David Ludwig, MD, PhD
If your child is overweight, you may be at a loss for how to help. Talking to kids about weight can be a sensitive topic, no matter their age. You don't want to say or do the wrong thing and risk alienating or hurting them. Sometimes it can be tempting to avoid talking to kids about weight altogether and keep living life as is, even though you worry about your child's physical and emotional health.
While it may be uncomfortable to discuss weight concerns, the sooner you bring it up and help your child take action, the easier it will be to help him or her achieve a healthy weight. Ignoring it won't make it go away, and in fact, waiting until your child is older to deal with weight issues may make it harder for him in the long run. While it is possible at any age, it can be much easier to tackle weight problems when a child is younger and more open to making different lifestyle choices.
Also keep in mind that overweight children are more likely to become overweight adults, which will put them at a higher risk for serious health concerns such as type 2 diabetes and heart disease. So talking with your child now can help put him on a path toward better health as an adult.
So where should a parent start? WebMD checked in with the experts who work with overweight children and a child who's all grown up to find out supportive ways to help children overcome weight issues while keeping their self-esteem intact. They offered these dos and don'ts for parents.
It's important to talk honestly to kids about their weight if they ask you about it -- and be available to help. "If your child is concerned about her weight, tell her you want to help, and make getting healthy a project you work on together," says Emily Ets-Hokin, a clinical assistant professor of psychiatry at the University of Buffalo School of Medicine.
Then put some action behind your words by helping her explore her interests and discussing options. For example, suggest taking a cooking class together to learn healthier ways to prepare old favorites. Bring her grocery shopping with you and have her choose a new fruit or vegetable to try every week. Or see if she'd be interested in getting pedometers for everyone in the family and setting a goal for number of steps per day. By involving your child in the decision-making process, you help her take charge of her health and build self-confidence.
When it comes to children and weight, what you do is more important than what you say. "Parents are kids' number-one role model," says Robert Pretlow, MD, author of Overweight: What Kids Say and founder of weigh2rock, a web site for overweight children and their families. According to Pretlow, in a weigh2rock survey that asked how the childhood obesity epidemic can be stopped, 70% of the kids who responded said the most important factor is parents setting a good example.
"Kids develop their attitudes about food and eating from their parents," Pretlow says. "If parents go to fast-food restaurants and expose their child to junk food around the house, that child will develop the same habits -- and those habits are extremely hard to break."
Limit the meals you get from fast-food restaurants. But when you do go to the drive-through, explain to your child about the healthier choices you can make, such as ordering a grilled chicken sandwich and a side salad or fruit cup rather than a burger and fries. Then order a healthier choice yourself.
It's never too late to develop healthy habits. Maybe you haven't always made healthy choices in the past, but today is a new day. Improving your own lifestyle can inspire your overweight child to do the same, says David Ermer, MD, a child psychiatrist with Sanford Health in Sioux Falls, S.D. "It's great for kids to see parents changing their eating habits, turning off the television, and getting some exercise."
Take on change in small steps. Make it easier for everyone in the family to eat healthier by ridding your house of all junk food. Take a look at your pantry and refrigerator and clean them out. Check the food labels and find foods with high percentages of saturated fat and with ingredients like sugar and words ending in "-ose," such as high fructose corn syrup. These should be marked for tossing.
Then, don't buy these junk foods going forward. Stock your kitchen with healthier snacks and foods. Low-fat yogurt, fresh fruit, raw veggies and hummus dip, whole-grain crackers and low-fat cheese, and sliced apples and peanut butter are all healthier snack options.
In addition to having fruit, vegetables, and low-fat dairy products on hand, stock your kitchen with whole-grain breads, cereals, and pasta, and lean meat and poultry. Having these healthy staples on hand can help your family limit trips to fast-food restaurants by making quick and easy healthy meals possible without a trip to the store.
"Criticizing kids about their weight is one of the worst things an adult can do," says college student Elisa Maria Torres of Milbrae, Calif. Now at a healthy weight, Torres was pudgy in middle school and self-conscious about it -- especially when her grandmother compared her unfavorably to slimmer friends.
"She'd say things about my weight during meals and I'd feel awful," Torres says. "I couldn't eat around her without worrying that I was eating too much."
Being overweight can bea symptom of a deeper issue that your child is experiencing. Ets-Hokin urges parents to find out what's going on with your child socially and at school.
For example, loneliness is often a factor in children's weight issues, according to Pretlow. "It's common for overweight kids to say, 'food is my friend,'" he says.
Overweight kids may be lonely because they are socially isolated. Pretlow urges parents to get kids involved in activities: "Music classes, clubs, or volunteer activities will keep your child active and will also help him meet people who share his interests." He also suggests engaging kids in family outings and physical activities.
A child may also overeat in response to unresolved issues at home, such as marriage or financial problems. If you suspect your child’s weight signals an underlying problem, consult your child’s doctor.
Establishing healthy eating habits is a much more effective approach than completely restricting foods. "Healthy eating doesn't mean your child can never have cake at a birthday party or a cookie at a friend's house," says Eileen Stone, a psychologist at Sanford Health in Fargo, N.D. "Your child is going to encounter treats, and you want them to learn to make good, balanced decisions about the food they eat."
Teach children to savor treats rather than gobble them up quickly. Show them what a healthy portion of ice cream or cake looks like so they know what to ask for. For example, 1/2 cup of ice cream is about equal in size to a light bulb. A healthy portion of cake is about the size of a deck of cards. Using these visual cues will help your child participate with friends without overdoing it.
There is evidence that eating with children and having regular family meals helps prevent childhood obesity, according to James Mitchell, MD, a psychiatrist and eating disorders expert at Sanford Health in Fargo, N.D.
"Research shows that when you eat with your child, they eat more slowly and make healthier choices," Mitchell says. "When you have family meals, eating becomes a social event."
Torres suggests that parents encourage physical activity as a natural part of life, not a chore, or kids are likely to resist. "Make it positive," she says. "Instead of making your kid go to a cardio class once a week, for example, do something spontaneous, like take a walk around the neighborhood. Set goals to encourage your child, such as, 'Let's see if we can walk a little further this time.'"
Remember that your long-term goal as a parent is the same whether your child is size 4 or 14: to raise a person who is comfortable with herself and knows that she is loved.
"Be careful of the messages you send," Stone says. "You never want your child to believe that your love for her is based on what she eats or doesn't eat."
As a onetime overweight child, Torres agrees. "Kids need to know that what you feel about them has nothing to do with their weight,” she says. “Part of loving yourself means taking care of your body and keeping it healthy. If your child knows she's loved and learns to love herself, she's far more apt to make healthy choices."
Robert Pretlow, MD, author, Overweight: What Kids Say; founder, weigh2rock.David Ermer, MD, child and adolescent psychiatrist, Sanford Health, Sioux Falls, S.D.Emily Ets-Hokin, PhD, clinical assistant professor of psychiatry, University of Buffalo School of Medicine, N.Y.Elisa Maria Torres, Millbrae, Calif.Eileen Stone, child and adolescent psychologist, Sanford Health, Fargo, N.D.James Mitchell, MD, psychiatrist specializing in eating disorders, Sanford Health, Fargo, N.D.FamilyDoctor: "Weight Issues in Children."KidsHealth: "Overweight and Obesity."HealthyChildren.org, American Academy of Pediatrics: "Is Your Child Overweight?"WebMD Tool: "Portion-Size Plate."
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