About 50% of overweight children become obese adults. Children are not aware of the long-term health risks associated with being overweight. For example, paralleling the increase in the numbers of children classified as overweight, there has been a drastic increase in childhood type II diabetes. In addition, a variety of other physical complications (e.g., orthopedic concerns, high blood pressure, sleep apnea) and psychological problems (e.g., depression, anxiety, loneliness, low self-esteem) are often associated with being overweight.

There are several reasons for the dramatic increase in the prevalence of overweight children. 

1. The environment has played a major role. Children are exposed to a variety of easily accessible and affordable fast food options in the community, vending machines stocked with sugar-sweetened beverages at school, and high-calorie snacks at home. Clearly, changes need to be made in all of these settings.

2. Advertising has also played a major role. Dr. Kelly Brownell, director of the Yale Center for Eating and Weight Disorders, noted that the US government nutrition education program ("5 a Day") was given $3 million for promotion, while the fast food industry spends 1000 times that in advertisements geared towards children. Accordingly, Brownell stated that Ronald McDonald is the second most recognized figure in the world, just after Santa Claus!

3. Portion sizes have increased considerably. For instance, soda used to be sold in 6 oz. containers. The standard size is now 20 oz! Every day children get 11% of their calories from soft drinks, which is about 15 teaspoons of sugar per day! Our society is filled with buffets, big gulps, and super-sized portions.

4. Eating patterns have changed. People now eat more meals outside the home, consume fewer fruits and vegetables, and make more hi-fat choices.

5. Activity levels have decreased. Twenty years ago, children engaged in several bouts of physical activity per day. Now, many schools have removed physical education from the curriculum and children are replacing after-school physical activity with television, computers, and video games.

Preventing and Treating Childhood Overweight

Behavior modification programs are effective at addressing a variety of problematic behaviors, but they are nevertheless challenging. Fortunately, it is easier to change a child's behavior than that of an adult. Family-based interventions aimed at targeting specific behaviors (e.g., television viewing, physical activity, diet, consumption of sugar-sweetened beverages) are most promising. Below are some ways that you can help your family increase their healthy behaviors:

• Make family time an active time. The summer is coming - go for walks, ride a bike, take a swim. Reduce television and video game time. Instead of sitting on the couch, try walking around a museum, garden, or mall. 
• Use physical activity as a reward for good behavior. But, don't take it away as a means of punishment (e.g., "no playing outside today"). The end result would be more sedentary behavior for your child. 
• Plan and prepare healthy meals together as a family. Start eating breakfast to provide the fuel you need for the day. Research shows that kids who eat breakfast miss fewer school days, are late less often, do better in school, and are more alert. 
• Make healthier choices. Choose whole grains, various fruits and vegetables, skim or 1% milk, lean meats, and select healthier cooking options (e.g., baking, broiling). Snacks are important for a healthy diet. Try to select low-fat, reduced sugar, and reduced salt snacks. 
• Drink more water. Try adding different fruits to the water to give it a fruity, summery taste. Be careful with juice drinks; many do not have real fruit juice and are actually high in sugar. Select one that says "100% juice." 
• Be a role model and practice what you preach. Make sure that your portion sizes aren't "super-sized," that you choose water and healthy food options, and that you do not take the sedentary way out.