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Kids and Weight: How to Have a Healthy Conversation

Last updated: September 18, 2024

Maybe you’ve noticed that your child has put on weight. Or perhaps your child’s health care provider has expressed concern about your child’s weight. Either way, it might be time to have an important conversation.

Approaching the subject can feel intimidating. Weight can be a sensitive topic. You may worry about harming your child’s self-esteem or hurting their feelings. It’s important to think through what you want to say and make it a healthy discussion.

National Childhood Obesity Awareness Month each September offers a good time to learn more about the impact of this increasingly prevalent youth health issue.

“We all want our kids to be healthy and thrive,” says Dr. Benjamin Duffy, an Obesity Medicine Specialist with ThedaCare. “With care and thoughtfulness, you can have a healthy conversation about weight with your child.”

Understanding Obesity in Kids

Kids struggling with obesity should know they’re not alone. Nearly one in five young people ages 2 to 19 are considered obese, according to the Centers for Disease Control and Prevention. In the United States, the percentage of children and adolescents with obesity has more than tripled since the 1970s, the CDC states.

For children, obesity is defined as having a body mass index (BMI) that falls at or above the 95th percentile for age and sex. Kids are overweight when their weight falls at or above the 85th percentile. Your child’s physician or advanced practice provider will help track this at their routine care appointments.

Contributing Factors

Childhood overweight and obesity are on the rise largely because of lifestyle, experts say. This includes limited physical activity — often due to excessive screen time — and overconsumption of unhealthy foods and drinks.

Genetics also can play a role. Children whose close family members are overweight or obese are more likely to struggle with weight. Hormonal factors, as well as certain medications, also can impact weight.

In addition, socioeconomic factors can influence a child’s weight. This can include living in a neighborhood with limited access to grocery stores or residing in a low-income area without a safe place to exercise.

“Take an honest look at each of these factors as you try to understand what may be influencing your child’s weight,” Dr. Duffy says. “A visit to your child’s pediatrician or family medicine provider can help rule out other factors that could contribute to weight gain. They can offer ways to help your child and family explore ways to maintain a healthy weight and lifestyle.”

Starting the Discussion

“Focusing on health — rather than appearance — is a good way to approach the conversation,” Dr. Duffy says. “Kids naturally associate weight with looks, particularly when negative stereotypes of weight are still prevalent. They may not realize that weight is a key indicator of health.”

Consider these 10 steps as you open the dialogue:

1. Don’t make negative comments.

This includes comment your child’s body, your own body, and anyone else’s. Offhand comments about other people can contribute to a general stigma about weight.

2. Focus on behavior, not appearance.

Emphasize the importance of making healthy choices such as eating fruits and vegetables, staying active, and getting enough sleep — rather than discussing the child’ body size or shape.

3. Know that stress can play a role in a child’s weight gain (or loss).

Factors such as social media may influence their sense of self-esteem. They also may be experiencing bullying at school.

4. Start with simple open-ended questions.

For example: “Is anything bothering you at school?” You also can ask how they’re feeling about their weight.

“This conversation will be easier if your child doesn’t feel judged,” Dr. Duffy says. “Make sure your child knows that everyone, including you, thinks about their weight sometimes. Weight management is part of taking care of health.”

5. Try to use first-person language.

I.e. “children who have weight issues” rather than “overweight or obese children.” This reinforces that extra weight is simply a physical challenge to overcome, rather than a quality to be judged.

6. Keep the conversation focused on health.

“You can talk about how carrying extra weight means the body works harder, and that can prevent your child from feeling their best,” Dr. Duffy says. “Obesity contributes to serious diseases like type 2 diabetes, hypertension, and high cholesterol, all of which are on the rise in children. Avoiding these diseases means your child will have more time to focus on the activities that make them happy and less time in the doctor’s office.”

7. Discuss the benefits of exercise and eating healthy foods.

These include mental clarity, increased energy, and healthy skin. Encourage your child to help choose healthy foods while shopping and to read food labels. Or visit a farmers market and talk about the different vegetables and fruits you find.

8. Encourage activity.

Help your child to get the recommended total of 60 minutes of physical activity each day. Set an example and participate in activities with them when possible.

You can ask your child what kinds of activities or sports they’d like to join. They’re more likely to stick with an activity long-term if it’s something they chose and enjoy,” Dr. Duffy says. “Share healthy time together by hiking, playing sports, or biking as a family.”

9. Limit screen time.

Excessive screen time can lead to decreased physical activity. It’s also frequently linked to mindless snacking on high-calorie, low-nutrient foods. Setting age-appropriate screen limits can help your child and family stay healthier and more active.

10. Model healthy behaviors.

This includes cooking and planning healthy meals together, eating at the dinner table rather than in front of the TV, replacing sugary drinks with healthier choices, and adding more fresh options.

“Having this conversation with your child may mean you must first have an honest conversation with yourself,” Dr. Duffy says. “Is it time for you to pursue a healthy weight? Is your child learning less-than-ideal lifestyle choices from you? You can get healthier together as a family, and your health care team is here to help.”

Connect to additional resources or use MyThedaCare to make an appointment with your child’s health care provider.

Tags: Childhood obesity Healthy Eating Pediatric Care sedentary lifestyle

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