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Kids Hooked on Food


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Title: Kids Hooked on Food

Helping Kids Be Healthy in a Supersized World
Mandy L. Perryman, Ph.D. Jeanne D.
Booth, Ph.D. Counselor Education Lynchburg
Obesity in Children Defined
  • Body Mass Index (BMI) a measure of weight in
    relation to height used to determine weight
  • Overweight defined as a BMI at or above the 85th
    percentile and lower than the 95th percentile
  • Obese defined as a BMI at or above the 95th
    percentile for children of the same sex and age

BMI for Children
  • BMI for children is age and sex specific
  • Differs from categories for adults
  • Body composition varies as children age
  • Fat percentages vary between boys and girls


Scope of the Problem
  • Approximately 9 million children over the age of
    six are obese
  • Over the past three decades the prevalence of
    obesity in children has nearly tripled.
  • CDC, 2008
  • Ogden, Carroll Flegal, 2008

Children in the Commonwealth
  • A 2004 study by the University of Baltimore
    examined what states were doing to treat obesity
    as a threat to public health. Report Cards
    assessed efforts to combat obesity in eight
    different categories through legislation,
    regulation, and education.
  • Virginias efforts to reduce childhood obesity
    received a grade of F.

Children in the Commonwealth
State rank in disparity level 29 (1 to 39) In
addition, the Pediatric Nutrition Surveillance
System found that 35.1 of children between the
ages of 2 and 5 from whose families participate
in WIC are overweight or obese.
Children in the Commonwealth
Virginia is 31st in the national rankings for
overweight children in this age range.
Children in the Commonwealth
The race disparity ratio for obesity between
Blacks and Whites in Virginia is 1.66. State
ranking 14th (1 to 23) The race disparity ratio
for obesity between Hispanics and Whites in
Virginia is 1.65. State ranking 18th (1 to 21)
  • For the first time in two centuries, due to the
    rapid rise in the rate of childhood obesity, the
    current generation of children will have a
    shorter life expectancy than their parents.
  • The New England Journal of Medicine, 2005

Addressing Obesity
  • For our children, we must deal with the issue of
    nutrition and good health, rather than on weight,
    the numbers on the scale, or percentages of body

What Contributes to Obesity?
  • Biology
  • Genetics
  • Brain Chemistry
  • Central Nervous System

Childhood Obesity Outcomes
  • Type II Diabetes
  • Hypertension
  • Cardiovascular Disease
  • Sleep Apnea
  • Adult Obesity

What Contributes to Obesity?
  • Psychology
  • Low Self-worth
  • Impulse Control
  • Mood Regulation
  • Anger Suppression

Psychological Difficulties
  • Obese individuals suffer almost twice the rate
    of depression as those with a normal weight
  • Jones-Cornielle, Waden, Sarwer, 2007

Other Outcomes
  • Disordered Eating
  • Eating Disorders
  • Poor Body Image
  • Body Dysmorphic Disorder
  • Psychological Difficulties

What Contributes to Obesity?
  • Sociocultural Pressures
  • Pressure to attain impossible ideals
  • Value acceptance
  • Relationship to self and others

Cultural Shift for Ideal Body Image
Model Behavior?
  • Most models
  • are thinner than
  • 98 of American
  • women.

Super Stars?
  • Norbit
  • Big Momma
  • Klumps
  • Nutty Professor

Minority Differences
  • African-American children are
  • over-represented in food commercials and
    under-represented in toy commercials.
  • Bang Reece, 2003

Minority Differences
  • African-American TV programming contains more
    commercials focusing on
  • Fast-food vs Dine-in restaurants
  • Candy, sweets, soda, meat, eggs, baking
  • Less on bread, grains, cereal, pasta, fruits,
    vegetables, 100 juice
  • Even fewer commercials (0) on a lighter, leaner
  • Henderson Kelly, 2005

The Social Stigma of Obesity
  • Latner Stunkard Study
  • First conducted 1961
  • Replicated 2003
  • Process
  • 458 5th 6th Graders ranked 6 drawings
    featuring children with specialized concerns
  • Results
  • Rated obese image lowest
  • Children as young as 3 years old are more likely
    to consider overweight peers to be mean, stupid,
  • ugly and sloppy.

  • The quality of life for kids who are obese is
    comparable to the quality of life of kids who
    have cancer. These kids are facing stigma from
    everywhere they look in society, whether it's
    media, school or at home.
  • Rebecca M. Puhl
  • Yale Rudd Center for Food Policy and Obesity

(No Transcript)
Stigma of Obesity
  • Employment Discrimination
  • Overweight employees are seen as lazy, sloppy,
    less competent lacking self-discipline
  • Health Care Discrimination
  • Patients viewed as unintelligent, weak-willed
  • BMI appointment cancellations
  • Obesity Specialists
  • Educational Discrimination
  • Average weight college students ? parents
  • Overweight students ? financial aid jobs
  • Fairburn Brownell, 2002

The Importance of Body Image
  • Body Image Ones inner picture of his or her
    outward appearance
  • Two essential body image components
  • Perception of ones appearance
  • Emotional response to that perception

Body Image
  • 42 of girls (grades 1-3) want to be thinner
  • 80 of these girls have dieted by age 10
  • 50 of kids (ages 8-10) say they are unhappy with
    their size
  • 81 of 10 year olds are afraid of being fat
  • NIH, 2005

  • Assessing Body Image

Contour Drawing Rating Scale by Thompson and Gray
Body Dysmorphic Disorder
  • Body dysmorphic disorder (BDD) is defined by
    DSM-IV-TR as a condition marked by excessive
    pre-occupation with an imaginary or minor defect
    in a facial feature or localized part of the
  • The diagnostic criteria specify that the
    condition must be sufficiently severe to cause a
    decline in the patient's social, occupational, or
    educational functioning.

Body Dysmorphic Disorder
  • The most common cause of this decline is the time
    lost in obsessing about the defect.
  • One study found that 68 of patients in a sample
    of adolescents diagnosed with BDD spent three or
    more hours every day thinking about the body part
    or facial feature of concern.

  • Americans spend over 40 billion
  • on dieting and diet-related products each year!

  • 25 of American men and 45 of American women are
    on a diet on any given day
  • 46 of kids (9-11) are sometimes/very often on
    diets and 82 of their families are
    sometimes/very often on diets
  • 35 of normal dieters progress to pathological
    dieting. Of those, 20-25 progress to partial or
    full-syndrome eating disorders
  • Hoek, 1995

Dieting Children
  • Parents often put overweight children on diets
  • Dieting is a risk factor for body dissatisfaction
  • Paxton, Eisenberg, Neumark-Sztainer,
  • Pressuring the child is ineffective can lead
    to overeating
  • Overweight children, teased by family members,
    are 300 more likely to consider suicide
  • Eisenberg, Neumark-Sztainer, Story, 2003

Where to Focus First?
Environmental Factors
  • Lack of Physical Activity
  • Portion Size
  • High Fat/Energy Dense Foods
  • High Glycemic Index of Foods
  • High Fructose Corn Syrup
  • Fast Foods
  • Accessibility of Fast Food
  • Low Cost of Fast Food
  • Palatability of Fast Food

Fast Food or Fat Food?
  • McDonalds is spread over the world and feeds
    more than 46 million people worldwide a day.
  • McDonalds accounts for 43 of the fast food
  • market in the US.
  • In Super Size Me, a documentary
  • by Morgan Spurlock, he gained
  • 10 pounds in one week eating only
  • McDonalds food.

Unhappy Meal
  • A study of more than 3,000 children found that
    French fries are the most commonly eaten
    vegetable for toddlers aged 15 to 24 months.
  • Mathematica Policy Research, Inc., 2002

  • Soda is being served to infants as young as 7
    months old.
  • Mathematica Policy Research, Inc., 2002
  • The average American child sees
  • over 7,600 food advertisements
  • on television each year.
  • Super
    Size Me, 2005

Can Kids be Hooked on Food?
What is the Glycemic Index?
  • Not all carbohydrate foods are created equal, in
    fact they behave quite differently in our bodies.
    The Glycemic Index (GI) describes this difference
    by ranking carbohydrates according to their
    effect on our blood glucose levels. Choosing low
    GI carbs, the ones that produce only small
    fluctuations in our blood glucose and insulin
    levels, is the secret to long-term health
    reducing your risk of heart disease and diabetes
    and is the key to sustainable weight loss.

High Fructose Corn Syrup
  • Fructose reduces the affinity of insulin for its
    receptor, which is the hallmark of Type-2
    Diabetes. This is the first step for glucose to
    enter a cell and be metabolized. As a result, the
    body needs to pump out more insulin to handle the
    same amount of glucose.

A Recipe for Change
Initiatives Across America
Obesity-Related School Standards
And Virginia Schools Should
  • Integrate concepts of good health in appropriate
  • Teach the dangers of dieting
  • Offer small group counseling and support
  • Prohibit restriction of recess for discipline
  • Examine school athletic policies related to
  • Restrict food rewards for achievement
  • Conduct appropriate classroom guidance lessons on
    wellness and to prevent size-related
    discrimination and bullying
  • Have nutritional information and resources

Families with an Obese Child
  • Stereotyped as dysfunctional or emotionally
  • Often stressed with
  • time finances
  • Many doctors visits
  • medications
  • Harper, 2006

  • Connor McCreaddie, 8, from Wallsend, North
  • His mother, Nicola McKeown, 35, had been called
    to a child protection conference with the local
  • "He refuses to eat fruit, vegetables and salads -
    he eats processed foods. When Connor won't eat
    anything else,
  • I've got to give him the foods he likes. I can't
  • starve him. But I'm confident I can get his
  • weight down with a bit of help."
  • Doctors say that Connor, at 218 lbs, is
  • considered three times the average weight for
  • his age, and is at risk for severe
  • medical problems.

  • Anamarie Regino is 7 years old, 5-feet-1-inch
    tall and weighs 200 pounds. Four years ago, she
    became the most publicized overweight youngster
    in New Mexico history when the state took her
    away from her family for two and a half months.

The Apple Doesnt Fall Far
  • Parent Overweight best predictor of Child
  • Whitaker, Wright, Pepe, Seidel, Dietz, 1997
  • When behavioral cost for food increases, parents
    and children chose alternative
  • Epstein, Dearing, Temple, Cavanaugh, 2008

Families with an Obese Parent
  • Non-obese parent may criticize
  • Child may also feel attacked
  • Child may fear being confronted
  • Obese parent likely to diet be critical of self
    around child
  • Jacobi, Agras, Hammer, 2001

Family Factors for Eating Disorders
  • Chaotic Family Environment
  • Critical Comments
  • Maltreatment
  • Family Over-concern about Dieting

Family-based Treatment
  • Entire family invested in
  • Reducing sedentary behaviors
  • Increasing nutritional choices
  • Controlling food stimuli
  • Practicing problem-solving cognitive

Why Focus on Families?
  • Critical environment for development
  • Childs first social world
  • Learned coping
  • behaviors
  • Food is used to reduce
  • stress to provide
  • comfort

Tips for Parents 1
  • Make sure your child understands that weight gain
    is a normal part of development, especially
    during puberty.

Tips for Parents 2
  • Avoid negative statements about food, weight, and
    body size and shape.

Tips for Parents 3
  • Allow your child to make decisions about food,
    while making sure that plenty of healthy and
    nutritious meals and snacks are available.

Tips for Parents 4
  • Compliment your child on her or his efforts,
    talents, accomplishments, and personal values.

Tips for Parents 5
  • Restrict television viewing, and watch television
    with your child and discuss the media images you

Parent Power
  • Model a positive body image.
  • Explore own values and beliefs about weight,
    dieting, and body image.
  • Examine current personal practices related to
    eating, exercise, and body image.
  • Monitor your discussions concerning food
    consumption and body issues.

The Family Who Eats Together
Family Meals
  • According to a survey conducted by the University
    of Minnesota, frequent family meals are related
    to better nutritional intake, and a decreased
    risk for unhealthy weight control practices and
    substance abuse.
  • A Harvard study (March 2000) showed that eating
    family dinners together most or all days of the
    week was associated with eating more healthfully.
  • The study showed that families eating meals
    together "every day" or "almost every day"
    generally consumed higher amounts of important
    nutrients such as calcium, fiber, iron, vitamins
    B6 and B12, C and E, and consumed less overall
    fat, compared to families who "never" or "only
    sometimes" eat meals together.

Family Meals
  • Children who ate family meals consumed more
    fruits, vegetables and fewer snack foods than
    children who ate separately from their families.
  • Children who frequently eat meals with their
    families tend to do better in school as well.
  • And a survey of high-achieving teens showed that
    those who regularly eat meals with their families
    tend to be happier with their present life and
    their prospects for the future.

Family Meals
  • About 18 of girls who eat only 1-2 family meals
    a week reported engaging in extreme weight
    control behaviors compared to 9 of girls who eat
    3-4 family meals a week.
  • More frequent family meals protect against
    tobacco, alcohol, and marijuana use, low
    grade-point average, depression, and
    suicideparticularly among adolescent girls.
  • Neumark-Sztainer , 2006

  • What a Healthy Relationship with Food Looks Like
  • A Lesson from Children

A Healthy Relationship with Food
  • Stop eating when you are full. The goal is to
    feel content and satisfied after eating.
  • Choose foods that make you feel satisfied, both
    in terms of taste and fullness. If you are
    craving a particular food and nothing else will
    do, then sit down, eat it and enjoy it.
  • Make your food taste good. If you need to add a
    little sugar, fat, salt or some herbs or spices
    to make a food such as vegetables taste better,
    then do it.

A Healthy Relationship with Food
  • Pay attention to what you eat. Focusing on the
    process of eating helps you tune into your body
    and makes it easier to stop when you feel
  • Make family meal times a priority. People
    generally prepare and choose healthier foods when
    eating as a family.

Resources for Parents
Other Resources
  • BodyPositive Boosting Body Image at Any Weight
  • Campaign for Real Beauty www.campaignforrealbeauty
  • Dads and Daughters  
  • National Eating Disorders Association  
  • Body Image Loving Yourself Inside and Out
  • Love Your Body

Thank You!