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Partnership between the parent and child is also a tenet of the Shapedown program, which was founded more than two decades ago at the University of California, San Francisco. Linda Lenoir, RN, MSN, a school nurse in Palo Alto, Calif., decided to become a Shapedown instructor when she started noticing that more and more children were overweight when she did scoliosis screenings.

Healthy households

“In the Shapedown program, it’s not the child who is identified as the ‘patient,’ but rather the family dynamics,” Lenoir said.

During the 10-week program, parents and children learn how to read food labels, remove junk food from the house, eat at holiday times, and limit computer and television time to encourage more exercise. Parents also are expected to facilitate daily family times at home when each member of the family praises and acknowledges one another.

Lenoir has taught the courses for about seven years through the Palo Alto Medical Foundation and the San Mateo County Health Services Agency. Each time, she looks forward to the changes she witnesses in families.

“At the end of the sessions, it is so satisfying to see children feel better about themselves, and feel empowered about how to choose what to eat and how to talk to people when they are teased,” she said.

In some cities like Los Angeles, entire school districts are taking on the problem of childhood obesity. The L.A. Unified School District has gone as far as to ban certain foods like sugar-sweetened soda on campus and the sale of junk food, said Karen Maiorca, RN, M.Ed., a school nurse in the district. School administrators also are joining forces with groups like the American Heart Association to plan ways to tackle the problem, and the district is offering activities that allow entire families to get physical exercise.

Although parental and school district involvement is valuable, not all children have that luxury when it comes to their problems with weight.

Tess Callinicos, RN, MSN, CPNP, a school nurse at Garden Place Academy in Denver, started a walking club during lunch to help students maintain their weight. She doesn’t expect the children to lose weight, but hopes they will thin out during their growth spurts if they can simply avoid weight gain before those spurts.

Each year, she works with a different grade level, and this year she’s walking with the first- and second-graders. This year’s participants were the first to receive pedometers to track how many steps they were taking (they averaged about 2,000 during the 25-minute walk). The pedometers have proved to be a major incentive to motivate the students to walk faster and farther.

Callinicos also has learned firsthand how important it is for parents to be part of the solution to a child’s weight problem.

Garden Place Academy is in an area with a high Hispanic population, and one of the kindergarteners Callinicos walked with last year weighed 94 pounds when he started her lunch exercise program. The walks helped him maintain his weight all year. But after three months of summer, he weighed 138 pounds. His asthma and sleep apnea make him a prime target for weight gain, but Callinicos knew his family’s eating habits were one reason he was packing on the pounds.

“When I approached the mom, she said, ‘I’m not going to starve my child,’ ” Callinicos said. She would like to invite people like this to a parent education group she plans to start in the fall.