Being obese is bad for children’s health — but even worse for their self-esteem. Claire Keeton spoke to two youngsters who fought the fat because they wanted to take control of their health
Does your five-year-old tip the scales at 50kg, more than double the recommended weight? Does your two-year-old toddler weigh close to 30kg?
This is not as outlandish as it sounds - Johannesburg paediatric endocrinologist Professor David Segal has treated children like this.
And although parents are aware that their children are becoming fatter and less active - as shown by the Healthy Active Kids South Africa Report Card 2014 released by Discovery Health - what they often don't know is what to do about it.
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Being so overweight is a risk to the health and self-esteem of children. And matters are not improving, with about one in four girls (27%) and one in 10 boys (9%) aged between 15 and 17 in South Africa being overweight.
When Dewald Potgieter was in Grade 4, nobody chose him to play touch rugby for their team and he was being called names. He asked his mother if he could join Weigh-Less, and lost 10kg over the holidays.
But back at school, exposed to the perils of the tuck shop, he put on weight again.
Only on his third attempt, in Grade 10, when his mother insisted he would have to pay back the money spent on Weigh-Less if he regained the weight, did his resolve stiffen.
"My mother helped me and that's what parents can do. They mustn't get angry, they must be motivating. My dad, mom and older sister dieted with me. It became a family thing," said Dewald, 17.
Now 20kg lighter, he plays tennis for his school's first team and runs for the district cross-country team in Alberton, on the East Rand.
Jemma Schapiro, 15, stopped modern and tap dancing when she got too big to put her feet together and, after intolerable teasing, she changed schools. These days she is an active and fit A-student after losing 15kg.
For nearly 10 years, Jemma said, she had felt sad and unconfident while she struggled with her excess weight and the social stigma attached to it.
"The sadder I felt, the more I would eat. From Grade 1 I was bullied and other children would call me names or leave me out.
"I couldn't look in the mirror, so I decided to lose weight. I had hit rock bottom, so I knew from that moment things could only get better," said Jemma, who for 18 months was disciplined in her eating habits.
Jemma, who has a "skinny mom and granny", said she wanted to motivate other teenagers to take control of their health and happiness.
block_quotes_start children under 12 should be encouraged to grow into their weight rather than lose weight - unless they are severely overweight block_quotes_end
"I decided to lose weight for myself, not other people, and made a crazy deal with my family in December 2014 that I would eat healthy or run naked in the streets," said Jemma.
Segal said: "The negative self- esteem of these children is the most damaging thing obesity can do - even before they are at risk of diabetes, heart disease or cancer. Sometimes they never recover from that."
He urged parents to take action before the fridge and TV became their kids' best friends and said the best predictor of a child's weight was the size of their parents.
"Obesity increases year on year and it is not just the number of cases but the degree. The children are so huge that I can't believe it took their parents so long to get here. They are scared to mention weight or weigh their children, but if you don't measure it, you can't manage it," said Segal.
Nelspruit clinical psychologist Moses Mkhabela said some children with low self-esteem consoled themselves by overeating and got bullied as they gained weight.
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"We need to uncover the cause of the low self-esteem for the child to help the child to try an unlearn the belief that he or she is not good enough. A psychologist can help with this and parents need to give unconditional love," said Mkhabela, who has seen children as young as four with these problems.
So what can parents do?
Lila Bruk, spokeswoman for the Association for Dietetics in South Africa, said the best approach was to tell the child the whole family would eat more healthily and be more active.
"This is such a delicate topic and the parent has to be incredibly careful not to cause the child to develop low self-esteem as a result. Also bear in mind that children under 12 should be encouraged to grow into their weight rather than lose weight - unless they are severely overweight," she said.
Dietitian Zelda Ackerman, the founder of Family First Nutrition, said most parents reacted to their children's weight gain by restricting their food instead of changing the entire family's "food environment".
She said: "Parents should never single out one person. The first thing to go should be energy-containing drinks like cooldrinks or fruit juice - except for milk ."
Ackerman said almost all of her overweight patients ate while watching TV. "If the mind is absent, you cannot feel satisfied and therefore children overeat when in front of the TV. This habit should be replaced with family dinners."
Paediatric guidelines suggest that screen time be limited to less than two hours a day and that children be more active.
Ackerman said activities "must be fun, not exercise. Jump on a trampoline, ride a bike, kick a ball and get your children to join you. Parents think their children will outgrow [excess weight] and they may not.
"The earlier they get professional help, the easier the problem is to fix, even from two or three years old."
sub_head_start The risks start early sub_head_end
Children at risk for lifetime health issues related to weight include:
• Babies who are small or large for their age in pregnancy;
• Formula-fed babies, because they don't choose their portion size but have a bottle to finish;
• Young children fed with follow-on formula because this is liquid calories and they should be eating solids;
• Children eating meals of high-calorie dense food from tuck shops or takeaways; and
• Children who consume calories in items such as fruit juices, fizzy drinks or smoothies.
- Source: Paediatric endocrinologist Professor David Segal, in private practice at the Wits Donald Gordon Medical Centre.
