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Child Development

Tackling Childhood Obesity: What Works, What Doesn’t

How childhood obesity became a global problem.

“Fast food only once a month; sweets limited to once a week; and a snack only once each week.” These guidelines are part of a detailed program researchers in Denmark have put together to tackle the nation’s growing problem with childhood obesity, now a global phenomenon. The research deserves attention here too because, according to the U.S. Centers for Disease Control and Prevention, one in three children is now overweight and the incidence of obesity among adolescents has quadrupled over the past 30 years.

The pilot study, adopted in the Danish town of Holbaek, has treated 1,900 patients, according to BBC News, and has “helped 70% of them maintain normal weight by adjusting about 20 elements of their lifestyles.” This isn’t in any way a “small-steps” approach. Instead, the program urges a dramatic reassessment (including by family members) of what children are eating and how much physical exercise they actually are getting. Whereas previous approaches failed to motivate children and their parents to modify behavior, adjustments have given rise to “a method that works and that families have really embraced,” according to Dr. Jens Christian Holm, who runs the program and urges other nations to “learn from their experiences in confronting this global health challenge.”

“Limit juice, iced tea, cocoa, soda or lemonade to once weekly,” the pediatrician advises. “Cycle or walk to school” won’t be feasible for many American children living far from school, but “free physical activities like walking/biking after school, walking the dog, or trampolining” are practical solutions strongly recommended by the program. So, incidentally, is limiting children’s screen time (television, computer, or tablet) to “two hours per day.”

Dr. Holm, notes the BBC report, “is vigorously targeting the passive time spent playing on computers or watching television. Some children are glued to their screens for up to 12 hours a day and the limit, he says, should be two.”

“Up to 12 hours a day” is possible only among children left more or less entirely unsupervised, and literally to their own devices. “Their entire life needs to be changed,” Dr. Holm says, “because they tend to be lonely, tend to be ashamed of themselves so they need to do this, and to interact with other children in their daily lives."

“Interacting with other children” may however be more of a challenge than it sounds, especially when the neurological “draw” of video games and social media combines with the large percentage of children who are shy or introverted. This last point is outlined clearly in an infographic called “Shy Kids, Spy Kids: Why Kids Don't Play Outside Anymore,” published by the company Playground Equipment, which also is raising concern about the growing lack of interaction among children spending hours, even whole days, gaming alone. The infographic conveys “how socially awkward kids tend to be inactive or glued to their screens all day, which results in obesity, bullying, and withdrawal from the real world,” noted Jennifer Holmes, a representative for the company, in an email to me.

Among the U.S. factoids she’s reporting: “Although 72% of modern parents believe in the power of playing outside, only 40% of kids would swop time for outdoor play over TV and computer.” The outcome? “Only one in three children engages in physical activities each day.”

In South Korea, as early as 2007, the government was so concerned about this problem it began sponsoring 140 Internet Addiction Counseling Centers nationally. These anticipated the Danish program in “follow[ing] a rigorous regimen of physical exercise and group activities, like horseback riding, aimed at building emotional connections to the real world and weakening those with the virtual one.”

Having spent the last year in Peru, I should add: I was dismayed to hear a growing number of middle-class parents there lament that their children no longer wanted to play outside together. They preferred to hunker down indoors, to engage in the mostly solitary activity of playing phone and video games (accompanied by junk food) at every available opportunity—at the expense not just of schoolwork, but of their friendships and attachment to things other than video consoles and 4G devices. It was a constant struggle, their parents complained (of course having purchased the games themselves as gifts), to get the children to play outside. When together, the children gravitated quickly to the nearest video console.

Back in Denmark, 10-year-old Jakob Christiansen is participating in Dr. Holm’s pilot study because he’s been bullied at school for being overweight and has taken to eating—and hiding—candy for comfort." I'm sure I'll miss sugar and the fact that I can no longer laze around," he says a bit ruefully. “It's going to be really tough, but I'll fight as hard as I can.” Follow me on Twitter @christophlane