When Carrie Grainger*, a mom of three from Peterborough, Ont., found herself picking out size 12 clothes for her eight-year-old daughter, Paige*, she realized it might be time to revisit whether her daughter was a healthy weight or it was something to worry about.
Grainger had always thought her husband’s husky build could be the reason for her first daughter’s slightly bigger shape. “And my doctor had mentioned that kids sometimes sprout out before they sprout up,” she says. But what if Paige was gaining too much too fast? The prospect of dealing with a weight problem was daunting. Grainger struggled with how to move forward. “I didn’t want to instill a bad body image in her—and I didn’t know for sure if her weight was even an issue,” she says.
Obesity is on the rise among young kids. “About 31 percent of Canadian kids between the ages of five and 17 are considered overweight or obese,” says Tom Warshawski, a Vancouver-based paediatrician and chair of the Childhood Obesity Foundation. According to the foundation, obesity is classified as abnormal or excessive fat accumulation that may impair health. Every child has a body shape that’s just right for them, says Warshawski, but parents might not know whether their child is just carrying a few extra pounds or if their health or well-being is at risk.
Kids who are overweight are vulnerable to a range of health problems, including type 2 diabetes, sleep disorders and mental health issues like depression. But while being overweight is a mental health risk, so is obsessing about diet, which makes this tricky territory for parents who are uncertain of how to address a potential weight problem.
“I think the last straw for me was when Paige came home from school and was complaining that she was the slowest kid,” says Grainger. “She said she hated running because she felt heavy and like she was standing out because she was really bad at it.” It’s not unusual for kids who are a bit bigger to struggle with physical activity or feel like they attract attention, says Yoni Freedhoff, medical director of the Bariatric Medical Institute, a nutrition and weight management clinic in Ottawa. “There is a very real chance of them having to worry that they will be made fun of while exercising because of the way they look when they run or jump or play sports.” Which, of course, can make them want to avoid exercising, compounding the existing weight issue.
Kids who are overweight or obese are at risk of high blood pressure and cholesterol, liver disease and respiratory problems like asthma. “They are also more prone to depression and anxiety,” says Warshawski. Just how serious of a mental health–related issue is obesity? Here’s an alarming finding: “We know that children who are obese rate the quality of their life lower than do kids who are undergoing cancer chemotherapy,” he says. Even those who are moderately overweight may have lower self-esteem and be at higher risk of being teased by their peers. “Weight is the number one source of schoolyard bullying,” says Freedhoff. Adding to the mental health toll, studies show that kids who are obese are also at risk of developing eating disorders. According to research published in Adolescent Health, Medicine and Therapeutics in 2016, about 25 percent of teenage girls who are obese turned to extreme weight-control behaviours, including induced vomiting and fasting.
Unfortunately, most kids won’t just outgrow their weight problems. Those who are overweight or obese often continue to be overweight or obese into their teens and beyond. “When you graduate from your teenage years overweight or obese, it’s extremely hard to turn around and get into a normal weight zone,” says Warshawski. Obesity in adulthood is associated with high blood pressure, stroke, heart disease and certain types of cancer. If the present trend continues with our kids, by 2040, 70 percent of adults will be overweight or obese, and the health ramifications will be widespread, says Warshawski.
We know that healthy kids come in a range of shapes and sizes, so how do you determine whether your child’s weight is entering the danger zone for their health? You can have your doctor calculate your child’s BMI to know for sure, says Warshawski, but regardless of your kid’s size, the advice is the same: Focus on nutritious meals and an active lifestyle. (See “Tipping the Scales in the Right Direction,” below, for specifics.)
If you do decide to talk to your family doctor, have the discussion privately, without your kid’s knowledge. The experts agree: It’s unfair to place any pressure on kids in regard to their weight. “Putting a focus on weight with a child directly risks their self-esteem, their body image and their relationship with food, and potentially sets them on a life of yo-yo dieting and frustration,” says Freedhoff. “If there is a weight issue, it’s for the parents to deal with alone, not the children.”
When you talk to a physician about your kid’s size, the doctor may use their height and weight to calculate their BMI. (Both could be taken in the office ahead of time, as part of a checkup, or done by you at home.) If your kid scores in the overweight or obese zone, and they are showing any signs of weight-related illnesses, like high blood pressure or joint problems, those are certainly cues to take swift action. Your doctor can provide some initial guidance, direct you to a weight management clinic or refer you to a dietitian who can help pinpoint some of your family’s diet pitfalls and assist with a healthy eating action plan.
Once Grainger decided Paige might need help to get her weight under control, she and her husband discussed the issue privately, and then she went to a dietitian—solo. “We weighed and measured the heights of all three girls at home first, and just said, ‘Hey, let’s see how everyone is doing,’” she says. “I didn’t want Paige to have any idea of why we were doing it.” Then she took the recorded numbers to the appointment, where the dietitian plotted them on the height and weight growth charts. Paige was in the 98.5th percentile for BMI. “The dietitian wasn’t too alarmed, because she wasn’t off the charts,” says Grainger. Still, Grainger wanted to make some changes right away instead of waiting until Paige got older, so she and the dietitian came up with a plan. Phase one involved a few changes to diet: “We’re a pretty clean-eating family, but we discussed serving dinner family style, instead of plating the kids’ meals, so they can decide what they eat and how much, so we’re not overfeeding them,” says Grainger. “And we also talked about limiting snacks.”
Making dietary changes is the best way to promote a healthy weight for your kids, say the experts. But to be successful and long-lasting, all diet changes have to be done together as a family. That means both parents and all children are on board with a new, more nutritious meal plan—not just the person who needs to lose weight. “You can’t look at little Jimmy and say, ‘You have a weight issue, so no pop for you, but the rest of us can have it,’” says Warshawski. “Expecting a child to make intentional behavioural changes in the name of health, in regard to food, which is a basic pleasure, is a very unfair expectation that many adults struggle with,” says Freedhoff.
Limiting treats for only the child who is overweight is also missing the bigger picture, which is that weight is just one marker of health. If one family member is showing signs of a diet that could use improvement, chances are everyone could benefit from a revised meal plan. “Unhealthy foods are bad for you regardless of your weight,” says Warshawski. “Let’s talk about good health, and let’s everybody embrace it.”
Making changes to improve everyone’s health is the best approach. In fact, you should leave weight out of it entirely, say the experts. The word “diet” need never be uttered, either. Even kids know it’s a term loaded with judgment—and it doesn’t lend itself to the positive outlook that should come with these types of lifestyle changes. “Frame it for yourself and your children that you are changing your eating habits so that everyone will have more energy to do the things they love,” says Nishta Saxena, a registered dietitian in Toronto who specializes in family nutrition. “It’s about gaining vitality, not losing weight.”
But just because you don’t talk about weight doesn’t mean you can’t teach your kid about developing positive habits for their health. By limiting how much you dine out, focusing on whole foods and skipping sugary beverages (including chocolate milk and juice), you’re showing them how to give their body the fuel it needs to grow well. Stepping back from the concept of so-called “kids’ food” is also important, says Saxena. “The chicken finger society we’ve created for kids is contributing to childhood obesity,” she says. “We shouldn’t be treating kids like they don’t have palates—they want delicious food, too.” It’s our job to introduce them to new flavours and a wide variety of nutritious foods.
Making healthy changes doesn’t mean you have to completely cut out sugar or delete Uber Eats from your phone, says Saxena. “I believe in moderation and making conscious, real-life choices.” Exactly what that looks like will depend on your specific circumstances, but she discourages families from placing total prohibitions on specific foods or food groups. “We can end up fetishizing certain foods, and then when kids get their hands on them, like at a birthday party, they’ll go wild,” she says.
One of the most important things you can do to teach your kid healthy habits is to lead by example, says Warshawski. That means sampling different dishes, as well as modelling good food habits (like not skipping breakfast) and removing screens and other distractions from the table at dinner time. Family dinners are more important here than most parents realize, he says. “Eating together as a family, instead of scarfing something down on the way to soccer practice, is associated with healthy weight and also a better mental health status.”
If you’re struggling to quit TV dinners and frequent trips through the drive-through, you may need to take a step back and look at the bigger picture—especially the family calendar. “Families often perceive that they don’t have the time. They do have time. They just aren’t prioritizing it well,” says Saxena. We’re busy shuttling kids to playdates, music lessons and sports in the evenings—making it hard to find time to buy, prep and cook nutritious food. Some families may need to make scheduling sacrifices in the name of nutrition. Remember, though, that this is an opportunity to spend time together and teach your kids a valuable life skill. “Shopping and preparing food with your children is quality time,” she says.
It’s also a good idea to take a hard look at any of your own food hang-ups and body image issues, because your kids will pick up on them more than you might realize. Some parents can benefit from personal nutrition or clinical counselling, depending on the issues they’re dealing with. Re-evaluating your family fitness also plays a role in developing a healthy lifestyle (though, according to Freedhoff, it’s only an estimated 20 percent of the weight management equation—for the most part, it really is about what you eat).
If you’re making changes but the weight isn’t coming off, get professional help from a doctor or dietitian who specializes in weight management, advises Freedhoff. He often sees families who are trying hard to help their kids but need guidance to zero in on the changes that will really help their individual situation. Whatever you do, don’t be discouraged—this kind of change is hard, he says. And that’s especially true for families struggling with other challenges, like financial strain, or mental or physical health issues.
Grainger thinks her daughter is motivated to make positive change, and she is, too. She has started working out at home more, and Paige has started joining her. “Paige wanted to take up horseback riding this fall and noticed she wasn’t as strong as she could be to do well,” Grainger says. “She’s expressed an interest in getting more fit so she can do what she wants to do, and that’s really positive.”
*Names have been changed