Health and Religion

Obesity in Children. How does it begin and what can parents do about it?

Herald A. Habenicht, M.D., is associate professor of health education at Andrews University Theological Seminary, Berrien Springs, Michigan.

 

Obesity has been defined as an excess of adipose mass, or body fat. Over weight, on the other hand, is weight in excess of one's normal range, which may or may not involve obesity. Dr. Jean Mayer, in his book Overweight: Causes, Cost and Control, points out that there is no arbitrary definition of obesity. Though there are several height and weight tables (e.g., the Metropolitan Life Insurance Company's 1943 table or the Society of Actuaries' 1959 one) that correlate height, weight, and body frame, these may at times be misleading. Dr. Mayer says that an even more reliable guide is the "mirror test." If when you stand naked before a mirror, you look fat to yourself—then you are fat.

The most reliable test in use today requires using a caliper to measure skinfold thickness, because half the body fat is found directly under the skin.

It is somewhat difficult to obtain valid data on the prevalence of obesity in the American population as a whole. Among insured persons, half the men between 30 and 39 years of age are at least 10 percent overweight, and a fourth are at least 20 percent overweight. In the 50- 59-year range, more than half are 10 percent overweight, and a third are 20 percent overweight. Studies on the weight of women show that they have slightly better average weight before 40 years of age, but fare worse than men when beyond 50 years of age. Dr. Mayer found that 10 percent of the school children he studied in Boston were over weight.

In the past few years researchers have directed considerable effort toward determining the size and number of fat cells (adipocytes) in obese individuals, from infancy through adulthood. We now know the following facts about adipocytes and obesity:

• Normal nonobese adults have an average of 25 to 30 billion adipocytes. People who are obese have three to five times as many.

• Obese adults who were normal in weight until they reached 16 years of age have about the same number of adipocytes as do non-obese adults; however, the size of their individual fat cells is larger.

• Adults who have become obese after reaching maturity have much less difficulty following and maintaining a reducting plan.

• The newborn infant has about one fourth as many adipocytes as a nonobese adult, with about one fourth the lipid content per cell. Most of these cells have formed during the last trimester of pregnancy—especially the last month.

• During the first year of a child's life, he normally experiences an increase in the number and size of his fat cells, whether or not he is obese.

• The nonobese child adds no further adipocytes to his body between the ages of 1 year and 10 or 12. Then he begins to add more fat cells until he reaches 16, when his complete number of such cells becomes fixed for life. Thereafter he cannot increase the number of these cells.

• A child who later becomes obese may have more and larger fat cells at birth than normal. He continues to proliferate these cells, which tend to grow larger also, until he reaches about 2 years of age. After that, the size of his fat cells remains relatively constant. He will continue to add to his excess weight by proliferating the number of fat cells until he is about 16. After that age, he stops adding more fat cells, but he will never be able to decrease the number. Any decrease in his weight must come from shrinkage of the lipid content of the individual fat cells. These shrunken cells exist as long as he lives, hungrily looking for fat with which to be refilled.

• Between 10 and 30 percent of adolescent youth have a major weight problem, and 80 percent of all children who are overweight remain so into adulthood.

• Children who are overweight at six months are on the average nine pounds heavier than normal when they reach 5 years of age. One child in four who is obese at the age of 12 is likely to become a normal-weight adult in later life; but of those who are still obese at 16, only one in twenty-eight is likely to regain his proper weight upon reaching adulthood!

The treatment of childhood obesity

It is much easier to prevent obesity than to treat it once it is established. During childhood and adolescence a person is naturally growing, and consequently can expect to gain weight. He must have certain food elements, especially protein, and if food is withheld injudiciously his growth may be stunted. It is far better and more effective to let a child "grow up to his fatness" than to expect him to lose weight. If he is to engage in a program of weight management, he should have a properly motivated exercise plan, in addition to other measures.

What can parents do to help their children? Here are some suggestions:

1. The pregnant mother should exercise self-control in her eating habits and avoid excessive weight gain. Once the child is born he should be breast fed at least six months. Human milk is species specific and does not usually result in fat babies. The baby should not be given solid food during this time.

2. Parents should refrain from serving high-calorie desserts and snack foods. It would be best if these items were not even kept at home; even nonobese children do not need them. The parent who shops for food should read labels care fully, avoid buying prepared foods that are high in sugar content, and buy and use sparingly such fatty products as margarine, shortening, mayonnaise, and French dressing. Parents can talk to their children about the TV commercials they see advertising snack foods, sugarcoated cereals, carbonated beverages, et cetera. The discussion should include basic facts about nutrition and the Biblical principle of keeping our bodies healthy for Jesus. This spiritual approach may be more effective than any other.

3. The family menu should not include a dessert every day. Desserts should be saved for Sabbath, birthdays, anniversaries, and special holidays. The entire family should eat a good breakfast to help prevent the blood-sugar slump that people otherwise feel at midmorning. Breakfast serves to diminish hunger pains that might come later, and helps control the appetite. When suppertime comes, serve only a light meal of fruit or soup.

4. Abundant physical activity should be a way of life for the family. Dr. Mayer says: "I am convinced that inactivity is the most important factor explaining the frequency of 'creeping overweight' in modern societies."— Overweight: Causes, Cost and Control, p. 113. Children should be encouraged to walk or ride a bicycle wherever they need to go. They should use stairs in stead of riding an elevator or an escalator. They should engage in outdoor activities such as hiking, tennis, swimming, and skiing instead of watching TV.

5. Children and teen-agers should not use "formula" diets on the market. These diets do not supply enough nutrients for growth, or enough water and bulk for normal body functioning. Furthermore, a growing young person should not go on a complete fast—this would be certain to,stunt growth.

6. A young person should not use drugs as an aid to suppress his appetite. H. Gershberg says: "Many drugs have been used in attempts to promote weight loss. They include drugs producing an orexia, drugs causing nausea, drugs preventing gastrointestinal absorption, hormones increasing metabolism and lipolysis, tranquilizers and diuretics. None has been shown in properly con trolled investigations to be more effective than a placebo when the diet is unrestricted.' '—Postgraduate Medicine, vol. 51 (No. 5, 1972), p. 136.

Anyone, young or old, who is seeking weight control should do it in the context of overall body health. He should have frequent medical examinations and should try to achieve balance in all aspects of his life. It is possible to control the factors that affect weight, especially when one is motivated by the wish to please God. "Whether therefore ye eat, or drink, or whatsoever ye do, do all to the glory of God" (1 Cor. 10:31).

Ellen G. White wrote on many occasions about the importance of self-control in our eating habits and appetites. She particularly points out the responsibility of parents to train and teach their children on this subject.

"The importance of training children to right dietetic habits can hardly be overestimated. The little ones need to learn that they eat to live, not live to eat. The training should begin with the infant in its mother's arms. . . . Care and regularity in the feeding of infants . . . will lay the foundation of habits that will be a blessing to them in after years.

"As children emerge from babyhood, great care should still be taken in educating their tastes and appetite. Often they are permitted to eat what they choose and when they choose. . . . The result of this training is gluttony."— The Ministry of Healing, pp. 383, 384.

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Herald A. Habenicht, M.D., is associate professor of health education at Andrews University Theological Seminary, Berrien Springs, Michigan.

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