Back in the 1970s, when Jaws and Star Wars had just been released in theaters, about 5% of children — one in every 20 — struggled with carrying too much weight. Fifty years later, that number is now 20%. One out of every five kids is now technically obese. September is National Childhood Obesity Awareness Month — let’s talk about why the problem matters and what we can do about it.
First, why it matters. As a clinician, weight is hard to talk about. Laden with layers of shame, blame, judgement, prejudice and frustration, it’s so easy to hurt a person’s feelings or damage their self-image through conversations about obesity. However, it is also my responsibility to help patients thrive and to live long and healthy lives in bodies that they love. Obesity matters because of its insidious ability to hinder a person from reaching their goals and enjoying their life. According to a large study of 900,000 adults published in the Lancet in 2009, severe obesity is associated with dying 8 to 10 years younger than those with normal weights, likely as a consequence of greater rates of cancer, heart attacks, strokes and diabetes. Children with obesity are much more likely to struggle with their weight as adults and therefore healthy habits need to start young.
Second, what we can do about it. Establishing healthy habits as a family may well be our very best line of defense against this problem and one memorable way to organize those habits is the 5-2-1-0 rule: 5 servings of healthy foods, especially fruits and vegetables, each day; 2 hours or less of recreational screen time per day; 1 hour of exercise every day; and 0 sugary drinks.
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For the “5,” eating healthy food is best done with the whole family on the same team. Instead of singling out one member of the family, commit as a group to model healthy eating by increasing your daily intake of fruits and veggies. When half of your plate and all your snacks, are made of fruits and vegetables, you’re making huge changes!
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For the “2,” remember that screens are fun, but too much is associated with poor sleep, mental health struggles and unhealthy weight gain. As an alternative to TikTok and videogames, consider reading a book from the library, drawing, building with LEGOs, practicing an instrument, learning to solve a Rubik’s Cube or playing a game as a family (my wife and I love Dominion). Growing up, my own mother made my brothers and me earn “tech time” by reading books and practicing music. Brutal when you’re 12 years old! But now I’m so thankful.
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For the “1,” move as a family: kids need to be active for at least 60 minutes per day and running, playing, swimming, community kickball, family pickleball nights and other shared activities are fun ways to get active and stay healthy.
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And for the “0,” the aggressive elimination of anything sugary to drink (juice, sodas, sports drinks), can be a game-changer for kids struggling with their weight. 5-2-1-0: more veggies, less screen time, an hour of play and zero sugar to drink. The rule is tough, but it makes a huge difference for families with kids struggling with their weight.
Of course, every child and every situation is different. All of these decisions are best made in a relationship with a doctor who you trust and who encourages you to make the healthy choice even when it’s hard. In my own clinic, I love talking to children about the kinds of people they want to be, the ways they could make the world a better place, which vegetables they could eat more or and how much cooler Rubik’s cubes are than video games anyway.
Dr. Gage Hallbauer is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501(c)(3) Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, Huntsville and Magnolia and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.
