COUNSELING OVERWEIGHT KIDS

COUNSELING OVERWEIGHT KIDS

Q: When counseling overweight or obese children, what strategies can I use to help them achieve long-term weight-loss success?

A: To provide quality care for pediatric clients you must take steps to understand the population and develop a good rapport. You’ll need to take a multifaceted approach to ensuring the child’s health and well-being. Initially, this will involve some legwork on your part, but it will be well worth it as your patients respond favorably to your dietary counsel and begin to live healthier lives.

Learning About the Population

First, you’ll want to become familiar with the child’s community and family structure, culture, and religious beliefs.

To gain insight into the community structure, you should do the following:

• Visit several supermarkets in the child’s neighborhood.

• Talk to foodservice dietitians at child-focused community programs; ask about child fitness classes and the types of foods they serve.

• Purchase some popular food products and display the empty containers in your office to spark conversations about healthful and unhealthful foods.

• Speak with the school’s foodservice personnel and ask for a copy of the cafeteria menu.

• Locate fast-food and kid-friendly restaurants in your client’s neighborhood and obtain copies of the menus.

• Visit nearby parks to see whether they have sidewalks or walking trails for physical activity.

From a cultural perspective, you must become familiar with your client’s primary language (if not English) as well as family structure and religious beliefs. To accomplish this, do the following:

• Learn key words and phrases in your clients’ primary language.

• Provide handouts written in the language they speak.

• Identify popular foods they eat, the recipes they use, and who typically cooks meals.

• Ask what their religious beliefs are and what holidays they celebrate.

• Inquire about the foods they eat during family get-togethers and what foods are generally allowed and prohibited.

• Determine who cares for the child after school and on weekends.

• Ask what they believe about food and nutrition and determine the primary source of their information.

Understanding the Client

Next, you’ll need to determine the barriers they face that may prevent behavioral change and weight-loss success. Here are some questions you can ask:

• When, where, and at what time does the child eat meals? Children may have been taught to skip breakfast or wait until a parent returns from work to eat dinner—which can be after 8 or 9 pm.

• What snacks does the child eat and when? Often, children (and their parents) don’t view snacks as mini meals that provide nutritional value.

• Does the child have a television and other electronic devices in his or her bedroom? If so, how much screen time does the child devote to them? Ask about iPods, iPads, computers, and cell phones even in low-income populations.

• Who shops and cooks for the family? Ask about shopping lists, cooking methods, and ingredient portions with parents, grandparents, and other caregivers.

• What beverages does the child consume and how often? Does the child use a bottle, sippy cup, or regular cup?

• Which fruits and vegetables does the child eat? Use food models, photos, or posters with young children to determine what they recognize.

Recipe for Success

In addition to learning all you can about your pediatric clients, you can speak with their pediatricians, discuss available meal options with local school officials, and ask supermarket managers to order more healthful foods normally inaccessible to clients. Taking a multifaceted approach to caring for pediatric patients will help ensure they achieve long-term weight loss success.

Health Information systems __