Our weight is always a balance between how much we take in as calories when we eat and how many calories we burn off with activity and exercise. Our metabolism is how our body uses (burns off) calories. Our metabolism is something our body naturally does and is set at a certain point. Those people that eat large amounts of food but stay slender have a higher metabolism than someone who eats small amounts but struggles to maintain a healthy weight. Our own metabolism is something that is hard to change without a lot of work! We can increase our metabolism, making it easier to burn off calories, by increasing how active we are. Not only does that burn off more calories that day, over time it sets our metabolism at a higher point so we can continue to burn off more calories – as long as we stay more active with exercise! How much more active will someone need to be? That is hard to know without starting.

I lost about 60 pounds from 2002 until 2006. Before 2002, as an adult, I did not regularly exercise and was significantly over-eating. In 2002 I started to exercise more and more and ate less at each meal. My weight gradually started to come down. It was not easy. I often was hungry. I would have liked to have eaten more (I love to eat!). I did not want to exercise 5-7 times a week. But I kept all of that up because it was working, I felt better and I was healthier. I started by walking more. I worked up to working out at the gym. It is not so important what you do for exercise, it is simply finding some activity you can and will do AND keep doing it! Walking, running, swimming, biking – there are so many good options for exercise!

Eating less over time takes discipline (doing something that you should do but do not want to). When you really want another helping of food that you enjoy, it is difficult to say no. But that is what is successful for so many people. This is called portion control – keeping the size of the portions (amount of anything that you eat) smaller than before. This helps lower the number of calories you eat. The trick is doing it consistently, meal after meal, day after day.

I rarely tell people to avoid certain foods. I think if you really crave some food and if you are told not to eat it, it is very hard to continue to stay away. Some people eat too much ice cream or chips or cookies or deserts. If you tell yourself “I am never going to eat that again!” and then you do eat it, I think it is too easy to get depressed that you ate something you wanted to avoid and give up and continue to cheat on your healthy diet. So, once in a while and in small amounts, it is fine to still eat those foods that you really crave.

One of the bad habits that we can get into is rewarding ourselves with food. “Wow, I had a bad day – I really deserve to have that bowl of ice cream” is a common sort of thing we do with food. Although this is human nature to feel this way, it is an easy way to over eat. Try to think about these times before they happen – and either keep yourself busy with something other than over-eating or choose a healthier, low-calorie choice. 

Although I do not think it very helpful to completely avoid foods you really love, it is important to know those foods that you should pay extra attention to. Some foods you can feel better about eating and things you should limit.

Foods that help maintain a healthy weight:

• Fresh vegetables
• Fresh fruits
• Drinking plenty of water
• Two to three servings of milk a day

Foods to watch:

• “Junk food” carbs: chips, pretzels, cookies, and crackers (check out www.snackwise.org)
• Soft drinks

Kids who maintain a healthy weight are more likely to eat breakfast each day. Also, kids who drink 2-3 servings of milk a day and limit their soda (even diet soda) drinking are more likely to maintain a healthy weight. 

 You are going to need to take another hard look at your eating and exercise habits if things are not working. And the frustrating thing is that you will need to simply eat less than you are now and exercise more than you are now. There currently is not a safe and effective medicine that helps people maintain a healthy weight.

If you feel that you need more guidance with healthy nutrition, we have a number of under- or over-weight patients meet with a pediatric dietician. The dietician and nutrition department at Nationwide Children’s Hospital’s number is 614-722-5740. 

Nationwide Children’s Hospital here in Columbus has a program called the Center for Healthy Weight and Nutrition that is aimed at children with a body mass index (BMI) at or above the 95% (that means that their weight for their height is greater than 95 out of 100 children their gender at their age) who are not making good progress towards a healthy weight on their own. This service requires a specific referral from our office. We will assist you with this referral if, after discussing it, your child will benefit from further assistance with their services. 

We certainly see children who have difficulty maintaining their weight in a healthy range. This can be incredibly frustrating for everybody. Some of these children have a good appetite but are petite, while others have a poor appetite and struggle to maintain a healthy weight.

For these children, we want to think about those issues that could be contributing to poor weight gain and have us want to further investigate: vomiting, diarrhea, blood in the bowel movements, unexplained fevers, food allergies, chronic abdominal pain, difficulty swallowing, acid reflux, and others.

There are quite a few children with no medical problems who are small or slender (or both) that we hope they can increase their calorie intake. For many of these children, offering them more food does not necessarily make a difference. They may still eat just a few bites and feel full (or just uninterested in eating). A few things are true about this:

1. There is not a single medicine or supplement or vitamin that will safely and effectively increase a child’s appetite. Although it is fine to give a daily over-the-counter multi-vitamin for children with poor weight gain, it will not help them increase their appetite.
2. We are happy to have you try different strategies to increase the calorie intake: offering healthy snacks in between meals, offering and encouraging larger portions, adding Pediasure® once or twice daily to their diet, and adding calories to foods that are already enjoyed.
   • By healthy snacks, we mean fresh fruit, smaller portions of meal-time foods (left-over mac ‘n’ cheese or spaghetti), cheese, yogurt, etc. It is not good for the long-term if we are having the child eat “junk foods” (cookies, soda pop, chips, etc.) to increase their calorie intake. Over time, we hope you can gradually increase the amount of food your child eats at a setting – if they really enjoy mac ‘n’ cheese and will eat more of that, we hope over time that this will help them increase their overall calorie intake. You may find it helpful to add calories to those foods your child already enjoys. Different ideas for that: will they dip their fresh vegetables in ranch dip? Will they dip their fresh fruit in yogurt? Can you put gravy on their meat or potatoes? Use whole milk when able, instead of a lower fat content of milk and dairy products. Will they put toppings on their yogurt or ice cream that will add a few calories?

We can monitor your child’s progress with their growth at their well visit. If you have specific concerns about their growth, we can address at a visit to the office in between their well visit. Call if you have questions.

Last Updated: 07/2019

Printable Version