Henry Anhalt: Certainly what's most important to keep in mind is that, parents in their best desire to help their children, need to avoid negative reinforcement. Don't do this, I told you not to do that, if you do this you know what may happen? It's important for parents to realize that those kinds of approaches aren't particularly effective, rather a multi disciplinary approach, that is the use of exercise, the use of diet, the use of behavior modification. To change children's behavior,r and have the whole family participate, our key elements in true success, there are a couple of programs that I am aware of, one program at the Maimonides Medical Center, which I have found, called the Kids Weight Down Program, and a program here at the St. Barnabas Medical Center, and its body care program, called the Healthy Life Program. Both of these programs excel, and that they offer multi disciplinary approaches to children who are overweight. Whose families and children require this kind of approach.
Host: So their approach would basically would encourage, about physical activity, selective eating, what?
Henry Anhalt: I think it's important to start with an assessment of the family, to get a sense of the family dynamic, and what they are capable of doing? Secondly, a careful analysis of the child's physical activities in the past and then in the present, are also important. And lastly, and perhaps the most important element is an analysis of the current dietary intake. Once those three assessments are made and readiness for change is established, the family can start their journey towards reengineering their lifestyle, towards leading a healthier lifestyle, and all of those components must be addressed. Proper parenting skills, proper exercise, proper eating, are all key elements in a successful lifestyle change.
Host: So a family that decides to keep certain foods out of the house, has a better success rate than having all those candy and something around, sometimes the kid just grabs that, because it's available, is that true?
Henry Anhalt: I think it's difficult for children to make choices when faced with the temptation of foods, that have great appeal, that they have been eating for a long time, and I certainly think that given the context that these children have grown up in, it's much better to remove the particularly problematic foods from the home. Now of course, the major philosophy of our program and others, is to moderate intake, that means not to completely exclude, but rather to minimize the amount of exposure to problematic foods. This however must be done within the context of appropriate behavioral support, otherwise it's likely to fail, and the cycle of negative reinforcement could continue.
Host: So a rapid weight loss, is not ideal, a slow weight loss and changing lifestyle is ideal?
Henry Anhalt: A slow and steady weight loss associated with appropriate lifestyle change is the most ideal way to approach weight loss. In some children, that may mean no weight loss at all, but rather continued leaner growth, that is to get taller and maintaining the same body weight, by definition they will be getting lighter for their size. This too may be an appropriate goal to expect of the child.
Host: Sometimes kids are going to diet and do really good job and get periods where they just stagnate, just stop to lose their weight. How can we get into those kind of periods, they don't give up?
Henry Anhalt: Like most everything else, that requires behavioral change. It's important to understand that there will be peaks and valleys, in terms of how we succeed in maintaining this kind of lifestyle change. It's important not to allow negative feelings to prevent the child from remembering the successes that they've had in the past, and look forward to the successes that they will have in the future. It can't be stressed enough, that children will experience ebbs and flows in their success, in approaching lifestyle change, and not to discard all of the positive change they have made, if they experience that prior in episode, where they are not that successful.
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