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Concerned about your child's weight? Read this

Have you noticed that your child's body has changed during the pandemic? Did a visit to the pediatrician start a conversation about your child's weight?

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UNC Health
RALEIGH, N.C. — Have you noticed that your child’s body has changed during the pandemic? Did a visit to the pediatrician start a conversation about your child’s weight? Does your child’s percentile ranking on a BMI chart seem especially high?

If any of the above are true, don’t panic – and think carefully before you broach this topic with your child. You don’t want to inspire self-image issues or obsession with body size or appearance.

We talked with Camden Matherne, PhD, a licensed psychologist who specializes in eating disorders at UNC Health, about what parents should do – and not do – if they’re worried about their child’s weight.

Do: Encourage balance and moderation

Don’t: Put your child on a diet of any kind

When it comes to kids, it’s best to avoid calorie-restricted diets or eliminating any food groups, unless you’re working with a pediatric specialist. In fact, doing this can backfire, especially in children who are genetically predisposed to develop eating disorders. It is crucial for children to get the nutrition they need to grow their brains and bodies.

If your child’s provider expresses concern about weight gain, talk to the provider – without your child, if possible – about ways to introduce more nutrient-dense foods and healthy movement in your child’s daily routine.

If your child comes to you saying they want to lose weight, it’s important to have an open and honest conversation that focuses on the positive aspects of their body while they grow. Focus on how food and exercise help our bodies feel good, not that they help us become a certain size.

Do: Be aware of normal child body development

Don’t: Draw attention to changes in body size - for anyone

Children naturally experience changes in their bodies at certain developmental stages, including periods of weight gain. Parents may not realize this and become unnecessarily concerned, Dr. Matherne says.

If you notice changes in your child’s body, don’t point it out to your child, or let them hear you talk about it with others. Try to avoid commenting on the body size and appearance of others, too. Even things that seem positive, such as “Wow, you look like you’ve lost weight!” send children a message that there is a “right” kind of body.

Do: Understand the stresses caused by the pandemic

Don’t: Forget to eat and feed your family on a schedule

Many people have been more sedentary since the onset of the COVID-19 pandemic. When after-school activities, sports and play dates were all on hold, kids were naturally less active and therefore may have gained some weight. Typical eating routines often went by the wayside.

The pandemic has not been normal for anyone, so parents need to give themselves some grace during this difficult time, Dr. Matherne says. In most cases, once kids are back in school and activities, they will return to their typical size.

In the meantime, it’s important to keep fueling your bodies. Children and adults should eat every three to four hours, but only as much as they need to feel satisfied. Going too long without food can lead to blood sugar crashes and cravings, but eating regularly - and mindfully - can help children and adults feel nourished and prevent overeating.

Do: Embrace variety

Don’t: Label foods as good or bad

Parents can help children get the most nutritionally balanced meals by offering a variety of foods at every meal and snack. When choosing foods, think about fruits, vegetables, grains, proteins and dairy. It’s best to eat as a family, and make sure everyone knows they can listen to their bodies when they decide to stop eating. Enforcing a “clean plate rule” interferes with your child’s natural satiety signals.

Balance also means incorporating things like sweets on a regular basis. When a child is denied a food or certain group of foods, they may crave them more and then overeat when given the opportunity or begin to sneak foods.

That’s why it’s important to remain neutral about foods and not label them as good or bad. Instead of saying, “You can’t have soda. Soda is bad,” you can say, “Soda tastes good, but what’s in soda doesn’t help your body grow. So, we only have it on special occasions.”

This is an opportunity for parents to listen to themselves and the negative talk that comes up around food. If a parent says, “I can’t eat that cupcake, I need to lose weight,” or, “I’m cutting out carbs,” that makes an impression on a child. If a parent has a medical reason to modify their own diet, they should minimize discussion of it around their child.

The way you talk about food around children sets a foundation for their relationship with food.

Do: Create a positive family food culture

Don’t: Single out individuals

If you want to embrace a more balanced approach to eating, do so as a family. Don’t single out one child for special treatment. While you’re eating, talk about food in a positive way. Here are some examples of how families might approach it:

As a family, we have pizza on Fridays.

We eat together at the table.

We wait five minutes to decide if we want second helpings.

Isn’t this broccoli delicious? I love it.

Wow, I can see your muscles growing. The protein in this chicken is helping you to grow!

Movement is part of the equation as well. Families can do all sorts of activities together that focus on joyful movement and fun. Some examples include riding bikes, hiking or doing a scavenger hunt. Cultivating a love for movement is beneficial for children and adults of all sizes and shapes.

Do: Listen to your child’s concerns

Don’t: Ignore red flags

If a child is self-conscious or being teased about their weight, let them talk to you about it. “It’s important to listen to your children, really listen to them,” Dr. Matherne says. Hear them out and validate their feelings. “Stay present, listen calmly, and don’t jump to problem solving. Just listen, validate and remind them they are not alone,” she says. Here are some ways to validate your child’s feelings:

This is really hard. I’m sorry you’re hurting. I’m here for you.

This stinks. I’m going to be right here with you. We’ll figure it out together.

Having open two-way communication with your children around food and eating helps as they are introduced to more concepts around health and dieting as they age. They will hear messages from peers, advertising and adults that aren’t conducive to a healthy relationship with food. When you’ve laid a foundation for a more balanced approach, it can help protect your children from these messages.

If you notice a change in your child’s eating habits, such as eliminating an entire food group, refusing to eat something if they don’t have the nutrition facts, or obsessing about food, this can be a sign it’s time to get additional help. Contact your child’s primary doctor to discuss a referral to a dietitian or eating disorder therapist.