Question

Seven-year-old Timothy's mother takes him to his pediatrician for his annual checkup. His weight is 68 lb (31 kg), plotted at the 95th percentile, and his height is 50 in. (127 cm), between the 75th and 90th percentiles for his age. His body mass index of 19.25 kg/m2 plots at the 95th percentile for his age. His growth percentiles have been increasing over the last several years.

Timothy's mother expresses concern to the pediatrician about her son's weight. His older and younger brothers are both thinner than Timothy. Timothy's mother is obese, but his father is a normal weight for height. Timothy is in the second grade. He rides the school bus to and from school. He participates in the School Lunch Program at his school, but his parents gave him extra money in case he wants to buy some additional à la carte food items from the cafeteria or items from the vending machines. After school, Timothy and his brothers stay in their home with a babysitter until one of their parents returns home from work. Timothy usually watches TV or plays video games after school. His parents leave snack foods—chips, cookies, and sodas—in the house for their sons to have after school. His mother usually prepares their evening meal, which consists of a meat, starch, vegetables, and a dessert item. After dinner, Timothy does his homework and then usually watches more TV with his parents. He usually has a dish of ice cream before going to bed.

1. What is your assessment of Timothy's body size based on his weight-for-age, height-for-age, and BMI-for age percentiles?

2. What suggestions do you have for Timothy's parents about improving his eating habits?

3. What suggestions do you have for Timothy's parents for increasing his physical activity level?

4. Is it significant that Timothy's mother also has a weight problem?

Answer 1

Answer 1. Timothy's bmi is 19.25kg/m² which means he is very close to or almost approaching the overweight category. His weight should be nearly 22 or 23 kgs, but he is 31 kgs. His height is apt according to his age. His height weight ratio suggests that he needs to take care of his health otherwise the results will be difficult for him to face.

Answer 2. Timothy's parents need to know that their son's eating habits and lesser physical activities will lead his health towards bad results. His overeating habits like eating extra in school besides tiffin, having mandatory desserts before bedtime regularly, etc are not good signs of health. His routine should be altered with more physical activities than more of food. They should stop giving him extra money food besides tiffin in school. He needs to take part in different games or school activities to remain fit and fine. While at home with siblings, the unhealthy snacks should be altered with healthy juices, fruits or sprouts or any fibrous foods. Bedtime dessert should be avoided and replaced by a glass of milk and that too with after a good gap with dinner. Dinner meals should also be shuffled many other healthy options rather than having foods with excess of fats and starch.

Such changes can prove to be helpful in maintaining good life or health for everyone especially Timothy's.

Answer 3. The increase in physical activities include riding bicycle to school, if possible. Also to take part in school games and sports. Being at home, Timothy can spend time by playing outside in park or lawn with siblings or even can do cycling then at nearby locations. Insted of staying home everytime and eating variety of things, Timothy should join any sport academy of his interest. Little changes will lead to major accomplishments.

Answer 4. Timothy's mother also having weight problems show that it can be genetic for Timothy. But even then, if both of them want to shed off the extra fat, they can do it with exercises and diet alterations. Diet plays an important role here in such cases, because the diet reaches to the gene level after digestion.