For children with physical disabilities, weight gain is sometimes an issue, as exercise isn’t always an option. Dr. Keith-Thomas Ayoob, the director of the nutrition clinic at the Children’s Evaluation and Rehabilitation Center at the Albert Einstein College of Medicine, shares tips.
On why weigh gain is particularly difficult for children with physical disabilities
“We have a luxury that they don’t have. If we are physically able, we can walk. We have all these kinds of ways of expending calories, and they don’t. Sometimes that means that they do a lot more sitting, a lot more sedentary behavior. It’s easier for them to gain weight. That combined, with sometimes other pyscho-social problems. Parents, for example, who may feel guilty that their child has a disability, or sometimes they just want to indulge their child. That sometimes ends in a lot of weight gain. It’s also difficult for these kids to get weight off. They don’t have the ability to have as many options for activity to burn off those calories. You always hear these stories: eat less, exercise more. That’s great, but what if you can’t exercise? What do you do then? We need to develop other ways of keeping these kids happy, and engaged, and satisfied with life, in ways that don’t necessarily involve food.”
On how to coach a child to look for non-food sources of excitement
“I want to get more of a structured eating style, so that the child knows what the child can count on. Sometimes when I see a kid who’s overweight, they are eating randomly. We try to stop impulsive eating… No, there are going to be set meals, and set times for snacks, so that the child knows that food will be coming. Secondly, kids are used to a certain volume. If we reduce the calories by reducing the volume, they are going to notice that their stomachs are not quiet as full. We really try to get the kids interested in eating more fruits and vegetables. I try to start with already works. So I ask the parents: What are the fruits and vegetables that they already like? Those are less likely to cause any type of pushback. Those we want to feature more often. Then we are going to say: If you like that fruit, then let’s try this one. We want to have fruits and vegetables more prominently featured, because first of all, the kids are usually under-eating them. Secondly, Those are high volume foods that have less calories… You really work with the parent, and tell them how much is appropriate for this child… If we are going to produce a weight loss, we have got to reduce the calories coming in, because we can’t really reduce the calories coming out.”
Dr. Keith-Thomas Ayoob is the director of the nutrition clinic at the Children’s Evaluation and Rehabilitation Center at the Albert Einstein College of Medicine.