Childhood obesity: nine million kids in the U.S. are considered overweight. That's three times the number in 1980. Health officials call the growing rate of youth obesity a national crisis.

Fourteen-year-old Michael Tyson--named after her father, the former boxing champion--dreams of her sweet-16 birthday party. "It'll be a big party, just like in Cinderella," she told JS. "I'll be the last one to come in, and everyone will look at me and say, 'Oh, you look so pretty.' Everyone will be so happy to see me."

Another part of Michael's fantasy, however, means much more to her than any kind of celebration. "Losing weight has been my dream forever," she says. "But it's so hard. Sometimes I don't think my dream will come true." At 5'9", Michael weighs about 320 pounds, which, doctors say, is unhealthy.

According to the American Obesity Association (AOA), about 30 percent of U.S. teens are overweight, and slightly more than 15 percent are obese. "Childhood obesity is a serious disease," says AOA President Judith Stern. "Some obesity-related conditions once seen only in adults are now common in kids."

Many overweight children suffer from a number of medical conditions, including high blood pressure, sleep apnea, and liver disease. Overweight children are also at risk for developing type 2 diabetes and heart disease.

A Family Problem

Health professionals consider several factors when determining whether a child is obese. In addition to assessing height and weight, they look for such indicators as high blood pressure, orthopedic (skeletal) problems, and skin disorders.

Studies show that children with obese parents are more likely to be obese. Whether this is the result of genetics or personal behavior is not yet known.

"Childhood obesity is a family problem," says Philip E. Vincent, a psychiatrist at the Child and Family Institute at St. Luke's-Roosevelt Hospital in New York City. The clinic offers medical, nutritional, and emotional counseling to obese and overweight children and their families. "Parents are important," says Vincent, "because they are key to the kinds of food that enter the home, [and] what times meals are eaten." Teens who attend the clinic with a parent show greater long-term improvement in managing their weight.

Positive Reinforcement 

It is no secret that overweight teens suffer from teasing. This can affect self-esteem, and lead to depression or isolation. "People make comments to make me feel bad," Michael says. "Sometimes I think, 'OK, so I'm fat, whatever.' But other times I think, 'No, it's not OK. I'm ugly.' I try to be proud of my appearance, but I do get depressed."

At age 10, Michael started using her mother's makeup as a way to cope with the teasing and abusive comments she received. "I would think that if I didn't have a beautiful body, I would try to have a beautiful face. I would wear makeup, style my hair, and paint my nails. I felt that if I looked nice, maybe people wouldn't notice how fat I was."

According to Tara Ostrow, a nutritionist at the Mount Sinai Adolescent Health Center in New York City, verbal abuse can make eating habits spiral out of control. "After a while, a child will start eating just to pacify [soothe] hurt feelings," she says.

The support of friends, says Ostrow, is as important as encouragement from family members. "It is hard for a child to choose to eat a salad or order a diet drink in front of friends. But the kids who get positive reinforcement from friends are the ones who are more successful with managing their weight effectively."

Is Surgery the Answer?

Some obese teens are turning to surgery, once considered an option for adults only. The operation closes off parts of the stomach and intestines, restricting the amount of food the patient can eat and digest. Many doctors, however, question whether surgery is an effective treatment for children.

"Surgery is a last resort," Vincent told JS. "It is more important for a child to make lifestyle modifications [changes]." This includes making healthier dietary choices, becoming more physically active, seeking emotional therapy or support, and most important, maintaining a positive attitude.

"Some kids think, 'Oh, I only lost one pound this week. What's the use of dieting and exercise?'" says Vincent. "One pound a week is excellent; it's progress. Over a year, that rate results in a loss of 50 or more pounds."

How to Get--and Stay--Fit

Good eating habits are essential to weight loss and weight management. A nutritious diet also fosters good health. For example, eating fruits and vegetables each day allows your body to get the vitamins and minerals it needs to grow and develop.

Michael Tyson is learning about healthy eating. Known to her friends as Mickey, the aspiring fashion designer and boxing promoter has lost 10 pounds over the past year. She is proud of her efforts. "It's really tough," she says, "I tried a lot of things that didn't work. Now, I'm finally losing weight-and enjoying it."

Michael encourages other kids not to give up "because there might be something out there that could help you." To keep your mind off your struggles, she says, "do something you love." For Michael, that means designing clothes. "Stay busy and think that you're beautiful, because you really are."

Words to Know

* obese: extremely, unhealthily overweight.

* type 2 diabetes: a form of diabetes in which the body does not produce enough insulin or the cells ignore the insulin. (insulin is necessary for the body to convert sugar into energy.)

* sleep apnea: a disorder characterized by short interruptions of breathing during sleep.

HEALTH TIPS

Here are some tips from experts:

* Eat a good breakfast.

"You might not have time for breakfast," says Tara Ostrow, "but it really is the most important time to get the energy you need for the whole day." Breakfast, Ostrow adds, should be the largest meal of the day.

* Eat fewer foods that are high in calories, sugar, and fat.

Fast food, sodas, and high-sugar fruit juices are loaded with calories. It's not necessary to give them up completely. Just keep consumption of them to a minimum.

* Eat smaller portions.

You don't have to eat a large portion just because it is served to you. "Avoid having the Big Gulp, or the large popcorn at the movies," says Judith Stern. "Even if you think you won't finish it all, you'll end up eating more than you would have had you ordered a smaller size."

* Exercise.

It is no coincidence that childhood obesity rates have increased as sales of video games and DVDs have skyrocketed. Don't be a couch potato. "Get outside, walk home from school, take the stairs whenever possible, try to get involved in after-school activities," says Ostrow. "Play your favorite song and dance in front of a mirror. Even dancing is exercise!"

* Keep a positive attitude.

"You have to change your way of thinking," says Philip E. Vincent. "Don't let verbal abuse from other kids weaken your determination to lose weight. A positive attitude helps motivate kids to become healthier and to maintain a higher self-esteem."

YOUR TURN

THINK ABOUT IT

1. What are some of the causes of obesity in children?

2. Which causes are hardest to avoid? Which are easiest? Explain.

* OBJECTIVE

Students should understand

* The number of U.S. teens who are overweight or obese is on the rise. Overweight kids are at risk for serious medical conditions, and often suffer from teasing and lack of self-esteem.

* WORD TO KNOW

orthopedic: branch of medicine dealing with correcting or preventing deformities of the skeleton.

* TEACHING STRATEGY

Ask students to describe their daily activities and eating habits. Which would they consider healthy? Unhealthy? Why?

* BACKGROUND

The American Obesity Association notes that "Today's youth are considered the most inactive generation in history." TV and computer games, cutbacks in school P.E. programs, and lack of safe recreation facilities contribute to this problem that, coupled with poor dietary habits, is also making today's youth the most overweight and unhealthy generation. Although other parts of the world have overweight and obese youth, too, the condition affects a greater percentage of U.S. kids.

* CRITICAL THINKING

DRAWING INFERENCES: Why is childhood obesity "a family problem"? (Parents largely decide what food is purchased for the home and set or don't set limits on what children eat.)

NOTING DETAILS: What is an important benefit of eating fruits and vegetables daily? (They provide the vitamins and minerals the body needs to develop and grow.)

* ACTIVITY

CHART A COURSE: Help students make a chart of exercise and diet goals that would get them more fit. Help them keep goals realistic, so they can be encouraged by their progress.

STANDARDS

SOCIAL STUDIES, GRADES 5-8

* Culture: How certain aspects of culture-such as the ready availability of unhealthy foods- influence behavior.

* Individual development and identity: Refocusing a sense of self in relation to the society in which one lives.

RESOURCES

PRINT

* Abramovitz, Melissa, Obesity (Lucent Books, 2004). Grade 6.

* Figtree, Dale, Eat Smart: A Guide to Good Health for Kids (New Win Publishing, 1992). Grades 6-8.

WEB SITES

* Fitness, food, and health site for kids kidnetic.com

* The President's Council on Physical Fitness and Sports fitness.gov

QUICK QUIZ

USA: CHILDHOOD OBESITY, PAGES 6-9

* Decide whether each sentence is true, false, or an opinion. Write your answer on the blank line provided.

--1. More young Americans are overweight today than were overweight in the 1970s.

--2. A real friend would encourage an obese kid to try to lose weight.

--3. Obese children are at risk for developing high blood pressure.

--4. Experts say that an obese child who has obese parents will not be able to lose weight.

--5. Overweight kids who attend weight-loss clinics with a parent are less likely to manage their weight effectively than kids who attend alone.

1. True

2. Opinion

3. True

4. False

5. False

1. biking (16-19 mph)

2. 288

3. 84

4. ice skating 

5. dancing fast

6. 360 calories

7. 756 calories

8. 768 calories

9. running at 6 mph (480 calories)

10. Answers will vary.