Pear-and-stethoscope_webI’m a pediatrician and a mom. The issue of childhood obesity, for me, is both professional and personal. Even if we’re not worried about our kids being obese, we want them to live a healthy, active lifestyle. Discussing this issue with my patients and their families is as important as writing a prescription when they are sick.

The obesity epidemic is rooted in environmental, genetic and cultural factors. Our culture makes it difficult to have a healthy lifestyle. Fast food restaurants can take a 10-calorie vegetable – the onion – dip it in batter, fry it and turn it into a 1,000-calorie snack! And portion control is off the charts. A typical bagel is now two times the size and calories it was 20 years ago. We’ve come to think of “more” as “better,” but, when it comes to food, that is not the case.

Children and teens spend too much time in front of TVs, computers and electronic devices that require no physical activity. And parents often worry about their children playing unsupervised outdoors, so they end up spending more time at less active, indoor activities.

The risks for overweight kids

Being overweight is a serious health problem for children. It can lead to diabetes, high blood pressure, hip and knee problems, and liver disease. If a child is obese early in life, they have a higher risk of being obese as a pre-teen or adult. The emotional consequences include depression, low self-esteem and lower academic achievement. But parents can reverse this trend by reinforcing a healthy lifestyle.

Body Mass Index

We use a tool called Body Mass Index (BMI) to determine if a child is overweight. For children and teens, it is age- and sex-specific; for kids aged 2 to 18, a BMI in the 85th percentile is considered overweight; in the 95th percentile obese; and in the 99th percentile severely obese. Although the BMI is not ideal, it is helpful for diagnosing at-risk children. Once we acknowledge there is a problem, we can develop a plan of action.

Eat less – do more

The short answer is fairly simple. If you take in more than you spend, you will gain weight. If you take in less than you spend, you’ll lose weight. The trend today of eating more but doing less puts our kids on the wrong side of this balance.

Children should, ideally, get more than one hour of physical activity every day. It doesn’t have to be a formal “exercise” or an hour at the gym. A walk or jog in the park is great, or playing their favorite sport. Anything that gets them moving is good.

They are what they eat

The best source for vitamins and minerals is not vitamin tablets, but fresh fruits and vegetables. Juices and sugary drinks are fattening and those pretty green and red drinks are not strawberries and kiwi; they are red and green dye and sugar. Water and fresh fruit is a better option. Get creative in your kitchen and let your kids try new foods. Don’t give up! It can take up to twelve times for a child to get used to flavors and accept new foods.

The role of psychology

Obesity is a chronic disease and addressing it is not about a quick fix or a diet. It involves a commitment to adopting a healthy lifestyle. Setting weekly goals can be helpful. Rewards are important, but don’t use food. Most important for us, as parents, is that we teach by example. Maintaining a healthy weight, eating well and getting exercise should start with mom and dad.

Rx for healthy living

It doesn’t involve pills. Here it is:

  • Five servings of fruits and vegetables every day
  • Less than two hours of screen time
  • Get out and play hard for one hour every day
  • Cut down or eliminate soda and juice

For more information, visit:,, and

To learn more, watch the HCGH Wellness seminar, “Weighing in on Your Child’s Weight,” at, presented by:

Edisa Padder, M.D., Pediatrician
Robin Toler, M.D., Psychiatrist
Ashli Greenwald, Dietitian
Suzie Jeffreys, Exercise Specialist

Edisa T. Padder, M.D., FAAP, is a pediatrician in private practice in Columbia, MD. who works with her patients and their families on these issues.

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Nutrition Label with circle CUYou love your child more than anything in the world. You want him or her to be happy and healthy. You have a pretty open relationship and can talk about almost anything. But when it comes to talking about weight with kids who are obese or on their way to being overweight, most parents are at a loss. They clam up and let the problem continue to get worse rather than confront the “Fat” issue, because it is such a loaded and complicated subject.

Most children are already self-conscious and sensitive about their weight and may be teased about it at school. Parents are often afraid they might compound the problem if they acknowledge a weight issue. Will my child develop anorexia if I mention her overeating? What if he thinks I don’t love him as much because he’s overweight? Is she overeating because of depression or some other problem?

Some ways to approach a touchy subject

So . . . how can parents bring up this difficult subject without hurting, alienating or making their child feel defensive? Here are some ideas:

Ask for help from your pediatrician. He or she has experience with this and can be neutral and bring up the topic of weight as a health factor, mentioning that the child has gone over the “healthy weight” line and that there are health risks involved. Talking about health, rather than social or cosmetic factors, can open the door to conversations about a healthy lifestyle and how important it is to overall well-being. You can continue the conversation by substituting healthy choices for fattening snacks and letting your child help with food shopping and preparation at home.

Put the focus on yourself. “Wow! Spring is just around the corner and I’ve really packed on some pounds this winter. Do you want to start an exercise program with me? Let’s try to lose some weight before summer.” Find an exercise you both enjoy and then be a partner rather than a superior. You can show, by your example, that regular exercise makes you feel better. You could even make it a family project.

Talk! Once the cat is out of the bag, it might be easier to address your child’s feelings about food. What is he feeling when he overeats? What is bothering her? Try to help them develop other ways to cope with their feelings and get them involved with activities they like rather than turning to food for comfort. Most of all, tell your child that you love them, no matter what.

Avoid isolation

Some kids with weight problems are treated differently by their peers. Encourage friendships; spend time together and let them know you have confidence in their ability to get healthy.

Depression and anxiety – when should you worry?

How do you know if depression is causing your child’s weight gain, or if weight gain is causing her depression? It can be a vicious cycle that’s hard to interpret. Emotional ups and downs are a normal part of growing up and all children will experience some degree of anxiety from time to time. But today’s social pressures are tough, and anxiety disorders and depression can lead to many devastating problems including suicidal thoughts and substance abuse. If you suspect serious depression or an eating disorder, consider consulting with a professional. Howard County Mental Health Authority ( and National Alliance on Mental Health (NAMI) Howard County ( are good resources for finding local mental health professionals.

To learn more, watch the HCGH Wellness seminar, “Weighing in on Your Child’s Weight,” at, presented by:

Edisa Padder, M.D., Pediatrician
Robin Toler, M.D., Psychiatrist
Ashli Greenwald, Dietitian
Suzie Jeffreys, Exercise Specialist

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Linger, even for one chapter in this massive book, and you will soon find yourself caught up in psychiatrist and National Book Award winner, Andrew Solomon’s comprehensive (albeit eloquent) and tender tribute to the myriad parents of “horizontal” offspring — that is, dwarfs, transgenders, schizophrenics, prodigies, those who commit criminal acts, and more.

Solomon’s all-embracing assertion (as a homosexual, and therefore, a horizontal child himself) is that the parents of such children, along with the children themselves, deserve voice and a raison d’etre. Even the ones certain to be defined as bad parents are given voice: Is it hard or easy to love a child that society has deemed imperfect? Does bearing a child with supreme challenges take us to the edge of an awful precipice? Or does it make us, as one mother says, “Deeper for it?”

Sue Klebold, mother of one of the two teens who committed the Columbine massacre, divested her soul to Solomon when the question was asked if it would have been better had her son never been born.

“I believe,” she said, “it would not have been better for me.”

Far From The Tree is the Camino Trail of epic reads. Take the journey anyway — if not for the privilege to walk in the shoes of some of the most diverse parents and children you will ever meet.

Aimee Zuccarini is an Instructor & Research Specialist at the East Columbia Branch. She facilitates several book discussions and writes the book reviews for The Maryland Women’s Journal.


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If you need help getting your family started on a healthier path, try Eat! Move! Play! Simple, direct, and manageable for any family!

I haven’t always been on the healthy path. There have been many years where I loved fast food! The convenience alone was worth the price I was paying. Then, I became a mom. Still, the convenience of fast food was a big factor. Then, I got divorced and started raising my daughter on my own. Still no change, and the convenience became an even bigger excuse. After a long day of work, a long drive home, and homework to do (yep, working full time and going to school), who wants to cook dinner at 6:30 at night?

Then, something changed. Finally. I started seeing myself and my habits through my daughter’s eyes. I saw how much she would expect me to stop at the drive-thru or to go get ice cream. It was then, that I saw my bad habits were creeping into her life. It had to stop. I became a part of Elf for Health, a group on Facebook, that gave daily challenges for four weeks. It wasn’t all health-driven, some of the challenges were to write positive things about yourself, call a loved one, etc. But it was the healthy challenges that started planting the seed within me. I began to understand that I needed to set better examples for my daughter. And frankly, I want to be around a long time for her- so, it was finally time to step it up.

Eating healthy and exercising are two great ways to lead by example. But there are other ways too, things we can do on a daily basis. I read an article by Steven C. Reuben for Johns Hopkins that hit the nail on the head. He said, “One of the most common teachable moments happens every time you drive your car with your kids inside” (p. 1). So true!! I am always careful when a driver cuts me off or rides my tail. If my daughter says something about a driver who cuts me off my response is this, “well, we don’t know what that person is going through, maybe they are just having a bad day or they aren’t feeling good.” (trying to keep it simple, she’s 4.)

A couple of weeks ago we were leaving Target and I saw a $10 bill on the ground next to my car. For that split second I thought, “Sweet! $10!” Then, I decided the universe was giving me a chance to teach her something, so I took that teachable moment. As I was writing a note she asked what I was doing. I explained to her that I thought the car next to mine dropped the money so I was writing a note and leaving it on their windshield. She asked, “Why?” I explained that we never know how bad that person needs that money, “it could be their lunch money.” She smiled and said that it was a nice thing to do. Teaching moment success!

Remember to pay attention, you never know when your children are watching you.

Monika is no stranger to the healthy-living community online. You may recognize her from Everything Mommy or Fitness Mama blogs. She has a 4 year old daughter, Ava, and works and goes to school full-time in Las Vegas.


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Senior Week

Senior Week

I am a two-time survivor of Senior Week in Ocean City. Not only did my parents let me go my senior year of high school, they let me go my junior year of high school, as well.  Both times I attended with relatively stable, well-behaved girls. Both times we stayed out of trouble. In fact, during the first trip, one of my roomies was questioned by an officer for throwing a can of beer away. She was of legal age (back in the day you could drink beer or wine when you were 18) and she was being responsible. He was impressed. She later married him. But I digress. Because, here’s the thing. Most of our well-behaved classmates did take risks they wouldn’t have taken at home. They drank when underage, they drove after drinking, they went to parties at other places where they didn’t know the hosts, they wandered off from the pack and didn’t show back up until morning, they swam in the ocean at night and they walked precariously on the balcony railings of high rises. They surely didn’t stay hydrated and they didn’t apply sunscreen. And the ones that did behave were put at risk by rescuing friends who were behaving badly.

As a parent, I understood this and encouraged my own children to take alternative trips with their friends. It wasn’t because I didn’t trust them. I did trust them. I trusted that they’d behave like kids and I trusted that they’d be surrounded by kids behaving like kids. I was realistic.

Each parent has to make the right decision for his or her child and I don’t disagree that Senior Week can be a good introduction to leaving the nest for college. So if you’ve decided to let them go, here are 10 tips to make it a safer experience.

  1. Encourage your children to skip Ocean City and find a destination where there are fewer opportunities for mischief. (I know, I know… Fat chance.)
  2. Sit down with your grad and discuss the rules. Number One Rule: Your child must answer his phone whenever you call and must check in on a regular basis.
  3. Encourage your child to park their car and leave it. Use the buses and mass transportation whenever possible and don’t ride with people they don’t know.
  4. Talk to them about drinking and drugs- the voluntary kind. Remind them that they are underage and if caught drinking, they could lose their license. (A new law in Maryland). Encourage them to be responsible for themselves and for their friends. Talk to them about involuntary drinking and drug use. Tell them to keep their glasses in their hands and their eyes on their drinks.
  5. Remind them about personal safety. Staying with the group. Avoiding strangers. And generally acting responsibly to ensure their own safety and that of their friends.
  6. Remind them to stay hydrated, use sunscreen and eat properly.
  7. Give them the number of the local emergency room and/or urgent care center and make sure they carry their I.D. (the real one) with them at all times in case of an emergency.
  8. Take advantage of HC DrugFree’s annual “Senior Week: Staying Safe in Ocean City” programs. Parents and seniors can meet with representatives of the Ocean City Police Department, ask questions and learn tips on how to have fun safely. Parents can also learn about their own accountability in providing vehicles, purchasing alcohol, signing leases, etc. for their children. It’s always nice to have the name of someone in the department your child can call if they get in trouble and it’s nice for you to have the name of someone to call if your kid forgets Rule Number One. (There are two upcoming programs on Thursday, March 13th and Thursday, March 20th. Check out the HC DrugFree page for more information.)
  9. If they’re headed to Ocean City, check out the Play It Safe Ocean City program, which offers perks like concerts, activities and free bus rides during the week.
  10. Finally, remind them that safety comes first and if they think a situation is out of hand, they need to remove themselves from the situation and/or involve an adult if necessary. (Promise them you will not ground them for life if they call you and need your help- or if you do ground them for life- that you still love them very, very much).

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After first rain in months, mud is the best toy. August 28, 2006. Image by David K from Dallas, USA

Whenever my grandmother would catch me or one of my siblings, when we were a lot younger (and, later, one of her great grandchildren) doing something disgusting, say licking a windowsill for example (it wasn’t me!), she would always console the governing child minder by saying: “A pound of dirt a year. That’s what every child needs.” I never thought much about this until I had children of my own and would catch them doing something gross like eating cat food or sucking on fingers…not always their own.

Despite my kids’ profound “moments of ew,” things do seem a lot more antiseptic these days than when I was a kid. There are now “wipes” in supermarkets to clean off your cart. Hand sanitizer is available in most public places. There are loads of products on the market to help keep junior from ever having to come into contact with real-life shmutz, and antibiotics seem to be prescribed more often than I remember (hence my little c. diff dilemma a few months back).

My other friends who are parents and I have talked a lot about whether we are becoming a little too much of a rubber-glove society and what effects this may have on our children and their immune systems. For example, one book I came across in the library Why Dirt Is Good by Mary Ruebush, Ph.D. (see, you can find almost anything in the library) states: “One result of our societal trend toward germophobia, supercleanliness, and heavy antibiotic use is weakened individual immunity due to lack of dirt. …we’ve also created evolutionary selection for the production of new ‘superbugs’–pathogens that can’t be killed by the usual sanitation methods and that resist antibiotic drugs.”

I’m not suggesting that we should allow our children to actually wallow in filth (or ingest it). And I think everyone will agree that we have no wish to return to the days of the plague or 30-year life spans. Some levels of cleanliness and germ-free living are definitely beneficial to our health. The Centers for Disease Control and Prevention (CDC) says: “An essential part of preventing the spread of infection in the community and at home is proper hygiene.”

But then they add: “To date, studies have shown that there is no added health benefit for consumers (this does not include professionals in the healthcare setting) using soaps containing antibacterial ingredients compared with using plain soap….” And… “Every time a person takes antibiotics, sensitive bacteria are killed, but resistant germs may be left to grow and multiply. Repeated and improper uses of antibiotics are primary causes of the increase in drug-resistant bacteria.”

This is still a pretty controversial subject, and I’m not sure anyone has yet developed the perfect solution. As with all things, it would seem that truth lies somewhere in the middle. As for my grandma’s dirt theory, she did live a very healthy and active (as well as sage and sassy) 98 years, but I never witnessed her consuming any dirt.

Joanne Sobieck-Lingg is glad to blog about her many, disparate interests (though expert in none, except maybe parenthetical asides). In past lives, she was a writer, proofreader, editor, project manager, teacher, and even co-coordinator of a certain health blog. She has been happily ensconced among the fiction and teen books at the Central Branch of HCLS since 2003.



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