I care for a foster child who is obese. She is four-and-a-half years old and wears size 12 clothes. When she’s at our home (four days a week), I feed her appropriately sized meals, and she rarely asks for snacks. At her mother’s, however, I suspect she helps herself to food whenever she wants. What can I do beyond what I am doing to help her to lose weight?
Childhood obesity is becoming more prevalent. Obese children are at risk of becoming obese adults, with all the health problems associated with excess weight. The most obese adults are likely to have been obese children. Is it nature or nurture? Most likely, both are involved, but since we cannot change our genetic endowment, we should focus our attention on those things that can be changed.
Weight control for overweight children is no easier than it is for overweight adults, except in one respect: children are still growing in height, so that simple weight stabilization rather than weight loss can be a reasonable goal. Not surprisingly, addressing the obese child requires consistency on the part of all caregivers involved. What the child is fed and what her level of physical activity is for four days a week is irrelevant if the expectations are different for the other three days. A four-year-old has already developed a set of eating behaviors that will require a concerted effort to change.
In the case of a child in foster care, the child welfare authorities need to take the obesity seriously and look more closely at this child’s environment for the 43% of the week that she is not in your care!