How to Lose Weight for Kids? Tips from Physiotherapist & Studies

Key points on weight loss in children

1. For children aged 0 to 12, receiving help to move more and eat better leads to weight loss.
2. For adolescents over 12, only strategies focused on increasing physical activity work for weight loss.
3. There are no harmful side effects in obese children and adolescents who have been offered weight loss strategies or prevention of excessive weight gain.

Obesity and overweight in children: What is it?

In children, just like in adults, we measure a child’s height and weight to determine if they are overweight or obese.

The weight and height are used to calculate the Body Mass Index (BMI). Then, we compare each child’s BMI to the BMIs of other children of the same age in the same country.

A BMI that is too high compared to other children of the same age indicates overweight or obesity.

There are online tools available to calculate the BMI of a child or adolescent in your country. Growth charts present in all children’s health records also allow for BMI calculation.

Losing weight or slimming down a child: Why?

Over the past 40 years, childhood obesity has increased significantly in most countries worldwide.

The number of obese children has multiplied by ten, meaning there are now over 120 million obese children and adolescents worldwide. Researchers’ projections show that the proportion of obese children will continue to rise.

Why is this a problem at the societal level?

Because childhood obesity is associated with numerous health and well-being issues, both during childhood and later in adulthood:

• Lower self-esteem and life satisfaction, often due to what is now known as “weight stigma” – discrimination against overweight or obese individuals.
• Physical problems and pains in children: spondylolisthesis, knee and back pain, recurrent sprains, asthma, etc.
• Increased risk of chronic and disabling diseases: diabetes, cardiovascular diseases (stroke, heart attack), arthritis, etc.
• Greater susceptibility to serious conditions such as cancer.
• Reduced life expectancy.

The younger the child, the easier it is to change their lifestyle habits, especially before the age of 12. Hence, the importance of providing early support and care to obese children and adolescents and their families.

Losing Weight in Children: How?

Now, let’s explore the effects of interventions aimed at reducing the BMI of obese children and adolescents, where these interventions are most commonly implemented, and finally, what specific measures can be put in place to help children lose or stabilize their weight.

Effects of Interventions

Numerous studies are conducted to examine:

1. The best ways to prevent childhood obesity, i.e., to minimize the likelihood of children becoming obese (referred to as primary prevention).
   
   These often involve policy-level measures, such as anti-poverty programs or restrictions on advertising.
2. The best ways to manage children who are already obese, with the goal of helping them lose or stabilize their weight.

This article focuses on the means of individually or group-wise assistance for obese children and their families to regulate the child’s weight. There are studies conducted on this topic across all five continents.

What do these studies reveal?

1. To help obese children aged 0 to 5 years lose weight, interventions should concentrate on both physical activity and dietary regimen.
   
   Proposing programs targeting either physical activity or dietary changes alone does not lead to weight loss in these children.
2. For obese children aged 6 to 12 years, interventions should either focus on physical activity alone or combine physical activity with dietary changes.
   
   Relying solely on dietary interventions is insufficient to reduce the BMI of these children.
3. For adolescents aged 12 to 18 years, interventions should primarily focus on physical activity.
   
   Combined interventions addressing both physical activity and dietary changes do not suffice to induce weight loss in adolescents, nor do those focused solely on dietary adjustments.
4. What matters most is not just losing weight but reducing the BMI of children.
   
   As children and adolescents are still growing, stabilizing their weight is often an adequate goal: as they grow, their BMI naturally decreases even without actual weight loss.

Do these interventions based on physical activity and diet have a significant effect? The majority of children and adolescents do indeed reduce their BMI.

However, the decrease is often not very significant.

Nevertheless, these interventions remain important as they can have more long-term effects at the population level: the earlier children are introduced to the importance of physical activity and healthy eating, the more likely it is for the adults of a generation to be in good health.

Where to Intervene?

Around the world, programs aimed at reducing the BMI of obese children are implemented in:

• Schools and daycares, most frequently.
• Health centers.
• Child-focused facilities, such as community children’s centers.
• The children’s homes (especially for young children).

Children are sometimes supported in groups and sometimes individually, as in home-based interventions.

Physical Activity and Physiotherapy for Weight Loss

Firstly, evaluating the child’s current level of physical activity is beneficial (provided, of course, that he or she is willing to participate in this process).

Physical activity doesn’t necessarily mean sports; one can be physically fit and not overweight without engaging in sports, but by having enough daily activities.

Conducting an Assessment

Physiotherapists or other profesionnals can conduct an assessment of the child. This assessment will help identify, by questioning the child and their family:

• The child’s level of physical activity during a typical week:
  • How does the child travel to school or their daycare?
  • What activities does the child engage in during the day (outdoor activities at the park, indoor activities, family visits, etc.)?
  • Does the child spend a lot of time in the car or stroller?
  • How much time per day does the child spend watching screens (TV, phone, computer, tablet, etc.)?
  • How much sleep does the child get? At what time(s) of the day? Is the child fatigued?
• Any potential pain the child may experience.
• The child’s ability to perform certain simple motor activities, adjusted for their age. For example, running a few meters, jumping, balancing on one foot, throwing a ball, walking uphill or downhill, etc.
• What activities the child enjoys doing.
• The possibilities for physical activity allowed by the child’s living environment.
• The family’s and child’s dietary habits (if not addressed in another intervention).

Proposing Strategies to Limit Weight Gain

Next, it will be important to define reasonable goals for increasing the child’s physical activity time and finding suitable, enjoyable, and accessible means for the child.

Over the weeks and months, the aim is to approach the recommended level of physical activity for all children: 1 hour of moderate (brisk walking) to vigorous (activities that cause significant breathlessness) physical activity per day.

Each child is different and may engage with various practices. Here are some examples of things that can be implemented:

• Suggest walking or cycling to and from school once a week.
• Plan 2 to 3 outings per week to nearby playgrounds and encourage the child to spend at least 1 hour playing there.
• Reduce screen time by one hour per day (when the child becomes bored, they will naturally turn to more physically engaging activities or sleep better).
• Join a sports club in the local community.
• Go cycling, rollerblading, or engage in other non-motorized activities every weekend in a suitable location, starting from home.
• Enroll in a gym.
• Start with physical activity sessions at a physiotherapist’s clinic to regain confidence.
• Remove television and all screens from the children’s bedrooms.
• Limit the use of smartphones to only phone calls.
• Follow exercise videos from preselected content on YouTube (e.g., zumba, cross-fit, etc.).

Supporting Commitment and Motivation

The management does not merely involve listing possible activities. A significant part of the intervention should focus on the motivation and commitment of the child and their family.

Trained and experienced professionals will know how to:

• Reinforce and acknowledge the child’s positive behaviors concerning physical activity.
• Encourage the child and their family to commit (for example, by having them write and sign objectives or express their desires verbally).
• Identify and demonstrate the short-term and long-term benefits for the child and their family in adopting a more active lifestyle.
• Highlight even the smallest progress made.

While several types of interventions are evaluated in the literature, there is currently no strong or even weak evidence showing a superior effect of physical activity sessions at school, physiotherapy sessions at home, or group interventions at dedicated centers.

Prevention of Childhood Obesity in the United States and Other Countries

Efforts to combat this epidemic have led to the establishment of various initiatives and networks dedicated to the prevention and management of pediatric obesity.

In France, Europe

In France, since 2003, RéPPOP (Réseaux de Prévention et de Prise en Charge de l’Obésité Pédiatrique) has been actively addressing this issue.

These networks operate in specific departments and are responsible for implementing comprehensive programs, raising awareness among the general population and healthcare professionals, providing training and information, and maintaining a directory of healthcare professionals and healthcare facilities involved in the prevention and treatment of childhood obesity in their respective territories.

The RéPPOP networks function autonomously from one another, meaning that the approaches and interventions they offer can vary significantly depending on the local context and resources available in each area.

This decentralized approach allows for tailored strategies to address the unique challenges faced by different communities in the fight against childhood obesity.

However, it also means that the effectiveness and accessibility of interventions may differ from one region to another.

In United-States

In the United States, similar initiatives and programs exist to address the issue of childhood obesity. One prominent example is the “Let’s Move!” campaign, which was launched in 2010 by former First Lady Michelle Obama.

The campaign aims to combat childhood obesity and improve the overall health of children by promoting healthier food choices and increasing physical activity.

Besides the “Let’s Move!” campaign, there are also various state and local initiatives, community-based programs, and public health efforts aimed at preventing and managing childhood obesity in the United States.

These efforts involve collaborations between government agencies, healthcare providers, schools, community organizations, and other stakeholders to address the multifaceted issue of childhood obesity and promote healthier lifestyles for children and families.