By: Susan N. Schriber Orloff, OTR/L

“Childhood obesity can have complications for the physical, social and emotional well-being of your child” The Mayo Clinic Staff Paper

And I should know…a reformed “chubster” who remembers being told that I was so fat I made “the carpool car go down when I got in”. NOT fun and 50+ years later, it stays with me. It did motivate me to lose 30 pounds in one summer, and when I went back to school in the fall, many kids did not know me.

Obesity, linked to many health issues, also has social and emotional implications. It can cause self-esteem issues, make the obese child vulnerable to bullying, and research (from the Mayo Clinic) has shown that it can also lead to behavior and learning problems as well as depression. Currently there is a lot of discussion about making obesity a learning disability.

Studies show that children heavier than their normal weight peers exhibit more anxiety, impaired social skills, and tend to act out and disrupt the classroom. Often these children are trying to be the “class clown”, but it often comes out wrong. And school related stress could feed a downward spiral of anxiety and poor grades often producing full-blown depression.

Of course, there is more to obesity that just “eating too much”. There are often real physical reasons a specific child seems to gain weight more readily than others. Some these conditions are: Type 2 diabetes, high cholesterol and high blood pressure, asthma (and other respiratory problems), liver and gall bladder problems, heart issues, apnea and related sleep disorders, etc. Metabolic syndromes (thyroid related, etc.) while not a disease in and of itself can assemble a cluster of characteristics that can contribute to obesity (excessive abdominal fat, high blood sugar, etc.).

The Centers for Disease Control and Prevention, (CDC) feels that schools must take a stronger stand in its food offerings and make them healthier. And while research does not support a correlation between intelligence and obesity, it does state that these children are often more tired, have less energy and may experience physical discomfort more than their normal weight peers negatively impacting academic performances. Absences from school are also related to obesity as these children do not move as much as normal weight children and often have lower resistance to infection.

Researchers Dr. Erin Hines and Dr Sue Fenton have published a paper about obesity can call it an “epidemic” here in America.

As pediatric occupational therapists, we can play a major role in helping these children with both physical/sensory and social management issues that arise from obesity. Eating is a sensory activity often linked to social interactions making it a “natural” for OT’s to create a healthy ADL program for obese children. Some of the ideas below are easier in the Clinic setting, but many can be adapted for school setting as well.

Some Ideas:
1. Start a “Comfort Food Club” in the Clinic or at school and have the members bring in a list of their favorite foods and then look up ways to make it with reduced calories. The Internet is filled with recipes for low calorie foods for everything from Mac n’Cheese to pizza. Many of these dishes can be prepared in a microwave making “cooking” easier. This could be during lunch once or twice a week, early in the mornings, etc.
2. Snack It Meetings: Meet as a group in the Clinic (or after school for 10-15 minutes) with a healthy snack they can take home and have them bring in ideas for the following day—healthy does not have to mean carrots.
3. Exercise Program using music, videos (of each other as leaders) –plan a club 2K walk and make sure that parents are involved if possible, you can have this “walk” during school times or before or after too! Up the “K” as kids are comfortable.
4. Help them set realistic goals for what they want to loose and when
5. Weird Fruit of the Week Club—send everyone to the grocery and see if they can bring back a fruit they have never tasted.
6. Make a plate. Research has shown that the American dinner plate is 2’ larger than those in Europe (10’ is the normative size). Using the bake and decorate plates from craft stores the kids can make their own place setting and when the plate is full the meal is complete—no seconds.
7. Affirmations diary—have participants think of positive things to say not only to themselves but to each other and everyone gets a copy.
8. Sen-sational Food Club—make sure that it “smells” good, tastes good, and has textures.
9. Computer/ TV Commitment Oath: set computer/ TV times on a diminishing scale and replace computer time with exercise or chores around the house. Research has shown that emotional stability is often more labile with the obese child. Service to others (family members, etc.) is a way to feel important, move more and increase self-esteem. (If “Johnny” has to take the trashcans down the driveway to the street each week, then he is moving and doing for others!)
10. Create a social skills club that focuses on NOT obesity, but feelings, actions and projected self-image and goals. (POP™ Personal Options and Preferences™* is a model for such a program.)

* POP™ Personal Options and Preferences™is a US Trademarked social skills program that is exclusive to Children’s Special Services, LLC and can be found at

This Month’s Featured Contributor: Children’s Special Services, LLC

Special Thanks to Susan Schriber Orloff for providing an article for this issue’s Therapy Corner.

Susan N. Schriber Orloff, OTR/L, is the author of Learning Re-enabled, a guide for parents, teachers and therapists. The National Education Association, and the International Learning Disabilities Association endorse the book. She is the Director of the Modified Developmental Preschool in Dunwoody, GA. Susan writes “Ask the Therapist,” a column in Exceptional Parent magazine, and is CEO and is the executive director of Children’s Special Services, LLC, an occupational therapy service for children with developmental and learning delays in Atlanta, GA.

She can be reached on the Web at

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