Am I overweight?

Obesity has become America's #1 health problem. More than 15% of American teenagers are overweight. You are overweight if:

• You weigh more than 20% over the ideal weight for your height.
• The skin fold thickness of your upper arm's fat layer is more than 1 inch (25 millimeters) when measured with a special instrument.

Obesity is defined as a weight per height ratio (body mass index or BMI) that is above the 95th percentile.

What is the cause?

The tendency to be overweight is usually inherited. If one parent is overweight, probably half of the children have the potential to be overweight. If both parents are overweight, most of their children will be overweight. If neither parent is overweight, the children have a small chance of becoming overweight.

Heredity alone (without overeating) accounts for most mild weight problems. Moderate weight problems are usually due to a combination of heredity, overeating, and underexercising. Some overeating is normal in our society, but only those who have the inherited tendency to be overweight will gain significant weight when they overeat. The family environment (how much TV is watched, how much your family exercises, and foods that are served) is equally important.

Less than 1% of obesity has an underlying medical cause. Your healthcare provider can check whether your obesity has a physical cause with a simple physical examination.

There are health risks as well as social problems that may occur when you are overweight. These include high blood pressure, type 2 diabetes, obstructive sleep apnea from severe snoring, exercise intolerance, lower self-esteem, and depression.

When is the best time to lose weight?

Losing weight is very difficult. Keeping the weight off is also a chore. The best time for losing weight is when a teenager becomes very concerned with personal appearance. A self-motivated teenager can follow a diet and lose weight regardless of what his or her family eats.

How do I lose weight?

• Motivation

  You can increase your motivation by joining a weight-loss club such as TOPS (Taking Off Pounds Sensibly) or Weight Watchers. Sometimes schools have classes for helping teenagers lose weight.

• Setting weight-loss goals

  Pick a realistic target weight based on your bone structure and how overweight you are. The loss of 1 pound a week is an attainable goal. However, you will have to work quite hard to lose this much weight every week for several weeks. You should weigh yourself no more than once each week; daily weighings generate too much false hope or disappointment. When losing weight becomes a strain, take a few weeks off from the weight-loss program. During this time, try to stay at a constant weight.

  Once you have reached the target weight, the long-range goal is to try to stay within 5 pounds of that weight. Staying at a particular weight is possible only through a permanent moderation in eating. You will probably always have the tendency to gain weight easily and it's important that you understand this.

• Healthy Eating Program

  You should eat three well-balanced meals a day of average-sized portions. There are no forbidden foods. You can have a serving of anything family or friends are eating. However, there are forbidden portions. While you are reducing, you must leave the table a bit hungry. You cannot lose weight if you eat until full. Eat average portions instead of large portions and avoid seconds. Shortcuts such as fasting, crash dieting, or diet pills rarely work and may be dangerous. Liquid diets are safe only if they are used according to directions. Calorie counting is helpful for some people, but it is usually too time-consuming. Consider the following guidelines on what to eat and drink:

  • Fluids: Mainly drink low-calorie drinks such as skim milk, fruit juice diluted in half with water, diet soda drinks, or flavored mineral water. Because milk has lots of calories, drink no more than 16 ounces of skim, 1%, or 2% milk each day. Drink no more than 8 ounces of fruit juice a day. All other drinks should be either water or diet drinks. If you can't give up soda, drink diet soda. Try to drink 6 glasses of water each day.
  • Meals: Eat fewer fatty foods (for example, eggs, bacon, sausage, and butter). A portion of fat has twice as many calories as the same portion of protein or carbohydrate. Trim the fat off meats. Eat more baked, broiled, boiled, or steamed foods and fewer fried foods. Eat more fruits, vegetables, salads, and grains.
  • Desserts: Try to eat smaller-than-average portions of desserts. Try more Jell-O and fresh fruits as desserts. Avoid rich, fatty desserts, such as ice cream. Do not eat second helpings.
  • Snacks: Eat mainly low-calorie foods such as raw vegetables (carrot sticks, celery sticks, raw potato sticks, pickles, etc.), raw fruits (apples, oranges, cantaloupe, etc.), popcorn, or diet soft drinks. You should have no more than 2 snacks a day.
  • Vitamins: Take one multivitamin tablet daily during your weight-loss program.
• Eating habits

  Most overeating is due to bad habits. To counteract the tendency to gain weight, you must learn eating habits that will last you for a lifetime.

  • Don't skip any of the three basic meals.
  • Drink a glass of water before meals.
  • Eat smaller portions.
  • Chew your food slowly.
  • Avoid high-calorie snack foods such as potato chips, candy, or regular soft drinks.
  • Do keep available diet soft drinks, fresh fruits, and vegetables.
  • Leave only low-calorie snacks out on the counter--fruit, for example. Put away the cookie jar.
  • Store food only in the kitchen. Keep it out of other rooms.
  • Eat no more than two snacks each day. Avoid continual snacking ("grazing") throughout the day.
  • Eat only at the kitchen or dining-room table. Don't eat while watching TV, studying, riding in a car, or shopping in a store. Once eating becomes associated with these activities, the body learns to expect it.
  • Don't eat alone.
  • Reward yourself for hard work or studying with a movie, TV, music, or a book instead of food.
  • When eating fast food, avoid value meals or "super-sizing."
  • Post some reminder cards on the refrigerator and bathroom mirror that state "EAT LESS" or "STICK TO THE PROGRAM".
• Exercise: Increasing calorie expenditure

  Daily exercise can increase the rate of weight loss as well as the sense of physical well-being. The combination of diet and exercise is the most effective way to lose weight. Try the following forms of exercise:

  • Walk or ride a bicycle instead of riding in a car.
  • Use stairs instead of elevators.
  • Learn new sports. Swimming and jogging are the sports that burn the most calories. Your school may have an aerobics class.
  • Spend more time outdoors.
  • Walk 30 minutes per day (for example, take the dog for a long walk).
  • Spend 30 minutes a day exercising or dancing to CDs or music on TV.
  • Using an exercise bike or Hula Hoop while watching TV. (Limit your TV sitting time to 2 hours or less each day.)
• Social activities: Keeping the mind off food

  The more outside activities you participate in, the easier it will be for you to lose weight. Spare time fosters nibbling. Most snacking occurs between 3 and 6 PM. Fill after-school time with activities such as music, drama, sports, or scouts. A part-time job after school may help. If nothing else, call or visit friends. An active social life almost always leads to weight reduction.

When should I call my healthcare provider?

Call during office hours if:

• You have not improved your eating and exercise habits after trying this program for 2 months.
• You are a compulsive overeater.
• You are depressed.
• You feel you have no close friends.
• You have other questions or concerns.