According to the National Center for Health Statistics:

• About one in every five children in the United States is considered overweight.

• The increase in overweight individuals over the past 15 years is seen in both sexes and all ages. Individuals who are obese as adolescents will most likely remain obese as they become older.

A Keiser Foundation report identifying junk food advertising as a major culprit for today's childhood obesity epidemic cited that 4.2 percent of children aged six to 11 were listed as overweight between 1963 and 1970, whereas 15.3 percent were listed as overweight between 1999 and 2000.

The National Children and Youth Fitness study, completed in 1987, found that at least half of youth do not engage in physical activity that promotes long-term health. And, less than 36 percent of elementary and secondary schools offer daily physical education classes.

I think we can safely assume that today's kids are eating too many calories and not exercising enough.

Although these statistics are astounding and frightening, they can also be seen as a business opportunity for the health and fitness industry. In response to the alarming statistics, government agencies have developed health initiatives and programs at the national level. Several states and cities have followed suit. Many hospital systems across the country have established comprehensive programs to address childhood obesity and an ever-growing number of fitness centers have recognized the need for such programs and made them a profitable part of their business.

Regardless of the specific operations of weight management programs for children, the basis of treatment for obesity in children and adolescents should involve behavior change, diet and exercise. It is important for the focus of the program to be on adopting a healthier lifestyle — not weight loss. Generally, weight loss is not recommended for young children because they are still growing and developing. Once adolescents have completed most of their rapid growth, weight reduction may be recommended.

Many hospital programs are clinical and have health professionals who may not be available at a fitness center. The key is to develop a program that is not too complex for your club's staff and budget. The SHAPEDOWN program is a great example of a successful weight management program for children and adolescents that would work well in a fitness setting (www.shapedown.com). It was developed more than 20 years ago by the University of California, San Francisco, School of Medicine. SHAPEDOWN is by no means the only program out there, but it can serve as a model for programming, based on the following premises:

• Family-based

  Not only does this provide support for the child, but it also assures that the people responsible for food shopping, scheduling and time management are involved in the process.

• Protective

  The program could benefit anybody, not just the child in need.

• Preventive

  It uses clinically proven diet and exercise recommendations.

• Sensitive

  The whole child is addressed, rather than just the obesity.

• Effective

  The program has been validated and published in the Journal of the American Dietetic Association (1987 Vol. 87, No. 3).

Although individual counseling can be effective, research has shown group work to be effective for children. There is no one program that is ideal, and the length of the program, number of classes, topics and activities will vary from facility to facility — based on staff, space, budget, and so on.

Whatever your program ends up looking like, always keep in mind that you're working with children, not adults.

Christine Karpinski, M.A., R.D., owns Nutrition Edge Inc. in Wilmington, DE. She is a registered dietitian and exercise physiologist. Christine can be reached at www.nutritionedge.net or by phone at 302-656-FOOD.

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