During an annual visit to the pediatrician, the doctor reports that your child’s body mass index is way too high. “The diet starts today,” you declare on the drive home, and immediately set to work ridding your house of chips, candy, and processed foods. For weeks, family dinners are low-fat, high-vegetable affairs, and desserts are a thing of the past. There are arguments, tears, and power struggles, but you hold firm. Still, you notice that your child does not seem to be losing weight, and, it seems, might even be getting heavier. Then, one day, as you’re searching for a lost library book, you glance under your child’s bed and find a stash of candy wrappers, chip bags, and empty pop bottles.
What now?
The struggle over childhood eating habits and body size is an increasing source of conflict for many families. Worried parents are aware of the health implications of obesity for children and adolescents, which can include risk for diabetes, heart disease, hypertension, asthma, and sleep disorders. Yet parents continue to struggle to find workable ways to help their children find healthful ways to eat, move, and live. Many are turning to a growing body of expert opinion that restriction-based diets not only won’t work for children—they might even make things worse.
Everyone has an opinion
Last year, Dara-Lynn Weiss published a widely discussed essay in Vogue, chronicling her experiences in putting her then-obese seven-year-old daughter, Bea, on a diet. She has since published a book, The Heavy: A Mother, a Daughter, a Diet, which has generated strong reactions on both sides, with opinions ranging from harsh criticism to fulsome praise. Christine Carter, author of Raising Happiness: 10 Simple Steps for More Joyful Kids and Happier Parents, reacted to the book this way: “Have you ever been ‘that mother’? You know, the one who others criticize or question? If so, then you know what incredible courage and daring it can take to raise a child in a way that doesn’t always meet other people’s expectations.” Many others came down hard on Weiss’ parenting choices, fueled by the harsh judgment that surrounds women on issues of motherhood, food, and body size.
Binge-eating two-year-olds
Katja Rowell, M.D., is a St. Paul-based family doctor turned childhood feeding specialist. She is also the author of Love Me, Feed Me: The Adoptive Parent’s Guide to Ending the Worry about Weight, Picky Eating, Power Struggles and More. Dr. Rowell reports that she observes “weight worry” in parents with children as young as infants, often starting with concern over “fat baby” comments, and escalating from there. She currently works with children as young as two- or three-years-old who are food-obsessed and eating as much as they can, whenever they can. “Restricting food can set off a cycle of anxiety and overconsumption even in adults, but especially in children,” she says.
“Trying to get kids to eat less, whether it’s a diet, portion control, or only allowing ‘green light’ goods, often heightens a child’s interest in food and disrupts normal development. It buries inborn skills of being able to listen to cues of hunger and fullness coming from the body.”
One mom’s perspective
One of Dr. Rowell’s clients, who asked not to be named, has struggled, and succeeded, in helping her daughter and family have a healthier approach to eating. In infancy, her daughter gained her birth weight back in her first four days of life, and was always an eager eater. A lactation consultant warned the mom against her every-two-hour feedings, saying the baby was “not a newborn anymore!” She says that after that incident, “I became very conscious of how much food my child was eating, and was sensitive to people’s comments about how ‘big’ she was. When she was four years old, I sought out Dr. Rowell, who helped me realize my child was getting all the nutrients she needed through an excellent diet, and in the perfect amounts that she needed.”
Still, the process has not always been easy. “Learning to trust my daughter completely at meal times was difficult. Eventually, I was able to let go of my worries. Now we prepare the meal and she can eat as much of whatever she likes on the table, no questions asked. We developed a system, like saying ‘the kitchen is closed,’ in between meals. We are a happy family sitting at the table now. Our meal times are all about enjoying the time as a family, being mindful of that present moment and grateful for sharing a delicious meal.”
She reports that her daughter, who had typically been in the 80 to 90 percent range for weight, is now in the normal range. And as she reflects on what she’s discovered, she says, “My path began with learning to trust myself as a mother. I learned that if parents provide kids with a balanced and nutritional diet, there should be no concern.”
Focus on behavior
There are many experts who support an approach to helping kids grow up with a healthy relationship toward food. Jillian Lampert is the Senior Director of Business and Community Development for the Emily Program, which offers treatment for eating disorders in residential and outpatient settings in the Twin Cities, Duluth, and Seattle. “The biggest worry I hear from parents is ‘I don’t want my child to be fat.’ I never hear, ‘I’m concerned about their arteries.’ In our culture, being fat carries a huge stigma, and parents want their children to avoid that.
“If you think your child has a weight issue, remember that what you’re trying to change is a behavior. Body size is not a behavior, but eating and moving are. Don’t focus on the weight,” Lampert advises, “just stay focused on the behavior.”
Lampert says that parents must help kids understand the concept of “eating until you’re satisfied, and then stopping, because you know you’ll be able to eat again soon. When we restrict kids from having certain foods, that’s when they’ll do something like go to a friend’s house and gorge on cookies, because they think they’ll never see another cookie ever again.” She also stresses the importance of activity. “Get yourself and your kid outside, moving and having fun—play kickball, play tag, go swimming.”
No more candy wrappers under the bed
“It’s important to get rid of the guilt and shame that are often associated with food,” says Dr. Rowell. “If you’re finding candy wrappers under your child’s bed, then bring those foods out from under the mattress and into the light of day. Sit down, have a cup of milk and enjoy that food, together.”
RESOURCES
Competent eating
Dr. Rowell offers the following strategies for raising a competent eater:
• Divide responsibilities: The parent decides what food will be served, when, and where. The child decides how much to eat.
• Enjoy family meals at the table: For kids under five, have a sit-down, distraction-free meal or snack every two to three hours, and every three to four hours for older kids.
• Breakfast matters: Make time for it, every day.
• Turn off the screens: No television in your child’s bedroom, and daily screen time should be limited to two hours.
