Paul felt at a loss about how to help Sarah lose weight. I told him that childhood weight issues are complex and a topic of debate among parents and pediatricians alike. We know that restricting a child's food intake does not work. Rather, restricting kids' food tends to result in sneak eating, binge eating, guilt, shame—the same stuff that adults encounter when they "blow their diets." But this time, the parents become the food police—an undesirable family dynamic.
Despite Paul's best intentions to prevent creeping obesity, I warned Paul against putting Sarah on a diet, depriving her of French fries, or banning candy. Dietary restrictions don't work—not for adults and not for kids. If diets did work, then the majority of people who have dieted would all be lean, and the obesity epidemic would not exist.
Diets for children cause more problems than they solve. They disrupt a child's natural ability to eat when hungry and stop when content. Instead, the child overcompensates and stuffs himself through "last-chance eating." You know, "It's my last chance to have birthday cake, so I'd better eat a lot now because when I get home, I'm restricted to celery sticks and rice cakes." I suggested that Paul delicately ask Sarah if she is comfortable with her body. If she admitted discontent and expressed a desire to learn how to eat better, he could then arrange for a consultation with a registered dietitian who specializes in pediatric weight control.
If you, like Paul, are the parent of a chubby child, you should know that children commonly grow "out" before they grow "up." That is, they often gain body fat before embarking on a growth spurt. Talk to your pediatrician to determine if the problem is real. You can also assess your child's weight with growth charts available at www.cdc.gov/growthcharts.
You might be rightly concerned about your child's weight; we're seeing more and more medical problems linked to childhood diabetes, high cholesterol, and high blood pressure. But your concerns about your child's weight might reflect your own anxiety about having an "imperfect" kid. Yes, you say you want to spare your child the grief of being fat—but be sure to also examine your own issues. If you yourself are very weight conscious and put a high value on how you look, you may be feeling blemished if your child is overfat. Often, a child's weight problem is really the parent's issue. You may want a "perfect child."
Be sure to love your overfat child from the inside out—and not judge her from the outside in. Little comments such as "That dress is pretty, honey, but it would look even better if you'd just lose a little weight" can be interpreted by your child as "I'm not good enough." Self-esteem takes a nosedive and contributes to anorexic thinking, such as "thinner is better," and dieting can go awry (see chapter 16 for information on eating disorders).
So, what can you do to help fat kids slim down? Instead of maligning them and trying to get them thin by restricting food, get them healthier by helping them see the benefits of being more active. This could mean encouraging them to watch less TV, planning enjoyable family activities (unlike boot camp), and perhaps even creating a walking school bus with the neighborhood kids. As a family, you might want to sign up for a charitable walking or running event. As part of a society, make your voice heard about the need for safe sidewalks, health clubs that welcome overfat kids, and swimming pools that allow children (and adults, for that matter) to wear T-shirts and shorts instead of embarrassing bathing suits.
Foodwise, provide your kids with wholesome, nourishing foods as well as semiregular "junk foods." (Otherwise, they will go out and get them). Encourage your children to eat breakfast. Plan structured meals and snacks; take dinnertime seriously. Your job is to determine the what, where, and when of eating; the child's job is to determine how much and whether to eat. (Don't force your child to finish his peas or stop him from having second helpings.) If you interfere with a child's natural ability to regulate food, you can cause a lifetime of struggles. Trust your children to eat when hungry and stop when content—and to have plenty of energy to enjoy an active lifestyle.
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I already know two things about you. You are an intelligent person who has a weighty problem. I know that you are intelligent because you are seeking help to solve your problem and that is always the second step to solving a problem. The first one is acknowledging that there is, in fact, a problem that needs to be solved.