Encourage Health Rather Than Weight Change
I am sure many are aware of the increasing concerns of childhood obesity. Statistics show that up to 1 in 3 children ages 2-19 are considered overweight or obese. As a pediatric dietitian I am concerned regarding the statistics and the potential for future health problems that can be experienced such as diabetes, heart disease, and high blood pressure. However, I do not believe that placing an emphasis on restricting food should be the only focus of treatment.
Throughout my career I have had multiple patients referred to me for weight management. Many arrive a little nervous and will state that they know they are here to go on a “diet.” However, I do not place children on a “diet” of restricting food and making them count calories. I may instruct families to place their child on a diet for medical reasons, like having a life threatening food allergy, but when it comes to managing a child’s weight my focus is on overall health.
Why Overall Health Beats Weight Status
Focusing on overall health rather than weight is supported by the American Academy of Pediatrics[JC1] , as stated in a clinical report from 2016 entitled “Preventing obesity and eating disorders in Adolescents.” The report concluded that when preventing and treating obesity the focus should not be on weight, but on encouraging a healthy lifestyle. An additional reason kids should not be placed on a diet is due to the fact that multiple factors have led to increased rates of children being overweight and obese and not all are related to personal food choices. Other factors include increased screen time for children, decreased physical education offering in schools, poor access to healthy foods, and increased serving sizes in restaurants.
Focusing only on food choices and failing to ask about physical activity, food availability, or time in front of a screen would lead to missing an important key to the puzzle. It would be pointless to provide a beautiful healthy diet plan to a child and never ask if they have access to any of the food listed.
Tapping Into Overall Health of Body and Mind
Recently, I have started discussions with my patients and their families about how they feel about their body. Do they like how they look? Does anything about their appearance bother them? What is their favorite physical trait? Have they ever been bullied based on their appearance? These are important conversations to have in order to understand the patients’ goals and how they view their self-worth.
If I am going to encourage children and their families to adopt healthy habits I want to make sure they have the confidence to love themselves enough to make some changes. I also want them to realize the number on the scale is not the only measurement of health.
Changes With Puberty
Many children are referred for weight management when they are going through puberty. This is a sensitive time to address issues with weight as a child’s body is naturally increasing in size and you do not want the child to think that the changes are somehow wrong.
Since children and adolescents going through puberty are growing at a rapid rate they have increased hunger. Restricting food could make them feel shame for the hunger they are naturally experiencing. The solution is to help a child accept their changing body and offer and encourage a well-balanced diet, while also teaching the concept of moderation and healthy inclusion of dessert type foods without restriction.
One of the ways I encourage families to practice this is by serving balanced meals to the family that include foods from most food groups. Serve meals family style so the child or adolescent can determine how much they want, and if dessert is served, allow it to be served with the rest of the meal.
Our society elevates desserts as a prize for everything from eating our vegetables to making it through a tough day of work. Some even reward themselves with a dessert for reaching a health goal. This sets our children up to seek comfort in food, which does not lend itself to healthy habits.
Ways You Can Encourage Overall Good Health Habits:
Therefore, moving forward if you or someone you know is concerned their child is overweight then review the tips below to encourage healthy habits rather than a weight loss diet plan.
Assess activity time. Make sure they have activity planned into their day. This can be done by asking them to take laundry up a flight of stairs, requesting that they go outside to play with the dog, suggest they dance or jump rope, and find time to take more family walks.
Examine your family meal routine. If you are not having regular family meals then work toward that as a goal. Benefits include decreased rates of obesity, low rates of risky behaviors, and increased self-esteem. Allowing children to serve what and how much food to put on their plate is the beginning of teaching them to trust their body and how much they need to eat. Making the dessert equal to all the other food allows it to not seem forbidden. When foods are forbidden it often increases the child’s desire for that food.
Look at how your family models healthy habits and healthy living. It is not motivating for a child to be told that they cannot have ice cream while a parent is eating a large bowl of it. Therefore, the journey to adopt healthy habits does not only belong to your child it is a journey that the entire family can benefit from. Parents need to role model positive self-talk, sustainable exercise habits, and show food choices that reflect what you desire for your child.
When addressing the issue of weight management many always want to talk only about the food and how their weight responds. If a child moves to make healthy choices that include increased activity or drinking water instead of soda, but their weight stays the same many would consider that a failure. However, increased activity and drinking more water will still benefit the child despite what the scale says since it decreases screen time and sugar intake. The journey a child and family take to establish overall health is not only about what food is consumed and what the scale says, but the entire environment the child lives in.
Resources for families:
Fearless Feeding: How to raise healthy eaters from high chair to high school. By Jill Castle and Maryann Jacobsen
Secrets of feeding a healthy family: How to eat, How to raise good eaters, how to cook. By Ellyn Satter
Find an expert in pediatric nutrition and weight management by visiting this link from the Academy of Nutrition and Dietetics https://www.eatright.org/find-an-expert
AAP clinical report on “Preventing obesity and eating disorders in adolescents.” http://pediatrics.aappublications.org/content/138/3/e20161649
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