Upfront

Obese children need ongoing support from adults and peers to drop their extra weight and keep it off, said psychologist Denise Wilfley, PhD, at APA's 2011 Annual Convention.When parents stock the home with healthy foods and encourage outdoor exercise—and when peers and family members join in the healthy eating—overweight children are most likely to show sustained weight loss over time, her research indicates. 

This sort of social support is increasingly important, Wilfley said: 17 percent of American children and adolescents are obese, nearly three times the percentage in 1980.

It's no wonder, she said. Unhealthy food is everywhere, and most children who struggle with overweight consume far more calories than their bodies require. They also spend too much time on such sedentary pursuits as television watching.

In this environment, it's important for caregivers and families to offer healthy options, help children make healthy choices and model healthy eating and an active lifestyle, said Wilfley, a professor of psychiatry, medicine, pediatrics and psychology at Washington University in St. Louis.

"So many parents say, 'My kid should have willpower to stop eating,' but that's not the right approach," she said. "Part of good parenting is avoiding the food power struggle in the first place by not bringing unhealthy foods into the home. The decision should be made at the grocery store, not at the dinner table."

Wilfley's research backs her stance. In one study she led, 204 7- to 12-year-olds were most likely to retain drops in body-mass index after two years if they received "social facilitation maintenance treatment," in which the children's parents and friends supported improved habits, such as increased exercise and healthy eating regimens. The findings were published in 2007 in the Journal of the American Medical Association (Vol. 298, No. 14). Beyond family and friends, we also need to advocate for healthy changes in our surroundings—at school and church, for example—and in our culture at large, said Wilfley.

—B. Murray Law