Helping Kids Beat the Summertime Bulge
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Edward Cumella is a professor of psychology at Kaplan University's College of Social and Behavioral Sciences. He is a certified eating-disorders specialist and the author of a book on the treatment of eating disorders, and has been executive director of the Remuda Treatment Centers for Eating Disorders. He contributed this article to Live Science's Expert Voices: Op-Ed & Insights.

During long summer vacations from school, children are often home all day, watching television, playing video games and surfing the Internet. While playing, they may snack regularly and consume sugary drinks. Unstructured time is a cue for overeating among children and adults. 

Therefore, during long, hot summers, America's children — especially those who prefer indoor and sedentary activities — can gain weight. If they lose the weight when school resumes, they may find themselves beginning a yo-yo weight cycle that lasts for years and results in obesity. If they do not lose the weight, they may be on track to continue gaining weight throughout their lives. Either way, a summer bulge can initiate a long-term struggle with weight and self-esteem. 

Surprisingly, researchers have known for more than a decade that most weight-related medical problems can disappear, with no focus whatsoever on weight loss, if individuals simply increase their pleasurable physical activity. Happy children are more interested in movement-related play than adults are. In most cases, children merely need the right opportunity and companionship to get up and move around. Their young bodies respond more quickly than mature bodies, and the positive experiences are self-reinforcing, leading children to seek to repeat these experiences. By getting up and moving around, they will not only stop summer weight gain, but also lose in a healthy manner any weight they may have gained.

Nevertheless, according to the National Health and Nutrition Examination Survey, one in five American children are obese, and 40 percent are overweight. Because of their weight, these children may develop hypertension (high blood pressure), high cholesterol and type 2 diabetes. As with obese adults, additional medical consequences include asthma, liver degeneration and sleep apnea. 

The American Academy of Pediatrics reports through its website, healthychildren.org, that because American society is weight-phobic, obese kids often experience discrimination and may be bullied. Multiple investigations into bullying reveal that stigmatization by peers produces low self-esteem, social isolation and depression, each of which hinders achievements in school, sports and social activities. 

Obesity results when children consume more calories than they use for metabolic functions. Calories needed for metabolism vary across children, depending on genetics, nutrition, health, environment and behavior. Hence, childhood obesity is rarely caused by one factor, such as summertime overeating. Yet, American children engage in less physical activity than those of past generations, and many consume large quantities of processed and fast foods. [Fight Childhood Obesity in the Home, New Guidelines Say]

During summer vacations, these unhealthy behaviors are often taken to extremes.

In particular, watching TV promotes needless snacking and lowers metabolism, and advertisements encourage children to eat unhealthy foods. As such, multiple studies conducted by the Harvard School of Public Health indicate that watching TV is a key behavior associated with childhood obesity. The more TV, the more obesity — a linear relationship exists between the hours of TV watched and the amount of weight gained. Although few studies have examined whether video games and computer use are linked with weight gain, these activities — which resemble watching TV in many ways — may have similar undesirable effects on weight.

The most common treatment we see for obesity is dieting. Nearly 98 percent of diets result in temporary weight loss, but lost weight is generally regained and often increases. Diets don't work. Furthermore, diets are especially dangerous for children, because children's bodies are smaller and have fewer nutritional reserves, leading to rapid medical decompensation such as low heart rate and dangerous electrolyte disturbances, and often impairing physical development.

For example, research — such as the landmark study by Donna Stewart of the Department of Obstetrics and Gynecology, Toronto General Hospital, University of Toronto, and colleagues, published in the American Journal of Obstetrics and Gynecology in 1990 — has demonstrated for decades that girls ages 11 to 16 who lose weight may become infertile because they do not have sufficient fat stores needed to produce the hormones that prepare them for the timely onset of menstruation. 

Furthermore, Dr. Carlos Grilo, of the Yale School of Medicine, has reviewed surgical options, such as gastric bypass or banding, and concluded that these procedures may also be unsafe for both boys and girls because these methods often lead to nutritional deficiencies that inhibit children's physical development at key periods in their lives. [Why Wait for New Food Labels to Curb Childhood Obesity? (Op-Ed)]

What can assist obese children without harming them further? Research suggests an approach called Health at Every Size (HAES) may be effective. The HAES community includes health care providers from virtually every profession and lists more than 30 books that explain and promote this approach to personal wellness. 

Yet many Americans and health care professionals are not aware of HAES or are taking a wait-and-see attitude as research continues to accumulate. The principles of HAES are intended to assist people to be at peace in their bodies while discovering compassionate approaches to self-care. 

HAES includes: 

  1. Respect, including respect for body diversity;
  2. Compassionate self-care, such as eating in a flexible and attuned manner that values pleasure and honors one's internal cues of hunger and satiety, and finding joy in being physically active; and
  3. Critical awareness, including challenging scientific and cultural assumptions about weight and valuing people's individual body knowledge. HAES can be summarized as "Eat well, move around and enjoy life."

The HAES strategy involves finding physical activities that children enjoy. These need not be athletic, but may include activities such as playing with animals, dancing randomly to music, walking or running around outside, riding a bike, and playing active games such as jumping rope or climbing in a jungle gym. The U.S. Department of Health and Human Services discusses, on its site dedicated to childhood obesity, the value of active play for children and offers a range of options for parents to consider.

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Children are much more likely to engage in these healthy activities if they are accompanied by another child. When play partners are unavailable, parents need to reach out to neighbors, family, church members and other sources to find playmates. Daytime activities in schools, youth clubs, community organizations and city parks readily provide situations in which children have playmates and adult supervision to ensure their safety. 

When children's play involves physical activity, children burn calories and are no longer sitting and snacking. Physical play is inherently healthy for children, and when given the chance and companionship to engage in such play, children naturally gravitate toward it. 

Parents simply need to recognize the importance of physical play for their children, and create situations in which it occurs. It doesn't cost any money, but it does require an informed parent who uses whatever resources are available to get their child to engage in supervised physical play with other children. Say to your kids, "Let's get up and move!" Then, make it happen. 

Follow all of the Expert Voices issues and debates — and become part of the discussion — on Facebook, Twitter and Google+. The views expressed are those of the author and do not necessarily reflect the views of the publisher. This version of the article was originally published on Live Science.