Childhood Obesity: helping without harming

By Lori S Brizee MS, RDN, LD, CDE

Lori is a Registered and Licensed Dietitian-Nutritionist with over 35 years of experience. She works with infants, children and adolescents as well as pregnant women who have a variety of nutrition concerns in the office of Erika Beard-Irvine MD Pediatrics. 

"Obesity in Kids"
There is a lot of press about "Childhood Obesity" these days. High body weight for height (or body mass index, BMI) in kids is  concerning, since it tends to go along with many chronic health problems. But, focusing on weight tends to backfire; it just stigmatizes kids who live in larger bodies. The problem is those chronic health problems, not the weight per se. Why not focus on healthy lifestyle habits that help prevent those chronic health problems regardless of body weight?

Just talking about a child's weight--telling a child that they are overweight can have  unintended consequences! If a kid thinks that their body shape or size is “wrong” or “bad” they think that they are wrong or bad—they feel shame and develop low self esteem. Kids who are ashamed of themselves are at very high risk for depression and anxiety as well as eating disorders—Anorexia, bulimia and binge eating disorder. These problems are far worse than having a high body weight!

If your child's weight is increasing faster than expected, or your doctor has told you that your child is overweight or obese, there are MANY THINGS YOU CAN DO WITHOUT EVER TALKING ABOUT YOUR CHILD'S WEIGHT!!!
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​​Read on for 14 Do's and Don't for dealing with weight concerns in children. These are  that can make a difference in anyone's  health. They also happen to have an impact on weight gain and growth.

Do's and Don'ts for dealing with weight concerns in children.
NOTE: these are healthy things we want do for ALL children, regardless of body weight!

• DO talk about and celebrate the things your child is good at or works hard at! School, drawing, music, acting, a sport, video games…None of these things have ANYTHING to do with whether your child's weight is high, low or in between!! We want all kids to feel good about themselves.
• DO make sure your child is getting enough sleep. (Be a role model and aim for enough sleep yourself.) Research shows us that low sleep is a huge factor in weight gain and obesity. Good sleep also helps with behavior, school performance and ability to be active throughout the day.  
  • National Sleep Foundation Recommendations for sleep times by age:
    • Infants 4-12 months: 12-16 hours sleep/24 hours (including naps)
    • Children 1-2 years: 11-14 hours sleep/24 hours (including naps)
    • Children 3-5 years: 10-13 hours sleep/24 hour (including naps)
    • Children 6-12 years: 9-12 hours sleep/24 hours (at night)
    • Teenagers 13-18 years: 8-10 hours sleep/24 hours (at night)
    • Adults: 7-9 hours sleep/24 hours (at night)
      • If your child has problems sleeping, check out the websites below, or consider consulting with a sleep coach.
        • www.sleepforkids.org 
        • www.nationalsleepfoundation.org

• ​DO make sure all your kids eat meals AND snacks at the table or an "eating place" WITHOUT screens, toys or books. This helps kids to eat what their bodies' need--enough, but not too much. A child is apt to stop eating when they are full if they can't eat while playing or watching TV.

• DO space meals and snacks 2-4 hours apart. Offer 3 meals and 1 to 3 snacks each day. No food, or beverages except WATER between meals and snacks!!! This helps kids learn what it feels like to be hungry and to be satisfied. A child is much more likely to eat the healthy foods you make for a meal if they have a good appetite. Kids who "graze" all day tend to eat a lot of foods that are not very high in nutrients, and they never know when they are hungry and when they are full. 

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• DO eat family meals whenever possible, without TV or other screens. Eating meals together has been shown to result in better nutritional intake, decreased obesity in kids, improved school performance.... ​​
• ​DO offer water or milk at meals and snacks; limit 100% fruit juice to less than 4 ounces/day (juice is NOT necessary for meeting your child's needs). Other sugary drinks like soda pop, fruit punch, lemonade should be once in a while treats, not every day or even every week beverages.
• DO serve a fruit or vegetable with every meal and snack. This will help your kids to meet needs for many nutrients--vitamins A, C and Folic Acid, potassium, fiber and  many other "phyto-nutrients" that help prevent cancers, heart disease, and other diseases of adulthood. 

• ​​​DO make at least half your grains, whole grains (brown rice, whole grain bread, whole grain cereals, corn, popcorn, quinoa...). Whole grains are far more nutritious than refined grains and they contain fiber that is essential for a healthy gastro-intestinal tract (e.g., whole wheat vs white flour, brown rice vs white rice)

• ​​DO ​find ways to keep your children active. Outside play whenever possible, active inside play without TV or other screens when weather keeps them inside (e.g. building with blocks/legos, building forts with blankets over furniture, hide and seek with siblings or friends). Even doing arts and crafts standing at a table or counter keeps kids moving.
• Do limit screen time to less than 2 hours/day outside of school and homework (TV, computer games, phones...). Just limiting "sedentary" time has been shown to result in kids being more active.

• ​DO look at your child’s stress levels—high stress can result in over or under eating.
  • Is your child dealing with a new daycare, school, home?
  • Is your child having difficulties with friends?
  • Is your child they being bullied?
  • Is your child dealing with parents' or other close relatives' divorce?
  • Is your child dealing with the death of a close relative, friend or pet?
• DO NOT talk about your child’s weight! Whether it is low, high or in between.
• DO NOT put your child on a diet OR restrict their eating or take away all treat foods!
  • Children who are restricted often end up sneaking or hording foods, resulting in far more weight gain than if nothing were done!
• DO NOT talk about YOUR weight or diet. If you are concerned about your own weight, try doing the things listed above rather than going on a “diet”.

​For more information check out: Healthy Choices, Healthy Children A Guide to Raising Fit, Happy Kids, by Lori Brizee with Sue Schumann Warner, published by Paraclete Press in 2011  (Can be ordered online via several booksellers, or borrowed or purchased from Dr Erika’s office)  

Consider making an appointment with a pediatric dietitian-nutritionist for an evaluation of your child’s growth and weight gain. Learn how to help without harm! Lori Brizee MS, RDN, CDE is available for consultations at Dr Erika Beard-Irvine’s office. Consultations are often covered by insurance. Lori likes to meet with parents of kids under 14 years, without the child present for at least the first visit