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It is Irresponsible NOT to Put Your Overweight Child on a Diet

Parents who ignore their overweight kids' problems are as irresponsible as the physicians who misleadingly tell parents to wait for their obese kids to "grow into their weight."
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Parents who ignore their overweight kids' problems are as irresponsible as the physicians who misleadingly tell parents to wait for their obese kids to "grow into their weight." Once upon a time, kids developed baby fat before their growth spurts and then leaned out. That's not what happens anymore[1]. That advice is outdated. That advice could kill your child at an early age[2].

I am a pediatrician. I am a child obesity specialist. I have helped thousands of overweight children get healthy. I am here to tell you that obese children need to lose weight. And yes, that involves putting them on some sort of diet. In fact, it is IRRESPONSIBLE not to put your overweight child on a diet.

And you need to start immediately. Before your child hits puberty. It is much easier for kids to lose weight and sustain weight loss before puberty[3]. During puberty, body chemistry changes make weight loss harder; lower your child's calorie intake and your child's appetite increases and his metabolism decreases. Wait until then and you have set your child up for a lifetime of battling the scale. Start around age 6 or 7 and your child will learn healthy eating habits before she realizes she was ever eating the wrong way.

Our kids are getting heavier and unhealthier than ever before, yet many parents and doctors are reluctant to do anything about it. The facts are staggering. One third of children in our country are either overweight or obese and at risk for medical problems due to weight[4]. The number of possible causes are overwhelming: portion size, processed foods, unhealthy school lunches. It doesn't matter. Parents need to stop pointing the finger and trying to figure out "why" this has happened and "who" is to blame. We are responsible. Parents would rather talk to kids about anything besides weight[5]; it seems they are more afraid of causing eating disorders than they are of their kids dying young of heart disease. It is time for America's parents to wake up. We can no longer risk our children's health for fear of hurting their feelings. Our kids are obese, and unhealthy, and dying young. And we are responsible.

Parents need to stand up and make some changes. We need to acknowledge our children's unhealthy weight. It isn't going to kill them. In fact, it isn't going to even surprise them. Overweight children know they are overweight -- even if you haven't discussed it with them. Your overweight child is getting teased and scorned, whether he or she shares that information with you or not. This is your chance to talk to your child about it in the right way, using the right words. Don't talk about looks and don't mention fat or thin. Discuss your child's health. "Your weight is not the healthiest that it could be. We need to make some changes so we can all be as healthy as possible." And then the hard part starts. You have to actually make some changes.

Refusing your child a second piece of pizza will not cause an eating disorder -- regardless of what your neighbor or mother-in-law tells you. There is absolutely no evidence for this. In fact, it makes sense that treating an overweight child in a sensitive manner will decrease disordered eating[6]. It is the obese child who wants to lose weight but doesn't know how to do so safely that is most likely to start starving or binging and purging.

It is okay to tell your child he or she can't eat something. Fortunately, you don't have to do that all the time. Treats can (and should be) allowed in moderation. At Red Light, Green Light, Eat Right, we encourage our patients to eat two Red Light (unhealthy) foods each week. Once those are eaten, however, it is time to make healthier choices -- and go out and exercise. Our goal is to teach kids how to make healthy choices on their own. However, as a parent, you do have the right to set limits.

Just don't make those limits public knowledge. Child weight loss does not need to be discussed in public and children should not be publicly criticized for poor choices. We all pick the wrong foods now and again. When around others, allow your child to make a poor choice and move on. Save discussions for emotionally-neutral times when behavior can be reviewed without being criticized. Allow poor choices to become teaching points. Remember, everybody in the family needs to (re)learn how to eat healthy.

It is okay to admit that you don't have all the answers. Your children will respect you more for being honest with them than for pretending everything is fine when everybody can see that it isn't. You monitor what your child watches on TV; you monitor your child's Internet use; it is time to monitor what your child is eating.

1. Reports From the Agencies: Institute of Medicine (IOM) Early Childhood Obesity Prevention Policies. Washington, DC: The National Academies Press; 2011 Shelley McGuireAdv Nutr January 2012 3 1): 56-57; doi:10.3945/an.111.001347
2. Childhood Obesity, Other Cardiovascular Risk Factors, and Premature Death. Paul W. Franks, Ph.D., Robert L. Hanson, M.D., M.P.H., William C. Knowler, M.D., Dr.P.H., Maurice L. Sievers, M.D., Peter H. Bennett, M.B., F.R.C.P., and Helen C. Looker, M.B., B.S.N Engl J Med 2010; 362:485-493February 11, 2010
3. Okie, Susan M.D. Fed Up! Winning The War Against Childhood Obesity. Joseph Henry Press. Washington DC. P. 46
4. Ogden, C.L., et al. 2002 JAMA 299(14):1728-1732
5. "Birds and Bees Are Kid Stuff: New National Study Reveals Weight a More Difficult Talk Between Parents and Teens than Sex, Drugs" The Free Library 14 September 2011. 01 April 2012
6. Okie, Susan M.D. Fed Up! Winning The War Against Childhood Obesity. Joseph Henry Press. Washington DC. P. 59