By Daniel R. Brennan, M.D., F.A.A.P., C.L.C., Special to the Voice

Have you heard that one out of every four children in the United States is obese? Ever wonder why kids’ clothes have become so baggy? Could it have anything to do with fast food, Spongebob Squarepants and a lack of exercise? You bet your bottom. Let’s take a look at a whopper of a topic: childhood obesity.

It is common knowledge that overweight kids are more likely to be overweight adults and have higher blood pressure, more heart disease, diabetes, and joint problems. Did you know that children who are obese at the age of 12 have 4-to-1 odds against ever attaining an "ideal" weight? After the teenage years have passed, the odds worsen to 28:1.

The McConnection and video game generation

There are as many theories about childhood obesity as there are calories in a (not-so-) happy meal. We have more "fast" food, "super-sized" meals and direct advertising to children. It should come as no surprise that the fast-food industry is the biggest television advertiser. Over $12 billion is spent each year in marketing directly to children, a 20-fold increase over the last 10 years. Now, there is a nugget to chew on.

Children are exercising less during school and after school. In many parts of the country we have fewer "safe" places for our kids to play. For some kids, the only exercise they get is moving their thumbs on a video game controller. Instead of play dates with friends, many sit in front of their computers and send instant messages. Others seem to be glued to their television sets, where they are fed advertisements about food.

A pound of prevention

An ounce of prevention is easier than a pound of loss. Prevention of obesity can start in the early years by encouraging long-term breastfeeding, avoiding food as a reward or comfort, minimizing television as a baby sitter and teaching good eating and exercise habits by example. Elementary students should be active, learn good eating habits and strive for a positive self-image. Teens should learn more about exercise and nutrition, avoid crash diets and, most importantly, stay active. Eliminating TV sets, video games and internet access from bedrooms is essential.

Peeling the couch potato — the treatment of childhood obesity

Unfortunately, the outcomes of obesity treatment in children have been discouraging. Dieting alone, weight-loss pills and supplements are some techniques that do not work. The only thing you’ll lose by nagging and criticizing is your patience.

Most children do not need to lose weight. Simply slowing the rate of weight gain will allow many children to "grow into" their weight. We often ask our patients to maintain their current weight rather than place an emphasis on losing pounds. We try to set realistic, short-term goals, such as trying to keep the same weight for a month at a time.

Make family changes. It is unfair to single out only one child in a family. The whole family will benefit from healthier food choices and more exercise. Set aside family time to go on a hike, take a bike ride, walk on the beach or go around the block. Taking your kids to play on the big toy at your favorite fast-food restaurant isn’t what we have in mind.

Enhance your child’s self-image. Try to modify behavior without placing too much emphasis on appearance and pounds. Peers can be cruel and parents should be positive and supportive. Remember that teens are prone to eating disorders such as anorexia and bulimia.

Set reasonable nutritional goals. It is more realistic to reduce junk food consumption rather than try to eliminate it completely. Nutritionists recommend that we increase our fruit and vegetable intake, drink more water and learn to read food labels. By cutting back on fast food, sodas and juices, we can reduce our caloric intake and our chances of developing diabetes and heart disease.

Instead of skipping meals, encourage your kids to eat three healthy meals a day, plus nutritious snacks. Take the time to pack a school lunch for your children and be sure to cut up fresh fruits and veggies for afternoon snacks. If it’s already washed and peeled, they may be more likely to eat it.

How often do you find yourself getting up during commercials to grab another handful of chips? Encourage your kids to go outside and play instead of being glued to the television. Most kids do not get enough exercise at school, so try to plan some after school activities. Organized sports including soccer, basketball and swimming are an excellent way to schedule regular exercise while providing adult supervision.

Unplugging the TV dinners — the family that eats together

Studies have shown that we eat more food while sitting in front of the television. By sitting down to enjoy a meal with your family, you may eat less and enjoy each bite. Consider eating on smaller plates and serving smaller portions of food. Try leaving the serving dishes on the counter and waiting a few minutes before getting up to have seconds. Drinking a sip of water in between bites may also help to curb your appetite.

The recipe for success

With common sense and moderation we can defeat the epidemic of childhood obesity. The recipe is simple. Consume less junk food and soda, reduce the amount of time spent in front of the television, and be sure to exercise, exercise and exercise!