Tackling a child’s weight issues is a touchy subject

PONTIAC, Mich. — He was having dinner with his pal's family, savoring delicious homemade Mexican food. As a lifelong member of the “clean plate club,” he said thanks and dug in when his friend's grandma offered more. Later, he met up with friends having dinner at a restaurant — “something new and tasty you just have to try,” they urged. As they visited, he finished their meals, too.

At home that night, Ryan Blanck looked in the mirror. He was 16, weighed 240 pounds, about 100 more than his frame needed. He wasn't an unhappy or bullied kid; he had tons of friends. But he had the wits, he says years later, to ask himself a question: “What are you doing to yourself?” He felt sluggish and didn't like his reflection in the mirror.

“I knew nothing about nutrition,” says Blanck, now 32, who founded Deviate, a performance consulting company that works with athletes and celebrities in Grand Blanc, Mich. “But I put on a pair of shoes and covered, mostly walking, a loop we called 'The Mile.' And I started to change.”

Anyone who's tuned into media has heard America is in the middle of an “obesity epidemic.” Nearly two-thirds of U.S. adults are overweight, according to the Centers for Disease Control and Prevention, and half of those are obese. Also too heavy are nearly 1 in 5 children; experts say this generation of kids may be the first to not have longer lives than their parents. Pediatricians say ills formerly found in adults like high blood pressure and type 2 diabetes now appear in younger patients.

Those facts, though, compete with different bad news: Children are inundated with unreal messages about their bodies and how they should look. If you peel back origins of eating disorders, you may find distorted body images were the accelerant.

Given the conflicts, how should a parent address real concerns about a child's weight and overall health without unleashing unwanted effects or smashing a child's confidence and self-esteem?

“Parents walk a difficult tightrope because the obesity epidemic is real,” says Edward Abramson, author of “It's Not Just Baby Fat.” He says being overweight has psychological risks. “Stigma attaches as early as kindergarten and doesn't go away; 100 percent of obese teenage girls had been at least verbally abused about their weight and studies show discrimination in school and work settings and in dating and relationships.”

Still, parents should use caution. A food fight can turn into an eating disorder. “Those consequences are profound, but on the other hand, if you look at eating disorders like anorexia and bulimia, there is almost invariably a history of diet and over-emphasis on weight. … It's hard to watch kids gain weight, knowing what the consequences are, but if parents are over-involved, there's backlash,” he adds.

It may also unleash a battle of wills, another place for a growing child to push against parental restrictions, he says. “That's part of growing up. But you don't want to make food part of that battle.”

Simply fuel

Parents inadvertently give different messages about food: If you can't have dessert until you eat your vegetables, Abramson says, even a little kid can figure out that dessert is good, vegetables bad, the obstacle between you and reward.

Or this one: Skinny is the only good body type.

The risks of mishandling something this weighty are real, experts agree. Marci Warhaft-Nadler, a body image advocate from Toronto who wrote “The Body Image Survival Guide for Parents,” sees it professionally: The boy, 8, crying that he doesn't want to go to school because his shirt makes him look fat. The eighth-grade girl who says no one at school eats lunch because they don't want to get fat. The older woman obsessed with body changes. Kids as young as 5 treated for body-image issues. And the one-quarter of all girls 6 and 7 who have dieted. Dieting numbers, in fact, are nearly identical for average-weight and overweight girls. Everyone does it.

“The messages come from everywhere and many really are negative,” she says. “We are so aesthetically obsessed, a genuinely fat-phobic society. It's crazy. We baby-proof for health, covering sockets and table edges. We can do that with images, too. … The more we can tell our children that fit bodies come in all shapes and sizes, the better.”

Jessica Setnick, a Dallas pediatric dietitian specializing in eating disorders, believes parents should look at a child's growth chart before they conclude a child is heavy. “I have seen far too many children brought in by parents who don't recognize the slippery slope of dieting to eating disorder to lifelong misery. Looking at a child's growth chart is the single most important factor in determining if there is a problem, or if the child is simply bigger than the parents want him or her to be. We have to support parents in seeing a child as okay and helping the child feel good about himself, regardless of size.”

A child who is a sneaky eater or eats constantly or steals food has an issue regardless of weight. It may take some sleuthing to sort out medical or emotional causes, as well as potential triggers for abnormal eating.

Sometimes a child just doesn't match the family's typical shape, a genetic difference. Besides that, Setnick says, “Kids get thicker around the middle before they grow and parents can see that and panic, but it's still perfectly normal.”

Real weight issues must be addressed, but because the danger of disordered thinking about one's body is so great, Setnick recommends parents talk to a pediatric dietitian without the child initially. It's helpful to bring growth charts and photos. That session can determine need and perhaps simple changes. She calls weight and height less telling than whether a child has always followed the same growth pattern. A child who was always bigger is different than the kid who was average and is now in the 95th percentile sizewise.

The right discussion

Discussion and action should be about health, not weight, says Warhaft-Nadler. Rather than either assuring a child he's perfect or that she needs to lose weight, parents should explain that healthy bodies come in all shapes and sizes and it's okay to be different. “It's about how we feel.”

That moves the discussion to health, where it belongs, says Tobie Baumann, a mom from Cartersville, Ga., who works in fitness consulting for Les Mills East Coast. “Weight is a physical repercussion of a larger issue, which is health.”

Size may be what someone sees when a child is truly overweight; there are things that aren't readily visible, such as rapid mood fluctuations and short attention spans, she says. The unseen, the tension and attention lapses, has long-term effects, including delays in education and in growth, mood disorders and more.

Baumann's already couching food discussion with daughters Emerson and Covington, 3 and 5, in terms of health, not how they'll look. “Guess what, you will have so much more energy and be even smarter and think faster as your body grows stronger with good food and exercise,” she says.

Warhaft-Nadler doesn't allow “fat talk” around her kids. “Love your kids, love yourselves and keep the focus on health and not weight.”

Family challenge

Baumann clashes with the cookie culture that is part of an American childhood. At schools, “I've taken pictures at parties of what's on a child's plate: Three kinds of cupcakes, brownies, cookies, Cheetos, Kool Aid. Adults have encoded it into children that a party is about having fun with lots of sugar.” Attempts to reduce the importance of food at the festivities or make them more healthy have been rebuffed.

Warhaft-Nadler believes change should involve the family in healthy eating and exercise. A child who's overweight should not be singled out. She works with a woman in her 40s whose mother worried about her size compared to her thinner siblings. “Everyone else could have ice cream; she could not. Now she's overweight and totally eats at her mother.”

A better family approach is wanting more energy and to be stronger. Baumann tells her girls they want to care for their bodies to feel their best. Warhaft-Nadler says, “ ‘We are making changes to feel better.' It has nothing to do with how we look at all. Who knows what each body is supposed to be? It should be how bodies work.”

The link between activity and health — and healthy size — is unassailable. The more active one is, the less pressure is placed on what one eats, Warhaft-Nadler notes. But parents need to use logic. Putting a son who is not physically active on the hockey team where he feels insecure is not a solution. Taking walks with him after dinner is.

Abramson says one way to interest kids in eating all kinds of food is having them help prepare them. They're harder to refuse. Warhaft-Nadler likes shopping as a family and trying new foods. Change can be fun.

Bodies in motion

Joel Perez teaches at Martial Arts World in Kissimmee, Fla., in part because martial arts helped him develop confidence as a child. His children, Crystal, 16, and Joel Jr., 6, started learning when they were toddlers.

He believes asthma and diabetes and weight have all gone up because Americans sat down. TV and video games have become a habit that limits kids. “Kids naturally have high metabolism and energy to burn, but they're being trained out of it. Complaints that children are hyperactive and don't pay attention have risen alongside that.”

Exercise should be something you do because you like your body and want to take care of it, not punishment, Warhaft-Nadler says. “You deserve to be healthy and feel good.”

She also tells parents to support their children in hobbies and passions that have nothing to do with weight. “You show they are loved and valued and they get a sense of accomplishment. It takes the pressure off aesthetics.”

Greg Marshall, fitness director at the Gym at City Creek in Salt Lake City, suggests finding a supportive partner who is not the parent. “If it feels like a parent is telling a child what to do, it may feel like punishment.”

A personal trainer, coach or other figure can support and provide direction. Then introduce activity of short duration a couple of times a week. Anyone is more likely to stick with an activity if it's enjoyable, so he recommends activities a child likes.

Marshall starts kids on resistant band exercises and calisthenics. Only very light weights are recommended. “You don't want to mess with their joints, tendons, growth plates. Kids aren't as coordinated as adults, so with heavy lifting they're at greater risk of tweaking their backs or hurting themselves. And they're still developing; you don't want to add a ton of resistance and blow anything out.”

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