How Can You Get An Overweight Child To Lose Weight Without Talking Them Into An Eating Disorder?

We've all heard the talk about the "obesity epidemic" sweeping across the United States and many other developed and developing countries, an epidemic that is affecting increasing numbers of children and adolescents as well as adults. Childhood obesity has more than doubled in the United States over the last three decades — leaving 18 percent of six- to 12 year old children obese in 2012, as well as 21 percent of adolescents between the ages of 12 and 19, with many more being overweight but not obese. 

Those statistics are worrying, but they take on a whole other dimension if your own child is affected. As a parent, you want your child to be physically and emotionally healthy. You know that overweight children are more likely to also be overweight as adults than those children who are at a healthy weight, and you know that this places them at risk of type 2 diabetes, heart disease, and even certain cancers. 

You want to protect your child from these risks — but as an informed parent, you will also have heard that eating disorders are becoming more prevalent among children. The American Academy of Pediatrics noted a 119 percent increase in hospitalizations for eating disorders in the under-12 population between 1999 and 2006. 

By encouraging your child to lose weight, could you inadvertently be putting them at risk of developing an eating disorder instead? Even in the absence of an eating disorder, anyone who was overweight as a child knows that this is an incredibly sensitive topic: say the wrong thing, and you are in danger of making your child feel terrible, putting a strain on your relationship with them and perhaps setting them up for lifelong negative self-image feelings. 

First Things First: How Do We Define Overweight And Obesity?

As with adults, Body Mass Index (BMI) is the measure that is used to determine whether a child is overweight or obese. A BMI measurement is calculated by dividing weight in kilograms by the square of their height, in centimeters. In children, however, this number is compared to that of other children of the same age and sex in percentiles. Children whose BMIs are above the  85^th percentile are considered overweight, with those above the 95^th percentile falling into the obese category. This can be assessed by your child's pediatrician at a routine well-child checkup or during a separate appointment made specifically because you are worried about your child's weight. 

READ Guide to Upbringing Healthy Children

Should Your Child Go On A Diet?

One thing is clear: children, who are still developing, should never be placed on a weight loss diet without the strict guidance of a healthcare professional. Indeed, taking a very critical look at the whole family's eating and exercise habits and making family-wide changes that do not single your overweight or obese child out may be the best approach to healthy weight loss for your child. That does not mean you can battle this problem by yourself, however — getting your child's doctor in on the decision-making process is the best thing you could ever do.

Helping Your Overweight Or Obese Child Get Healthy

The Centers for Disease Control and Prevention (CDC) offers the following general tips for parents with overweight or obese children, tips that could very well apply to any family, regardless of weight issues:

• Encourage healthy eating habits for the whole family by offering a diet rich in fruits, vegetables, low- or non-fat dairy products, and lean meats, fish or non-meat proteins such as beans.
• Stick to reasonable portion sizes, removing the temptation of junk foods by not purchasing those items.
• Develop a family culture of physical activity, encouraging your children to play sports and limiting sedentary time to homework as well as leisure activities such as playing computer games or watching television — but no more than two hours a day!

In addition to these tips, remember that even juices labeled "100 percent fruit juice" are rich in sugar, and that not eating breakfast in fact increases the odds of weight gain.

What Else Can You Do?

OK, you already know you shouldn't yell at your child for asking for a donut, make fun of their body, or tell them hurtful things about how they would be able to fit into pretty clothes if only they lost weight. 

Balancing your child's needs to feel good about themselves and about their body with the need to get them healthy is tricky, and it is highly possible that you will accidentally say things that turn out to be very hurtful. As such, seeing a counselor — you, not your child — can help you gain tips that enable you to discuss your child's weight in a beneficial, rather than harmful manner. While you try to find the right counselor, here's one tip: always emphasize health above weight.

Positive Changes

Something far more powerful than talking about weight is living a new life with healthier habits, however. Our children are far more likely to do as we do than they are to do as we say. You can become a powerful ally to your overweight or obese child by being physically active together, and by making sure you have respect for the many benefits of that physical activity. Rather than seeing and portraying it only as a vehicle to enable weight loss, remember that sporting or walking in nature together reduces anxiety and stress, releases feel-good chemicals, aids academic concentration and work performance, and is a wonderful bonding opportunity for the whole family. Children who see that these changes are being implemented by the whole family and hear them talked about in a positive way are much less likely to feel resentful about the new routine.

The British NHS advises that all children be physically active in some way at least 60 minutes a day, and reminds parents that overweight children do not need more exercise than children who are at a healthy weight as "their extra body weight means they will naturally burn more calories for the same activity."

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Food, in fact, has a similar potential of being turned into a positive rather than negative experience. The right foods don't just make you feel healthy, but also, when eaten together during family meals, offer everyone the chance to enjoy time together, both while cooking and while eating.

Finally, if in doubt, consult your child's pediatrician. However, if your child is facing other health issues that are being ignored because the only advise you are getting is "lose weight", then it's time for a second opinion — doctors should never lose sight of the fact that overweight and obesity don't exclude the possibility of other medical conditions.