Obesity is normally caused by multiple factors which are a combination of obese parents, genetic factors, unhealthy eating habits, bad modelling from parents who will eat badly and not exercise, children having a low energy expenditure through more hours of watching television, playing video or computer games, no physical activity and having a high consumption of high fat snacks.

One usually knows a child is overweight or obese by having the weight and height taken and together with the knowledge of the child's age one can determine whether the child is within a healthy weight range or not.

The treatment for this is usually physical activity, a healthy diet management (not a restrictive diet), attitude and behaviour modification and good modelling from all the family. The whole family would need to change its eating habits and physical activity patterns. This would be done by eating healthy food, limiting portions, cutting down on high fat snacks, cooking at home rather than eating out too often and carrying out physical activity together where possible.

Prevention

It is never too early to start. Obesity is easier to prevent than to treat. Parent education is necessary as misinformation causes bad habits. One cannot afford to be lenient in this. For example one has to pass on the message that healthy drinks are milk, water or freshly squeezed fruit juices. Soft drinks should not be allowed and these days we eat out too often to allow children to drink these at restaurants. Desserts are another issue. We should get our children used to the idea that a dessert is a fruit. One can have the occasional cake however, desserts in restaurants are usually loaded with cream and sugar, so one should just omit. A child may be thin and afford the portion but this is all about habits and behaviours towards food. This is an investment in our children to remain healthy. Restaurants should change their kids' menus if they should have them at all. One should offer healthy pasta dishes, healthy pizzas where children can make up their own toppings from a number of healthy foods, dips and raw vegetables, ricotta pies with a wholemeal low fat pastry, pitta bread with a healthy choice of fillings, etc. If a kids' menu is to include a dessert and a drink this should include freshly squeezed orange juice, water and milkshake without ice cream or loads of cream. The dessert should preferably include a fruit salad, apple pie, apple and dried fruit crumble, yogurt ice cream and ricotta filled sponge cakes or baked cannoli. I get very annoyed when at a restaurant my children will be choosing food from the main menu and try to select healthy options and the waiter suggests they look at the kids menu and choose nuggets! The time has come for the Health Promotion Unit to suggest the kind of food restaurants should offer on a kids' menu.

A note to parents is that habits take time to form. It is not overnight that children take to healthy foods especially when bombarded with so many tempting high sugar and high fat foods and drinks. It takes repetitive tries and modelling by parents and an effort to provide the healthy food options at home.