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Expert on childhood obesity Add to ...

L. Morgan from Toronto Canada writes: We know people can lose weight if they are a controlled environment, but how effective are weight loss treatment camps for children in helping them keep weight off over the long term? What tools do the children get to cope with the environment that caused them to gain the extra body fat in the first place?

Dr. Chanoine: Weight loss camps are indeed effective in promoting very significant weight loss in the short term. They are also often expensive and require removal of the child from his/her family, his/her friends and so on. Weight loss camps put emphasis not only on the child but also on modifying the environment (family, school, habits...) and often offer a very comprehensive program that goes well beyond "weight loss." It is however not clear to me what the long term effects are (at 1, 5 and 10 years). This should be the number one focus of those organizing these camps.

D ster from North Vancouver Canada writes: I have a 1 year old who is bigger than average (99th percentile according to the charts but height/weight proportions are normal)and a big appetite. He gets lots of playtime and we take pains to set a good example when eating. However I'm concerned that we need to start restricting his diet so as to prevent him from creating bad eating habits (with regard to portion size) later on. Without knowing any more specifics is there any way you can tell that I am being completely paranoid or are these concerns legitimate? Also - some tips for preventing young kids from developing emotional eating habits? Thanks

Dr. Chanoine: A: At BC Children's Hospital, I see more and more very young children (1-3 years) with a very rapid weight increase. Of course, at that age, complications are not an issue. They are usually very healthy-looking infants/children who are growing very well. Usually, I am unable to find any specific (hormonal or other) cause for this rapid and sometimes very impressive weight increase. Whether these children later become obese adolescents or adults is also unclear and it is generally thought that about 1/3 rd of heavy 1-3 year old will become obese adults (meaning that 2/3 won't!). Nevertheless, I think it is appropriate to take some sensible steps and try to promote a very healthy lifestyle in these children and to ensure that their weight increases proportionately less than their height. It is also interesting that this rapid weight gain often occurs when solid food is introduced (shift from breastfeeding/formula to diversified food). I suggest the following steps: 1. Look in the family to see whether the parents had a similar early growth; this seems to sometimes "run" in families 2. See a dietitian once, not for a weight loss diet (which would be inappropriate at that young age) but to ensure that there is no obvious dietary mistake (portion size, excess juice, hiden calories and so on). Parents sometimes do not have a good idea of what a normal portion is; 3. Ensure that he/she is indeed kept "busy" with non-food related activities. 4. Ensure that the number of meals/snacks is appropriate but don't offer comfort food in between. 5. Offer healthy choices that can be consumed without restriction (low density) with the intention of promoting satiety, as well as enough water. 6. Whether food should be limited once calorie needs are fulfilled, and whether weight should be measured regularly would be a recommendation that is not based on hard science but I feel it is a reasonnable approach provided that parents maintain a very healthy attitude towards food.

J Fraser from Canada writes: Hello. I have two children ages 2 and 4. The older boy, quite frankly, looks pudgy in his bathing suit unlike many of the other preschoolers I see in the pool. He even has a little belly and the beginning of 'love handles'. He looks like me at that age. In contrast sister is slender and long-limbed, like her father. The kids are exposed to the same diet and both have the same opportunities for active play. Years ago people talked about 'body type'. Is that still considered relevant today? Thanks.

Dr. Chanoine: We have to remember that our children get part of the genetic information from the mother and part from the father. The determination of body mass is closely linked to the genetic background (more than 50-80% depending on the studies) and thus it is not surprising that 2 siblings offered the same lifestyle/diet may respond differently to this same environment and look more like one of the parents depending on which genes they "received". The same goes for the height, shape of the face and so on. Once your children are old enough, the reason why they look "different" can be explained to them in simple and positive words.

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