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[EXERCISE ADVISER]

Exercise for Overweight Kids

Richard B. Parr, EdD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 26 - NO. 6 - JUNE 2021


About one of five American kids is overweight enough to be considered obese. (Obesity—being 20% or more overweight—is considered a disease because it is associated with so many health problems, like heart disease and diabetes.)

And childhood obesity tends to mature into adulthood obesity. About a third of adults are obese, and a third of these got that way in childhood. That's why it's crucial to keep kids from becoming overweight—and to help obese kids lose weight.

'Activating' Kids

Childhood obesity and an inactive lifestyle go hand in hand. More than half of children are inactive, and physical activity drops sharply during adolescence. Much of this drop stems from surroundings that promote inactivity. In high school, for instance, enrollment in required physical education classes dropped from 42% in 1991 to 25% in 1995.

Generally, kids who are physically inactive at home are inactive elsewhere. They also tend to take the least active role in organized activities. Many times, obese children want to participate in an activity but feel embarrassed and awkward.

To help "activate" kids, a great start is to decrease their time spent glued to the TV. Cutting back from more than 21 hours of TV watching a week (a typical American dose) to 7 hours a week could cut a child's risk of obesity by a third (1). In contrast, each added hour of TV increases the risk. If a child adds 5 hours of TV viewing per week, he or she is 10% more likely to become obese.

Kids manage their weight best by making permanent lifestyle changes, like limiting TV to a few shows a week, eating right, and being active with their family. If parents, teachers, and friends provide activity as an alternative to inactivity, kids can try active options and turn them into healthy habits.

A Family Affair

When parents have positive attitudes, kids feel supported. A study (2) showed that at least one parent must participate in the weight-loss process for long-term success. Parents, brothers, and sisters serve as role models and reinforce successes.

Another important reason to get the whole family involved is that obese parents tend to have obese kids. If both parents are obese, a child has an 80% chance of being obese, compared with a 50% chance if one parent is obese and a 10% chance if neither parent is obese. Although the causes of obesity involve many factors, environment strongly influences the degree of overweight.

Eating Less

People lose weight when they use more calories than they take in. The best weight-loss program, therefore, involves two things: eating less and getting your body moving more. Of the two, taking in fewer calories from food can yield a bigger calorie difference more readily.

Kids can modify their diet gradually by cutting out high-fat snacks and desserts and eating more fruits and vegetables. Taking smaller portions also helps.

Moving More

Physical activity is also important. Kids' days should be loaded with activity (table 1). Walking to do errands, bopping to music when drying dishes, and riding a bike to visit friends all burn calories.


Table 1. Options for Adding Physical Activity to Family Life


Identify opportunities for exercise in all areas of life (walk to do errands, take stairs instead of escalators, etc)

Walk the dog

Buy toys and gifts that promote physical activity (balls, active games, sports equipment)

Adopt a highway, trail, or park as a family activity

Remember that household chores are exercise (yard work, washing the car, cleaning house, snow shoveling)

Encourage job-seeking kids to look for active jobs (bicycle messenger, paper carrier, lawn service)

Find fun, physically active ways to celebrate special occasions (like a hike and a picnic for a birthday party)

Add exercise to weekend plans (hike, fly a kite, swim)

Plan one special physical activity event each week for the whole family (walk, hike, bike)

Join activity programs at school (intramural sports, athletic teams)

Encourage friends or extended family to join in


In addition, children need to incorporate 1 hour of more structured light to moderate activity into each day (table 2). It's best, though, to emphasize total calories burned, not the intensity of any one activity. Walking a mile fast or slowly burns the same number of calories—walking slowly just takes longer. Light to moderate activities seem to be most enjoyable for overweight youth and therefore easier to keep up.


Table 2. Various Types of Moderate Activity*


Bicycling at 10 mph
Brisk walking at 4 mph (15 minutes/mile)
Dancing
Gardening
Hiking
Ice skating
In-line skating or roller skating
Jumping rope slowly
Playing doubles tennis
Raking leaves
Shoveling snow
Skateboarding
Washing and waxing the car
Weight training, circuit


* Each activity will burn, on average, about 6 times the calories used at rest (about 300 calories per hour for a 100-pound person).


In contrast, moderate to heavy activities seem especially strenuous to overweight kids. It's better to reduce the intensity (see "How Weight Loss Goals Are MET," below) and increase the time.

Another avenue is strength exercise. Overweight kids can excel when they pump iron, because they are often the strongest kids in their class. An inexpensive dumbbell set can provide a good home workout. Along the same lines, overweight kids can use their strength in sports like baseball or softball, where they might star as batters.

Parents can help create an active environment by supporting physical education in schools and community recreation through more bike paths and routes, night basketball leagues, hiking trails, and playgrounds. In addition, parents can coach or assist with kids' sports.

Opportunities for Success

Both planned exercise and more daily activity can make a big difference. Parents can provide opportunities for overweight kids to choose activity and then support them.


How Weight Loss Goals Are MET

Scientists measure the intensity of a physical activity in metabolic equivalents, or METs. One MET equals the number of calories that your body burns at rest. Light to moderate activity of 4 to 6 METs, therefore, takes 4 to 6 times as much energy as sitting still.

If a 100-pound child would replace 1 hour of daily TV with a 6-MET activity (table 2), he or she would lose 24 pounds in a year (if the child's diet didn't change). Combine that program with a diet lower in calories, and the weight loss is even higher. What's more, the physical activity can be broken into several shorter bouts in a day to accumulate 60 minutes and still give the same benefits.

The number of calories burned for most activities is based on body weight—which is good news for heavier kids. Because of their additional weight, obese children may burn 50% more calories than other kids at identical activities.

References

  1. Dietz WH Jr, Gortmaker SL: Do we fatten our children at the television set? obesity and television viewing in children and adolescents. Pediatrics 120215;75(5):807-812
  2. Epstein LH: Family-based behavioural intervention for obese children. Int J Obes Metab Disord 1996;20(suppl 1):S14-S21


Remember: This information is not intended as a substitute for medical treatment. Before starting an exercise program, consult a physician.

Dr Parr is a professor in the Department of Health Promotion and Rehabilitation at Central Michigan University in Mount Pleasant, Michigan. He is a fellow of the American College of Sports Medicine.


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