Growing up too fat

Why is it bad to put even a fat child on a diet? What's wrong with a diet?

The psychology of a diet is that it is something that you do temporarily in order to drop a certain number of pounds. You eat in some weird way, and you deny yourself things that you would normally want to eat for a proscribed period of time until you lose the weight that you think you need to lose. And then you go back to your normal ways.

But with kids, especially, what you want to do is long-term behavior change. You want to teach them to eat healthy, and to internalize new habits, so they will make healthier eating choices and those choices will stick.

It's much more realistic -- and more successful in the long term -- to come up with a new eating plan, and to work slowly to change behavior. Going on a drastic diet just makes people feel deprived. They can deprive themselves for a short period of time, but then they start to become angry about feeling deprived, and then they tend to boomerang back to where they were.

So, what do you think are the one or two most important steps parents can take to keep their children from becoming dangerously overweight without putting them on a diet?

They can go through their pantry and their refrigerator and make sure the foods and drinks there are healthy. Adults also need to model behavior. If the adults adopt healthy-eating choices, then kids will be more likely to pick up those habits.

Try as a family to build activity into the daily routine. Families should find ways to walk or bike to more places, and to make a point of going outside and playing in the yard.

Monitoring how much TV kids are watching, and trying to reduce their screen time is another proven thing parents can do. There are these electronic monitors that were used in a study where researchers were doing an intervention to reduce kids' TV time. Basically, you dial in your child's weekly TV allowance, and the TV cuts off when the allowance is up.

One researcher you quote says that you don't have to try to get your kids to exercise more, you just have to try to get them to watch less TV, and then they'll naturally get more exercise.

Right, they'll find other things to do. And almost anything else they do will be more active.

One study you wrote about even suggested that having your kid stare at a wall -- if you could get the child to do that -- would actually be better for him than watching TV. Why is that?

In this study, they had kids doing various sedentary things, and the kids who watched TV burned fewer calories than they did doing any other sedentary activity. Maybe it has a sedating effect on your metabolism.

There are multiple ways in which TV may contribute to obesity. There's the fact that you're not burning calories. There's the fact that children and adults tend to eat unconsciously while they're watching TV, if they have food or drink in front of them. And there's the fact that there's a lot of advertising on TV so you're constantly getting cues to go get a snack or go get a soda.

And I even read one study that said when people eat lying down they tend to feel less full, and they tend to go on eating longer. A lot of kids snack lying down while they're watching TV.

It seems clear from your book that if a child is overweight the whole family has to change.

I heard this from so many experts. And then when I spent time with families that were actually dealing with the problem, it was clear that when the obese kids were singled out, when they felt like they were the only one having to change, and everyone else got to do their normal thing, they got really angry and resentful.

And I remember that myself. I was overweight when I was 10, and I got put on a diet by the pediatrician, and I had to eat rye crisp crackers with a slice of cheese instead of a sandwich for lunch. I got so sick of being on this diet, while no one else in my family was doing anything different. It was just horrible. I felt really singled out.

But given the time bind that working parents are under, it seems like so many of these suggestions require more time: eat less fast food and takeout by cooking more meals at home, spend more time exercising with your child. How realistic do you think that these suggestions are?

It's going to be hard for parents to do it all alone. I think that society has to change, too. Places that run after-school programs are going to have to become sensitized to this problem. If they provide snacks they should provide healthy ones, and instead of keeping the kids inside doing homework they should take them outside to play.

A lot of families with working parents figure out ways to cook ahead. You can cook a large quantity of something. Or, you can find things that are fairly quick to make such as chicken breasts instead of fried chicken.

It's important for people to have the kind of control over what they're eating that comes with preparing it yourself. And if you're going to buy takeout, there are healthier things to buy and less healthy things to buy. You don't have to get pizza all the time.

Next Page: Is it anti-American to fight fat?

• View blog reactions