A weighty issue

Here’s a true story for you. A few weeks ago on vacation, a family was ahead of us in line for lunch while we were waiting for ice cream. One of the boys, around 9-10 years of age, was a big chubby and was looking into the freezer and seemed very uncomfortable. I heard his dad say: “Let me look at that” and the boy handed him a snicker’s ice cream bar. “Oh, this is ok – not many calories. You’ve been very active this week – and it’s ok to have a treat once in a while”. A few minutes later his mother arrived and smiled. “You deserve that treat – you’ve been great all vacation. Plus, a treat is ok now and again”. All walked off happy – the boy now smiling and eating his treat.

These parents not only handled this situation with incredible tact and sensitivity, but utilized an approach was only recently outlined by the American Academy of Pediatrics. What I found exciting was the AAP’s policy statement on childhood obesity emphasized the very tips I first discussed in my column back in April:

1. Identify and track patients at risk by virtue of family history, birth weight, socioeconomic, ethnic, cultural or environmental factors
2. Calculate and plot BMI (Body Mass Index) once a year in all children and adolescents. (for more information: www.cdc.gov/nccdphp/dnpa/bmi/index.htm)
3. Use change in BMI to identify rate of excessive weight gain relative to linear growth.
4. Encourage and support breastfeeding.
5. Encourage parents and caregivers to promote healthy eating patterns.
6. Routinely promote physical activity, including unstructured play.
7. Recommend limiting of television and video time to a maximum of two hours per day.

I wish more parents could adopt these approaches. The arguments I hear the most about why parents do not want to talk about weight with their kids involve body image, self-esteem and the fear of “making them anorexic” or they do not want to confront their own weight issues. Kids are vulnerable and sensitive but we are not doing our children any favors by either avoiding the topic or not addressing it at all. The stakes are too high otherwise – our children run the real risk of serious health problems either later in childhood or as an adult. So, the time to start teaching our children about nutrition and weight is when they are very young, and especially if they are overweight.

I think a lot can be learned from that family I witnessed on vacation. Like these parents did, we should not shelter our kids from feeling bad or paralyzed about the weight, but help them refocus to making healthy choices. That boy was not banned from eating ice cream but they helped him make a healthy choice of what was there and to learn that everything is ok once in a while.

Cars need special fuel and care just like our bodies. We’d never put mud into our cars and expect them to run well. When our kids are very young, we need to teach our kids what fuels make our bodies run best . Instead of looking at weight as a “problem”, let’s teach our kids that weight maintenance is part of life – just something we have to do as adults and as children. By removing the taboo surrounding weight loss discussions with our kids, and incorporating weight maintenance and healthy eating into our daily lives, the skills needed to stay at a healthy weight will become as natural to our kids as brushing their teeth and doing homework. Let’s teach them early in life what took most of us decades to learn.

© 2005 Pediatrics Now.
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