Caring for Kids…at Billings Clinic

Parents, you’re in charge!

Did you know that half of overweight kids will become overweight adults?

In your busy life, take time to take charge of healthy meal and activity choices for your family. The future health of our children is up to us.

Parents should be in charge of:

  • food in the home
  • when and where kids go out to eat
  • screen time for mobile devices, computers and TV
  • activities after school each day

Most of us are good at one or two of these things, but all of us have room for improvement.

Here are a few of the common questions that I hear in my pediatric practice each day at Billings Clinic-West, with some practical answers that might work for your family.

1.       How do I help my kids choose healthy options?

From the time babies are introduced to food, parents should get in the habit of providing a fruit and vegetable at every meal or snack. That way kids learn to take their hunger away with nourishing foods and not just fit them in because they should. In our culture we think watermelon and corn on the cob are fun foods. Parents can work off that model and present healthy options in artsy new ways. It’s ok to make rules for young kids like “no dessert if you don’t eat your fruits or veggies” or “start with a fruit or veggie for your after-school snack before eating the cheese and crackers.”

You are in charge — so have fruits and veggies available and don’t tempt your kids by having junk food in the house.

2. I’m so tired at the end of the day. It’s just easier to get pizza or drive-through fast food. What’s wrong with that?

Nothing is wrong with that in moderation – try for once a week. Pizza night is a fun tradition, just buy less pizza so there’s just enough for the kids to have one or two pieces only. Don’t order the all-meat grease bomb pizza. Do add veggies. Going to a fast food place feels like a necessity sometimes. If you go more than once a week, you are probably developing a bad habit. The “kid’s meals” have been nicely regulated recently, so you can at least be sure you aren’t overloading your child with a whole day’s worth of calories in one meal. Stick to the kids’ menu yourself too! You’ll feel better afterwards and model better eating.

For example, a “Happy Meal” for kids with a small hamburger, apples and milk equals 410 calories while a “Quarter Pounder,” large fries and a pop equals 1,150 calories!

3. How do I know if my child is overweight?

Since about one out of three of Montana kids are overweight, doctors have gotten in the habit of bringing this up at every visit. Your child’s weight is calculated according to weight and height and compared to other boys or girls their age. This is called Body Mass Index (BMI). If the BMI is greater than 85% of their peers, they are considered overweight. Half of all overweight kids will become overweight adults, so it takes parents’ effort to help a child improve their BMI.  Rarely does a child lose their “baby fat” without their parents actually intervening. Check out to use a BMI calculator.

4. Is it more important to focus on nutrition or exercise?

Start by making the easiest change for your child and build on that. For example, some overweight kids got that way by drinking too much pop. STOP BUYING THE POP and you’ve helped them lose 250 calories without even feeling hungry. (Dropping 250 calories per day means 1/2 pound weight loss per week!) For others, their vice is juice, sports drinks, chips or cookies. Talk about what foods might be a problem in your home. For other kids, it’s easier to add exercise. Those kids naturally love to play and be active — they just also love video games. Stick to screen time rule of 2-hours or less (outside of school) or add a rule that the kids walk to school or walk the dog.

It only takes a few minutes to drink 150 calories (one can of root beer), but it takes more than 30 minutes of bicycling or skateboarding for a 100-pound child to burn off those calories.

5. Should we try the Paleo diet and just eat nuts, fruit and meat like the cavemen?

Most fad diets have their virtues but are hard to stick with for very long. Do whatever floats your boat, but if you are serving it to your family, make sure you don’t present it as a “diet” and be sure it is balanced with plenty of fruits, vegetables, whole grains and iron-rich proteins. Losing weight for kids is not that hard when parents take charge.

We just need to learn a lesson from reality shows – parents can be the personal chefs and trainers for their kids to keep them healthy — because their lives depend on it!

Fun, educational videos, recipes and resources for parents and kids are available on our “Healthy Kids” webpage at

Claire Kenamore, MD

Dr. Claire Kenamore is a Billings Clinic pediatrician and advocate for healthy children in Montana.

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