What to Do if No One Is Helping Your Child with Obesity

Source: Daniel Conley

Talking with children about weight gain is tricky. There is no simple script or approach that will help caregivers navigate this kind of conversation. Speaking with a child about their weight is just like speaking to anyone about their weight—your words need to be balanced, kind, necessary, and true. Also a caregiver must prepare by being clear about their intent, considerate of the timing, and have a good understanding of their child's social and psychological development. With that said, it is my, and a growing number of experts, opinion that we should discuss weight with children. When we fail to kindly and compassionately discuss children’s weight gain, their feelings about gaining weight, how they are experiencing the added weight, we may be neglecting an important experience in their development.

And sadly, our silence does not protect them from bullying, from feelings of unworthiness, from social isolation, or from sexual predators who may perceive them as older than their biological age due to early puberty. What is most concerning is the relationship between bullying and suicide, especially in youth with obesity. Children with weight-related teasing or who experience bullying are two to three times more likely to report thoughts of suicide or to engage in self-harming behavior, such as cutting. This is an alarming statistic.

Children with obesity face weight-related stereotypes, social exclusion, and discrimination. Often they experience bullying and insensitivity not just outside the home, but in it as well. When parents, even those with the best of intentions, attempt to address weight gain with their child, they may unintentionally contribute to feelings of depression, anxiety, low self-esteem, and poor body image. Dads have said to me, “This is embarrassing, but why does my eight-year-old son have breasts?” Mom’s are worried about early puberty and how they can protect their 9-year-old who just started menstruation and has the body of a developing preteen. Parents want to learn how to talk with their children and their pediatricians about these taboo issues and others such as latent bed-wetting due to sleep apnea and Type 2 diabetes.

The big secret is that researchers and experts know that obesity isn’t a willpower problem—it's a physiological problem. Starving somebody thin works temporarily, but the body is too smart and will eventually take over by lowering metabolism and increasing hunger. Getting medical help for a child that is gaining too much weight isn't taking the easy way out. It may be the only way out. We need to help parent’s find the right doctor, talk to them in a way that will help their child, and understand when to move on to show clinicians they are serious about managing their child's health.

Children dealing with extra weight need resilient, compassionate advocates. Children need good medical help, kindness, and compassion. In this pandemic of obesity, we should have obesity clinics in every neighborhood, within walking distance from schools, accessible to parents and caregivers during their non-working hours. Obesity prevention education needs to be part of every prenatal visit and postnatal visits. Obesity screening should be done every quarter, not only during yearly well visits, when it may be overwhelming to learn your child has gained twenty pounds more than they should have.

Some parents, like Deb Rappaport, of Treat Kids, recommend parents become their own family's obesity expert. Here are her four reasons why:

1. Obesity specialists are hard to find but you can start here. And if you can’t find a specialist, you may need to educate a willing clinician. The 2019 Obesity Medicine Algorithm is a good place for a clinician to learn best practices.
2. Treatments and responses vary. Clinicians recommend different diets, medications, and frequency of visits. You’ll want to know enough to ask what they recommend to patients and to ask for changes if your child isn’t getting better.
3. Children's growth patterns and schedules can be a roller coaster. As a parent, you can remind kids that while growth spurts during puberty, they can control their sleep and how they respond to stress.
4. Compassion is essential to combating feelings of blame and shame. Parents need to understand that too much hunger and too little movement isn’t their or their child’s fault. Obesity is a metabolic dysregulation and is not caused by a child’s lack of willpower.

Parents must keep searching and not give up hope until they find the right combination of things that will help their children and help them feel like confident, capable, compassionate parents again.

We can do better by our children—and we must; the consequences are too great. The risk of having even one child feel unloved and unsafe is heartbreaking, unnecessary, and unacceptable.