I loved reading the article in the winter issue of Northwest Health on kids and obesity. Many of my colleagues are passionate about this growing epidemic and contributed to the content of this article. Some things really resonated with me.
Obesity is something that I see more and more in clinic these days. American kids truly are heavier and less active than at any other time in human history. I am also beginning to see associated diseases, such as high blood pressure and glucose intolerance, more often now than I did when I started over a decade ago.
A child’s weight can be a challenging and sensitive subject to broach with families, at times. Even though it is never my intent, my words can be taken as an attack on parents’ parenting skills. Personally, there are times when I handle the conversation well and other times when I clearly wish I had the opportunity for a do over.
Ironically, on a daily basis, I will have a family come in with a child who is growing in a perfectly normal way and tracking along a consistent and stable percentile. But they still have the concern that their child is underweight. Quite often it can be the grandparents with the real concern, but unfortunately they are not the ones sitting in the room with me. I really do echo the sentiments of Dr. Nalini Gupta, in Spokane, “The problem is so pervasive that a lot of people no longer seem to know what a normal-weight child should look like.”
I fully agree with Dr. Paula Lozano when she says that the good news is, it’s not a mystery how we got this way. She goes on to say that we need to eat less and move more. Unfortunately, this is something that can be very difficult to actually deliver on. “We all try to be good parents, but in this environment, we need to be super parents.”
In fact, recently at our South Region pediatric meeting, we had one of the physicians give a talk about how to have a meaningful conversation with families during a clinic visit. For pediatrics, prevention is the key, and in the case of obesity, prevention is far easier than treatment. There are things that we primary care providers can start doing at a very early age to give parents more tools and guidance on how to feed their child. Our focus today was to get us on the same page as a group so we are all giving a more consistent message on the prevention front at a very young age.
The cliff notes version of what we discussed at the meeting is that as parents, when it comes to food, we are in charge of what our child gets to eat, where they eat, and when they eat. The child gets to be in charge of deciding if they are hungry or not for a given meal or snack. This helps a child learn to follow their own hunger cues. If they aren’t hungry then they should never be forced to eat. My own daughter chooses not to have dinner at least once a week and we are perfectly fine with this.
In clinic, I will occasionally ask a parent about their own eating habits. Who knows better than they do whether they are hungry or not? Why would it be any different with their child? The light bulb often goes on at this point. Our job as parents is to provide healthy and nutritious food. To prevent grazing, we should dictate when it is mealtime and when it is snack time. We also need to set the expectation, and model the behavior, that all meals and snacks are eaten at the table and with the television turned off. There’s also so much to be said for gathering the family whenever possible for family dinners, which not only helps kids eat better, but helps strengthen their emotional health, as well.