What to do about the ‘astronomical’ weight gain in children during the pandemic

The pandemic has created a perfect storm for an “astronomical” increase in childhood obesity, according to a pediatrician at the National Children’s Hospital.

“In children, BMI is measured in percentiles. We are seeing children go from the 30th-40th percentile to the 80-90-95th percentile – therefore, going from the normal weight category to overweight to obesity in the last year, “said Dr. Nazrat Mirza, medical director of the pediatric weight management clinic at the National Children’s Hospital.

“In our weight management clinic, we are seeing children gain 20 to 30 pounds in the past year,” she told WTOP. “Some of them gain in the space of two to three months more than 15 to 20 pounds.”

The clinic has received over 600 referrals from pediatricians over the past six months. Normally he gets a total of around 800 to 900 for the year.

Mirza believes that the loss of structure associated with the lack of in-person learning at school has impacted meal times, physical activity and bedtime, leading to “an astronomical increase in the prevalence and the severity of obesity depending on where you are ”.

“So if you are at a normal weight, [you move] to the category of obesity, and if you’re already obese, you develop more severe obesity, ”she says.

Parents need to recreate that structure and get back to basics, Mirza said, offering these suggestions:

• Serve three meals a day. “Make sure half the plate is fruits and vegetables, a quarter of protein and a quarter of carbohydrates,” Mirza said;
• Offer children zero to two snacks per day. Make sure fruit or vegetable snacks are already chopped or prepared;
• Make healthy foods and snacks easily accessible and available;
• Remove all comfort food / junk food from the house. “Out of sight out of mind;”
• Eliminate sugary drinks. “We see children drinking seven to eight glasses a day. Get sugary drinks out of the house; “
• Parents should not eat junk food in front of children. “Don’t bring it home and don’t expect the child to show self-control; it’s really difficult; “
• Limit screen time after school to no more than two hours per day;
• Make time for 60 minutes of daily activity, such as walking or playing. “Maybe parents could break this down into 20 minutes, three times a day [or] 15 minutes, four times a day – whatever works for this family; “
• Return to normal bedtime. Children need eight to 10 hours of sleep per day. “When they are up all night, they snack all night;”
• Embrace the concept of healthy “everyday” foods like fruits and vegetables and “sometimes” foods like candy or restaurant meals. “Limit this to once a week.”

Don’t make junk food a reward, advised Mirza. Emphasize that it is a food “sometimes” just as you might “sometimes” dress for special occasions.

“A kid might say ‘OK, so when can I eat junk food? When am I good enough to eat junk food? “. So Mirza said that children should know that they are not being punished.

Childhood obesity is associated with complications such as cardiovascular disease, diabetes, fatty liver disease, hip dysplasia, knee and ankle problems, sleep apnea, and worsening asthma. There is also the psychosocial component of low self-esteem, anxiety, and depression.

Families must be united. Don’t think of adjustments as a diet.

“It’s not a one-off thing. It’s for life. It’s eating healthy for life, ”said Mirza, pausing between each word for emphasis.

Shame doesn’t work either. “We don’t stress the weight with the kids. It’s not helpful, ”she said.

Every journey begins with a first step.

Don’t expect the weight to drop immediately. Changes in a healthy lifestyle that lower the risk of cholesterol and diabetes will begin to occur metabolically, Mirza said, perhaps with an improvement in mood.

“A child who has high insulin can feel depressed. And the high insulin is due to the fact that they eat too many carbohydrates and it’s the precursor to diabetes, ”said Mirza. “So just by eating healthier and exercising, you can lower your insulin and improve your mood.”

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