Childhood weight problems are very delicate. The way in which they are handled at every step of the way can determine whether the child grows up to have a healthy relationship with food and exercise or whether the child begins a cycle of dieting, repeated weight gain and loss, sneaking food, self-loathing, and health problems.
In my experience, when health care providers address childhood weight issues, parents often feel blamed for or guilty about the situation. Others have struggled with their own weight and eating problems- and having the focus directed at their child’s weight brings back unpleasant memories as well as a desire to protect their child from what they have gone through. I am sensitive to these concerns and do not scold or blame parents.
Because it is becoming established that dieting with a goal of weight loss not only does not work in the long term, but also appears to lead to weight gain, I do not recommend putting children on weight loss diets. Instead I coach parents (and the child, depending on age) on how to help their child build a healthy body with good nutrition and regular activity- the exact same things that are needed by all children regardless of their size or weight.
If you would like help improving your child’s/family’s health by eating better and moving more, here’s how it would work:
- We would meet (without your child) to discuss the situation
- I would obtain and review your child’s growth charts with you to see if your child has always trended on the large size or if there has been a marked and unexpected increase in rate of weight gain and/or BMI. If the growth charts show an unexpected change, we would work together to try to identify what caused this mysterious change.
- If you were interested, I would coach you on things you could do to help your child and your family be more successful with healthy eating and physical exercise with a goal of your child having a healthy body and growing up to the size his/her genes intended him/her to be.
- If we decided it would help for your child to meet with me, I might talk with him/her about:
- getting into a rhythm of regular meals and snacks (not skimping during the day),
- having permission to eat some “junk food” (and not sneak it),
- using their cues for hunger and fullness to guide their intake (with a BIG focus on not eating when bored and stopping eating long enough between meals so they have an appetite for the next meal),
- eating more of the healthful foods they already like (but might not eat enough of),
- moving their body more- with a focus on fun, enjoyment, and health rather than weight loss,
- the fact that people come in all sizes and genetics plays a large role in this