Managing Your Child's Weight with a Family Approach

If you have a child that is overweight or obese, you know the emotional pain that it can cause both to your child and to you as a parent. While this may be a sensitive subject, it shouldn’t be simply ignored with the hope that “they’ll grow into it”. Finding an approach that is effective but sensitive to your child’s self-esteem is important.

Over the years of working with parents and children in regards to weight, I’ve unfortunately seen some concerning issues. Parents often start by instructing their children to make good choices when it comes to food. I've seen extreme cases where it almost seems that the parent(s) expect their child to do this alone. “You have to pick the fruit instead of the cookies after dinner”. “You’re supposed to have the plain Cheerios, the Lucky Charms are only for your brother”. When tempting foods are in the house, this can often sabotage the efforts of adults- can you imagine how difficult this is for children? You want to teach your child to make good choices, but creating a healthy atmosphere for them is equally important. Children learn behaviors by watching others. A “do as I say, not as I do” approach is not going to work. What goes on in your home is a model for your child’s future as well. If dessert is provided after every single dinner, this is most likely how your child will feed him/herself as an adult and how they will feed your grandchildren.

If you are singling your child out for being overweight, this is suggesting that there is something wrong with them that makes them different. You’re showing them that they need to be punished with a strict diet because of their weight. This can cause issues related to body image and self-esteem. This can also cause issues like a poor relationship with food, restrictive eating or even eating disorders such as anorexia nervosa or bulimia either now or later down the road.

So what are you to do? A whole family approach! This is necessary to create healthy habits without singling anyone out. Yes, that means you need to change. You'd do anything for your children, and healthy behaviors benefit everyone. When grocery shopping, limit the sweets and junk food and make sure healthy snack and meal options are always available. Limit eating out and fast food. Don’t use treats or going out for ice cream as rewards. Start some sort of family physical activity such as walks after dinner. Improve your own health habits to model appropriate behaviors. This doesn't mean that you can never eat chips or candy ever again - any food can be part of a healthy diet, as long as it’s in moderation and reasonably portioned.

A lot of families find this approach overwhelming due to the wants and needs of everyone else in the house. Another child may feel that it’s unfair to “punish” the whole family because of one or two people. Remember, this is not a punishment. Healthy eating is beneficial to everyone. Make trying new foods fun and enjoyable. Some parents have concerns regarding a family approach because they may have other children in the family that are underweight, very active, picky eaters, etc. Remember - you are promoting healthy eating, not a restrictive diet. Your other children aren’t going to wither away because there’s not always ice cream in the freezer. You may need to explain to everyone that one child gets an extra “soccer snack” because he needs extra energy for all the games and practices. This puts focus on the activity rather than the child, making everyone still normal and equal.

I’ll never forget a family I used to work with several years ago. The mother came in with her elementary school age twin girls – one being very tall and considered obese based on her growth chart, while the other was quite small and close to being considered underweight based on her chart. Mom was especially concerned about her smaller daughter because she felt she was a picky eater, had issues with sometimes severe constipation, and felt she wasn’t getting the nutrition she needed. For the first few appointments, everyone, including myself, was overwhelmed. How was this family going to juggle such opposite issues while also dealing with daily life? As we continued to discuss what the girls were eating, we found in many cases there were singular solutions which could help both girls. For example, mom would pack VERY large portions of snacks like veggie straws in both girls’ lunches. The girl with obesity would eat the entire bag, which just continued to promote her eating excessively large portions. The smaller girl would be so overwhelmed with how big it was, she would just leave the bag unopened and bring it back home with her. Another example is Mom would often go through the drive-thru and pick up things like chicken nuggets and French fries. It was quick and convenient and she wanted to provide her smaller daughter with enough calories of food she would actually eat. These low fiber, high fat meals made the constipation worse, leaving her one daughter uncomfortable and full and then she would not eat much for days. The other daughter would eat her entire meal along with what her sister didn’t eat, consuming hundreds of extra calories and gaining weight weekly. Eating less fast food and more meals at home, in addition to being provided appropriate sized snacks were the keys to success for both these very different girls. Finding solutions that work for everyone is possible.