BOSTON - Prevention, not treatment, will help contain the growing epidemic of obesity among US children, according to speakers who addressed the topic here Sunday at the American Academy of Pediatrics' National Conference.

"The problem is we are a very crisis-oriented society," Dr. Robert Murray of Children's Hospital in Columbus, Ohio, said at a press briefing. "Medicine is built this way," he added. "We wait for high cholesterol to develop and then we treat it. We wait for diabetes to develop and then we develop a drug to treat it.

"Setting up a treatment model for obese kids won't work," he continued. "The new numbers show that one in three kids are at risk for becoming overweight and one in six is overweight, so we are losing ground at a very rapid rate."

Murray believes that the business and legislative communities don't realize how "extremely" costly obesity is becoming. "Only when this country fully understands the link between obesity and lifestyles and the costs that they see each year in terms of double-digit healthcare inflation will they be ready to talk about prevention." Estimates show that the obesity epidemic will cost Americans $260 billion for treatment by 2010.

Murray is a strong advocate of the National School Lunch Program (NSLP) to help prevent school-age children from becoming overweight adults. Ample data show that, through this program, children consume twice the servings of fruits and vegetables and greater amounts of grains and dairy. He said he would like the NSLP to be expanded to include breakfast. The cost of providing a breakfast and lunch through the NSLP is minimal compared to the cost of treating obesity, he said.

"I think the NSLP is probably a mother's and teacher's best friend and they don't know it," Murray said, explaining that "we can put a better, more focused student in the chair by providing a nutritious breakfast and lunch through the NSLP. I think it should be universal."

Murray also urged pediatricians to use the 12 well-child visits between birth and age 5 to prevent obesity with the same intensity used to promote child immunizations. Keeping a child at a normal, healthy weight will prevent the vast majority of adulthood obesity, he told reporters.

Ellyn Satter, a registered dietician from Madison, Wisconsin and AAP faculty member, echoed these remarks.

Satter said she is particularly concerned that many parents adopt a policy of "underfeeding and overexercising" a heavy child. "It has been tried and it does not work," she said. "Restrained feeding is a big problem I see in my clinical practice. Parents today are so worried that their child will get fat that they hesitate to satisfy the appetite, whereupon the child becomes food preoccupied and then overeats whenever they get the chance."

This sets the child up for problems with weight later on, she said.