The rules that help obese children

Mphake emphasised that physical education was important, not just for children's health, but because they learnt valuable skills through play.

Mphake emphasised that physical education was important, not just for children's health, but because they learnt valuable skills through play.

Published Nov 14, 2014


London - Danish doctors claim to have cured childhood obesity by getting children to follow a set of basic rules which include no second helpings of food within 20 minutes of eating.

Snacks and sweets are rationed to once a week, fruit juice or fizzy drinks once a month and children must walk or cycle to school.

The rules also state that pots are kept in the kitchen at mealtimes - rather than on the table to avoid the temptation of second helpings.

The rules have been drawn up by Danish paediatrician Dr Jens Christian Holm, who claims to have helped 1 300 overweight and obese children.

He first began testing his set of rules –The Children’s Obesity Clinic’s Treatment (TCOCT) protocol – in the town of Holbaek in 2008.

But it has been so successful it has been adopted by eight other districts across the country.

Dr Holm’s plan hinges on sticking to between 15 to 20 rules aimed at improving the diet, boosting exercise levels and slashing time spent sitting down.

One states that children must feel satisfied after each meal so they aren’t tempted to snack later. But if they are still hungry after their first helping, they must wait at least 20 minutes for seconds as this is how long it takes for the body to feel “full”.

Others include no television before 5pm and for no more than two hours a day as well as no white bread for lunch.

Initially they are admitted to hospital for 24 hours where they undergo tests and scans including measurements of body fat, blood sugar and blood pressure.

They also answer a very detailed questionnaire about their diets and lifestyle, with the help of their parents.

Doctors then help them draw up a more specific set of rules tailored to their likes, dislikes and routines.

These stay in place until the child has reached their target weight.

Dr Holms said that of the 1 900 patients who have been put on the programme since its launch, some 70 percent have lost significant amounts of weight and kept it off for at least four years.

He said: “In general, obese children are neglected. They are often lonely and many of them don't participate in activities with their peers. They lack self-confidence.

“With this scheme there is a real hope they can lose weight and have a good quality of life.

“We create the environment and tools with which the children and their families can overcome this.”

Dr Holm says that, unless children change these habits, the “obesity will persist”.

“People will get very frustrated, sad, and they will be lost,” he said.

“Their entire life needs to be changed, because they tend to be lonely, tend to be ashamed of themselves so they need to do this, and to interact with other children in their daily lives.”




Under The Children’s Obesity Clinic’s Treatment (TCOCT) protocol, a doctor creates a plan comprising 15-20 components.

These, according to the BBC, may include:

1. No crunchy muesli or fruit yoghurts for breakfast - choosing oatmeal, dark brown bread, meat and fish instead

2. No fast food or white bread for lunch; choose brown bread, meat, fish and vegetables instead

3. Portions served up in the kitchen - no pots and pans at the dining table

4. Plate proportions for dinner should be: half vegetables, a quarter brown rice, pasta or potatoes, and a quarter low fat fish or meat

5. Wait 20 minutes before having second helpings - this allows time for the body to feel full

6. Feel satisfied after each meal

7. Only two pieces of fruit per day

8. Fast food only once a month

9. Sweets only once a week

10. Snack only once a week

11. Limit juice, iced tea, cocoa, soda or lemonade to once weekly - only half a litre in total

12. Cycle or walk to school

13. Organised physical activity eg dancing, handball or gymnastics

14. Free physical activities like walking/biking after school, walking the dog or trampolining

15. Screen time (television, computer or tablet) limited to two hours per day

16. No television/computer access until 5pm

17. Set a regular, early bedtime

Daily Mail

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