In whatever course I teach, talk I give, or workshop I lead, the recurrent questions about weight management programs are, What really works? and How long does it take? To both, the answer is that it depends. There is no simple or easy answer, though many parents desperately wish there were.
I can say with more certainty what does not work for kids: restrictive diets--eating plans that strictly curb the amount and type of food permitted. There is little, if any, evidence that they work.
Most experts agree that success in cobating obesity depends on long term weight management, not a "diet." Weight management is not just weight loss. It means rethinking individual behavior and choices to sustain a healthy weight, day in and day out.
ATKINS Most health professionals raise eyebrows ehen kids are "doing Atkins" because those kids (and their parents) are likely to eat excessive amounts of unhealthy saturated fat while missing out on the nutrients and fiber in fruits, vegetables, and whole grains that are so essential to long-term good health.
Still, a diet for all family members is appealing because a family that gains weight together may lose or at least manage weight together. Under careful supervision by a physician and dietitian, the low-carbohydrate approach tailored to a child and family may be useful in helping severely overweight adolescent children learn to control and reduce weight. Even so, I would then argue against prohibiting nourishing foods that kids do like. Corn and watermelon (examples of carbohydrates that are limited under the Atkins plan) are among ids' favorites, good sources of vitamins, minerals, and highly touted "phyto-nutrients."
SUGAR BUSTERS This plan prohibits the "terrible three" snacking staples of soda, french fries, and candy and provides kid-friendly recipes, ranging from whole-wheat pizza to tofu shakes. It includes healthy carbohydrate foods--whole grains, fruits, and vegetables. But critics fault this plan as too extreme--prohibiting favorite foods and imposing unusual and time-consuming preparations. One parent told me, "Prohibition never works with kids." I agree; moderation is the key.
RAISING LOW-FAT KIDS IN A HIGH-FAT WORLD Judith Shaw's book is geared toward parents willing to put time and energy into a family shift away from the high-fat habit. Not a diet, this is an all-out overhaul of family eating. Health professionals generally applsutd this method because it puts knowledge into action. Without skills, energy, and time, however, many parents find these laudable goals difficult to achieve. Selecting only one or two manageable suggestions to work on is more reasonable. Simply guying cinnamon graham crackers instead of potato chips or replacing the soda shelf in the refrigerator with a big container of water gives copious returns for small changes in the kitchen.
WEIGHT WATCHERS In 2000, the U.S. Department of Agriculture initiated a scientific review of weight-loss plans--high-fat, low carb diets such as Atkins and Carbohydrate Addict; balanced plans such as Weight Watchers; and low-fat, low animal protein, high-vegetable plans such as Ornish. After analyzing as much relavant data as could be assembled, the study concluded with a recommendation for a diet resembling Weight Watchers'--balanced carbohydrate and fat, and flexible choice from a wide variety of foods. The report concluded: "The American public needs to be told (and believe) that diets are not followed for 8 days, 8 weeks, or 8 months, but rather form the basis of everyday food choices throughout their life."
