may also help to drink a glass of water before each meal.

4.  Fast Food:  Limit to once per week.

5.  Television:  Limit television, recreational computer time, and video games to ten hours per week.  (The "movie ticket" system can be a relatively painless method.)  No one should ever eat in front of the television; this is an important risk for obesity.  If there is a TV in the bedroom, it should be removed to a public area of the house.

6.  Positive reinforcement:  Often, parents want to reward their children for good behavior or performance.  This is a good idea, of course, but food rewards should be avoided in general.  (Sometimes this must be discussed with a teacher who might use food rewards.)  A small toy or a book is a better reward.  Of course, the praise and attention of an involved parent is always the best reward for good behavior.

7.  Snacking can sabotage the best diet.  When your child complains of hunger between meals, ask if he’s actually bored instead.  You can teach him to find activities other than eating when he’s bored.  If he insists that he’s hungry, ask him to drink a glass of water first, before you offer an appropriate snack.  (On the other hand, there’s nothing wrong with a scheduled snack, if it’s offered at the same time each day, and the food is appropriate.)

8. Sleep habits have an effect on weight. People who are sleep-deprived tend to eat food they don’t need, especially junk food, in an attempt to feel better. Ensure a regular and reasonable bedtime, even on weekends and vacation. Ban TV and cell phones from the bedroom. If the child awakens at night, she can
have water or milk, but she shouldn’t eat. She may read or listen to music, but she shouldn’t watch TV, or use the cell phone or computer. (If a child has a
persistent problem being awake for more than 20 minutes at night, please consult us.)

9.  It is helpful to have the whole family participate in feeding and exercise routines.  However, don't use the bathroom scale too frequently; emphasize healthy life habits, rather than focusing on the numbers and the pounds.

10. At times, families may feel at a loss to explain one child’s rapid change in weight. Consider consulting the Weight Management specialists at DuPont
Hospital (302-651-6040) if the weight gain doesn’t slow.

Remember: the goal is to give children the sense that they have control over their own bodies, rather than feeling out of control of the changes their bodies undergo.  If you continue to be concerned about your child's growth, please discuss it with us.

     --  Copyright David M. Epstein, MD, 2004, 2007, 2012, 2013