All children should have a medical evaluation by a doctor before starting weight loss therapy. The goals of therapy are to:
- lose weight slowly (e.g., approximately 0.5 kg or 1 lb a month)
- maintain normal childhood growth (e.g., growing taller in height) with no weight gain
- change diet, exercise, and behaviour
- involve family in counseling and support
- keep the weight off once it is lost
Recent research has shown that diet, exercise, and behaviour modification are most effective when the whole family is involved. A weight loss program may be futile and actually harmful if the family is not ready to make changes, because unsuccessful efforts may lower a child's self-esteem even further.
Since family support is such an important part of therapy, several "parenting" principles should be followed in the management of eating and activity behaviours:
- Find reasons to praise your child's behaviour.
- Offer rewards for positive changes in behaviour. Never use food as a reward.
- Establish daily family meal and snack times.
- Determine what food is offered and when. Let your child decide whether to eat.
- Offer only healthy options.
- Remove temptations.
- Be a role model.
- Be consistent.
Drug therapy and surgery are sometimes used to treat obesity in adults. However, they are not routinely recommended for children and are generally not considered unless obesity is life-threatening.
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