Therapy of obesity in children and adolescents

What therapy is needed?

Which therapy is necessary depends mainly on two questions.

1. How overweight is the child?
2. Are you still waiting for some length growth spurts? These take place between the ages of 5 and 7 and between 11 and 18 years.

If the child is only light Obesity (just above the 90 percentile) and it is to be expected that it will grow in length, it is completely sufficient if it first tries to maintain its weight.

If the body grows in length with constant weight, the BMI automatically decreases - the child loses weight without reducing their weight.

Should be a Obesity are present (weight above the 97th percentile), it is advisable to reduce the weight in order to lower the BMI. Then the first course should go to Pediatrician to lead. He will discuss the necessary therapy concepts.

Crash diet

Crash diets (few calories and put together one-sided) are absolutely taboo for children because there is a great risk that the child can no longer meet the nutritional requirements necessary for its development. These changes in diet are and only have a very short-term effect and do not convey sensible eating habits.

After such diets, the weight can hardly be stabilized in the long term and the risk of the yo-yo effect (increasing faster and more than before the diet) is given. In addition, these diets can contribute to the development of eating disorders.

Slow transition

It only makes sense to slowly but permanently switch to a balanced, low-fat and high-carbohydrate mixed diet. The Eating habits and eating behavior should be changed slowly and in small steps. This is the only way the child has a chance to keep their weight permanently in the normal range.

A Diet change using the optimized mixed diet as a basis is transferable to the entire family and healthy for everyone. For the overweight child, it is always best if the whole family is ready to gradually change their diet. Children cannot accomplish this task alone and need support.

Move

It is also important to change the children's exercise behavior for the better.
Here, too, parents are required to give their child a hand. A world of seating should become a world of movement. It starts in everyday life and the role model of the parents is important. Here, too, a change in small steps is recommended in order not to overload the child.

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motivation

There are often worlds between knowing what to do to prevent or eliminate obesity and the will and strength to implement these measures. In order to achieve the goal, the support of the parents is the best motivation! Instead of nagging or scolding, it is better to look for solutions together.

Setbacks and failures cannot be completely avoided and the more self-confident the child is and the more support and consolation it receives, the easier it is to overcome such phases.

A certain control of the measures and changes that have been initiated makes sense, but must not be too strict. Otherwise the joint observation of the weight can become a great burden for parents and children.

Here are some examples of strict and customized measures:

• Strict measures
• You must never eat chocolate again!
• From now on you will not be allowed to watch TV for more than half an hour a day!
• Adapted measures
• You can eat one bar of chocolate a week, but you should divide it up yourself!
• You can watch TV for two hours a week. You can choose the time yourself!

Practice of nutritional therapy

The optimized mixed diet for children and young people

This form of nutrition corresponds to current scientific knowledge about the correct nutrition of children and adolescents. This diet is "optimized" because it contains all the nutrients children and young people need for growth, development and health.

The criteria for the optimized mixed diet are as follows:

1. The nutrient supply has to be right. Protein, fat, carbohydrates, fiber, vitamins, minerals and water must meet the recommendations of the German Nutrition Society and be adapted to the child's age.
2. The food selection should contain the usual, also inexpensive foods, few finished products and no diet products
3. Certain favorite dishes and foods (for example sweets) should not be banned entirely but restricted.
4. Meals should be taken regularly. There are three main meals (2 bread meals, 1 warm meal) and two small snacks in between.
5. The optimized mixed diet should protect against later, nutrition-dependent diseases. These are primarily overweight, diabetes, Lipid metabolism disorders, Cardiovascular disease, gout and some cancers.

This results in three basic rules for choosing food:

1. Plenty (green area): plant foods and cereals
2. Moderate (yellow area): food of animal origin
3. Economical (red area): high-fat foods and confectionery

The traffic light colors

The Traffic light colors help with putting together the meals and with the assessment and classification. Even small children can understand this guidance system.

It should stop at all „red foods“ call in the head. These foods cannot be eliminated completely, but they should only be used rarely and then consciously and sparingly.

They are primarily:

• Drinks with high sugar content such as cola, lemonades or iced tea
• Fruit juice drinks and fruit nectars, malt beer.
• Nuts of all kinds because they contain a lot of fat. Nuts are recommended in small quantities or mixed with oat flakes and muesli, for example
• Fat spreads (nut nougat cream etc.)
• Croissants and similar baked goods
• Sweetened breakfast cereals
• Potatoes fried in fat
• Dairy products with a high fat content
• Most types of meat and sausage
• Pies and pastries, sweets, chips, biscuits
• Most fast food products

Moderate amounts of „yellow foods" are allowed:

• Pure fruit juices, low-calorie lemonades
• Dried fruit
• Honey and jam
• Types of bread and rolls with a lot of white flour
• Unsweetened mueslis and cereals
• Baked potatoes of all kinds, mashed potatoes
• Lean milk and dairy products
• Poultry meat and poultry sausage
• Low-fat fish (unbreaded)
• Yeast and biscuits
• Pasta with low-fat sauce
• Pizza with a vegetable topping

Green light, even when you are very hungry, applies to them „green food“:

• Fresh fruit, vegetables in any form (prepared without fat)
• Salads with lean dressing
• Wholemeal bread and wholegrain rolls, wholegrain flakes, wholegrain rice waffles
• Boiled potatoes without fat
• Water, mineral water, juice spritzer, herbal and fruit tea without sugar

This results in a balanced supply of nutrients.

Most of the food energy comes from carbohydrates (cereals, potatoes and fruits). Fat should primarily be of vegetable origin and provide 30% of daily food energy. The remaining 15% comes from protein and is half of animal (milk, meat, fish, eggs) and half of vegetable (grain, potatoes) origin.