Elizabeth has always stood out. She’s a smart, engaged student, quick with puns that keep a class laughing. “She gets that from her dad,” says her mother, Robin. She’s beautiful, too, with big brown eyes, dimples, lightly tan skin, and chestnut hair.
Elizabeth also stood out because she was bigger than her classmates — taller and broader — even before kindergarten. Robin’s not sure where Elizabeth got the early height, but she got the heft from both parents, who were overweight as kids and have continually struggled with their weight.
So the family decided to eat healthier and add more dance lessons for Elizabeth. It worked. When she was in middle school, an annual checkup showed Elizabeth had gotten five inches taller and only two pounds heavier since the last check. For the most part, she had grown into her weight — just what her pediatrician wanted and what medical guidelines recommend for most children.
“She’s always been beautiful,” Robin says. “But she’ll gain if she doesn’t keep watching what she eats. Luckily, she’s always moving.”
A common problem
A few generations ago, overweight kids were an uncommon sight. But over the past 30 years, kids ages 2 to 19 have gotten much heavier — now, about a third of all children are either overweight or obese. On average, rates have leveled off in the past 15 years, but they’ve actually worsened for teens. And worryingly, kids who are very overweight are becoming even more seriously overweight. Some experts blame a perfect storm of convenience foods, sweet drinks, computers and video games, and cuts in school athletics programs, but we may never be sure how we got here.
What exactly does it mean to be an overweight or obese child? As with height and other measurements, children are compared to others their age and sex. A 10-year-old girl is considered overweight if her body mass index (BMI) is higher than 85 percent of all 10-year-old girls (85th percentile), and obese if her BMI is higher than 95 percent of her peers. BMI takes into account both height and weight, so two kids who weigh 70 pounds but are different heights will have different BMIs. You can check your child’s BMI and percentile here.
When a child is overweight, it can take a toll on kids and parents alike. Some kids might blame themselves, struggle with poor self-esteem, or sometimes feel overwhelmed by the choices they have to make every day. In the long term, obesity puts kids at risk for serious health problems like heart problems, type 2 diabetes, and asthma.
Over the past 15 years or so, experts have been trying different ways to tackle the issue of overweight and obesity in kids, from banishing soda from schools to rethinking how neighborhoods are designed. Along the way, we’ve learned a few things that work — and some that don’t.
Three ways to help
So many factors go into your weight — what you inherit from parents, what you learn, how your body works, how society treats you, what’s available in your community, and what you can afford, says Captain Heidi Blanck, PhD, Chief of the Obesity Prevention and Control Branch within the Centers for Disease Control and Prevention (CDC). The answer doesn’t boil down to such a simple “eat less, move more.”
What’s a parent to do? For starters, don’t push your growing kids to lose weight.
Unless your child’s doctor has said otherwise, the goal is to “reduce the rate of weight gain, while allowing normal growth and development,” says Blanck. Her comments are typical of a new way of thinking about weight in kids. It boils down to this: Focus on health instead of weight, keep the rules simple, and support each other as a family.
1. Focus on health, energy, and mood
“Modest changes in physical activity, nutrition, and weight can provide significant health benefits, even if a child never reaches an ‘ideal’ weight,” says pediatrician Natalie Muth, MD, author of The Picky Eater Project: 6 Weeks to Happier, Healthier Family Mealtimes.
A child may not be where they “should be” on the growth chart, Dr. Muth says, but if he or she “eats healthfully and is very physically active and is generally thriving, I am happy with that.” She hopes kids and their parents can be happy with that too.
In a recent study, parents thought it was their responsibility to communicate the dangers of fatness. But their kids said those kind of scare tactics weren’t helpful. What was helpful was encouraging healthy behaviors, like reminding them to eat healthy food and to go outside and play.
“What works best for families varies,” says Dr. Muth. “But in general, when people are trying to change, focusing positively on doing something new — versus taking something away — is often more motivating.” Interestingly, kids said they noticed they felt better when they were making healthy choices and they noticed they felt less grumpy and argumentative.
Robin says Elizabeth is still probably considered overweight, but she looks great in her dance outfits and fits into regular junior-size clothes. According to Dr. Muth, that’s success.
2. Keep the rules simple
Often, parents have trouble setting and sticking with new rules, and it can seem like a constant battle. And kids get frustrated with parents when they are inconsistent with the rules — like not letting them eat candy after four in the afternoon but having ice cream for dessert.
A solution for this may be to start with the basics and keep the rules very simple.
Have healthy food in plain sight. Get what your family will eat, and make it the easy choice. Robin keeps fruit-infused water on hand, and her family wants to drink it. Each day, she steams broccoli for salads or dinner because it’s currently Elizabeth's favorite vegetable and the only way she likes it. You’re not spoiling your kids if you do it how they like it — you’re helping them.
Keep temptations out of the house. That way, no one has to worry about making the “wrong” choice and you don’t have to be the food police.
But don’t ban goodies outright. Depriving your family can be frustrating, and it may ultimately have very little effect on weight.
“We don’t have cookies or ice cream in the house regularly,” Robin says. “But I don’t serve frozen grapes for dessert when we have a special dinner either. Who’s happy with that? It’s just not realistic.” When they do indulge for special occasions, they shop as close to the event as possible (see “keep temptations out of the house”).
Cook together. It can teach kids a useful skill, encourage them to eat the veggies they cook — and it’s fun! Involve them in planning the meals and grocery shopping too, so you have more chances to talk about your choices. Dr. Muth recommends the recipes section of chopchopmag.org, which focuses on teaching kids to cook with real foods.
Make it easy to be active. That’s one of the key ways that the Massachusetts program Shape Up Somerville has helped lower the rate of childhood obesity in their town. Part of the program worked on making better, safer environments, like bike paths and walking trails.
Robin admits they aren’t a family that naturally exercises together, but they have prioritized Elizabeth's dance lessons and encourage her to bike or walk with friends. She also sees her mom walking regularly and her dad doing yoga.
Limit screen time. While you probably can’t keep out all electronic screens, you can turn them off, prioritize unplugged playtime, and create tech-free zones or times, like during meals and one night a week.
Plan family activities. “Plan active outings where more walking will happen naturally — like going to the zoo. Take public transportation if you can because it often naturally includes more walking,” suggests Shape Up Somerville’s director Lisa Robinson, RD.
3. Support each other
It’s not easy being an overweight child. The heavier you are, the less you want to be active. Extended family members like grandparents may not always say or do supportive things. And your child may be bullied without you knowing it. That’s why Dr. Muth believes health should be a family affair. “No child should ever be singled out or given rules that other family members don’t have to follow too,” she says.
Of course, all of you may not have the same goals. The Shape Up program started with a lot of community input and involvement. Robinson says she and her staff always remember the slogan, “Nothing for us, without us.” It reminds them not to assume what others want, and to keep checking in to find out what’s working and what’s not. You can do the same with your family — ask what they want and find out how to help.
Sometimes the conversations may not be easy, but be positive, stay consistent, and praise the little wins. One day, they’ll be all grown up and making their own choices — let’s hope they’ll make good ones!
Editor: Deepi Brar
Sandy McDowell is a freelance writer based in Atlanta, Georgia.
Selected references
- Centers for Disease Control and Prevention (CDC). Childhood Overweight and Obesity. CDC website.
- Obesity Rates and Trends Overview. The State of Obesity, a project of the Trust for America's Health and the Robert Wood Johnson Foundation.
- American Academy of Pediatrics. Common Weight Loss Challenges. healthychildren.org.
- Schalkwijk AA, Bot SD, de Vries L, et al. Perspectives of obese children and their parents on lifestyle behavior change: a qualitative study. International Journal of Behavioral Nutrition and Physical Activity. Aug. 2015.
