Children eat lunch at an elementary school in Paducah, Ky. Photo: The Paducah Sun via AP
health

As with adults, no easy way to address weight with children

13 Comments
By CANDICE CHOI

Red, yellow, green. It's a system for conveying the healthfulness of foods, and at the center of a debate about how to approach weight loss for children.

This month, the company formerly known as Weight Watchers provoked a backlash when it introduced a food tracking app for children as young as 8. The app uses a well-known traffic-light system to classify foods, giving children a weekly limit of 42 "reds," which include steak, peanut butter and chips.

Obesity is a growing public health issue that nobody is sure how to fix, and around one in five children in the U.S. is considered obese, up from one in seven in 2000. Childhood obesity often leads to adult obesity, and to higher risk for conditions including heart disease, cancer and diabetes.

Getting kids to eat well and exercise is crucial, but figuring out how to do that effectively is extremely difficult — and sensitive. For some, the app was a reminder of bad childhood experiences around weight and shame, in public and at home.

"I don't think we appreciate the bias and stigma that families struggling with weight face," said Dr. Stephanie Walsh, medical director of Children's Healthcare of Atlanta. That can make it even more stressful for parents worried about their children's health, she said.

There is no easy answer for achieving a healthy weight, regardless of age. But when it comes to addressing the topic with children, pediatricians and dietitians say there are best practices to consider.

TALKING IT OUT

Parents may feel a conversation is not necessary, particularly with younger children, and that they can alter behavior by making lifestyle changes. But experts say a talk can be constructive, especially if the changes are going to be noticeable.

The key is to approach the subject with kindness and caring, and avoid blaming any of the child's behaviors. Children should also understand that any changes would be intended to make them feel better, and not about how they look.

As uncomfortable as addressing the issue may seem, failure to do so may make a child feel worse if they're being teased at school or feeling bad about themselves.

"In some ways, just to get it out there may be sort of a relief," said Tommy Tomlinson, an author who recounted his lifelong struggle with weight in "The Elephant in the Room."

MAKING CHANGES

Any adjustments to meals and activities should involve the entire family, so children don't feel singled out. This is tied to the belief that the most powerful way to help a child change their behavior is by setting an example.

Framing changes in a positive light is also key, Walsh said, whether that's suggesting new recipes to try together or asking about activities they might be interested in.

"Keep things upbeat," she said.

Then there is the matter of giving guidance on foods. Parents might not like the idea of directing children to a dieting company's app, especially since it gives older children the option to "upgrade" to a coaching service that costs $69 a month.

The company that now calls itself WW says the app is based on Stanford Children's Health's Weight Control Program, but views vary on the traffic-light system.

Dr. Sarah Hampl, a pediatrician specializing in weight management at Children's Mercy Hospital in Kansas City, Missouri, said it can be an easy way to understand a complicated topic. Experts say the system can help adults eat better as well.

But Kaitlin Reid, a registered dietitian at UCLA, said it's a way of classifying foods as good and bad, which should be avoided. Seeing any foods as bad might result in feeling guilty whenever eating them.

WHAT TO AVOID

When Tomlinson was 11 or 12, he was taken to a doctor who gave him diet pills. Few health professionals would do that today, and there's broad agreement on other mistakes to avoid.

Using the word "diet," for example, could imply there's something wrong with the child, and that the changes are short-term.

Trying to scare children by warning them about potential medical problems isn't helpful either. And if parents are making broader lifestyle changes, they shouldn't feel the need to intervene or scold every time a child reaches for a sweet.

"Guilt and blame are not good motivators for change," said Stephen Pont, associate professor of pediatrics at the University of Texas Dell Medical School. By the same token, experts say parents should avoid making negative comments about their own bodies.

Regardless of whether parents see noticeable changes right away, Pont said, there are long-term benefits of instilling healthier habits in children.

© Copyright 2019 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

©2019 GPlusMedia Inc.

13 Comments
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Its not the kids, its the adults that are the problem. Just as soon as the adults start preparing healthful meals for the whole family and making sure the family gets enough daily exercise, the weight problems of the kids disappears.

7 ( +7 / -0 )

Parents ideally lead by example and exercise together. Also parents are usually the enabler by buying junk food.

8 ( +8 / -0 )

Supermarket Trolleys should also be smaller.

Unhealthy items getting far more discounts than the heathier ones, making it easier to choose between two.

Because of above two, people keep putting the unhealthy foods full of trolley. I was shocked when i saw these as normal in UK. Everything seem like double.

-2 ( +1 / -3 )

Just a suggestion. Try less (hours of) Fortnite and untold number of boxes of Hot Pockets a day (i.e. "automated child-care"), and more veggies and a few miles of roadwork with the family, then maybe we'd have less kids with Type II diabetes by age 11?

I know...dumb idea. Threw it out there to see if if it'd stick to the wall or not.

3 ( +3 / -0 )

If the children are younger then this is simply a matter of the parents needing to take charge and set a good example themselves. Insist on serving and eating a healthy well balanced diet and limit junk food and snacks.

Overeating teens are harder to handle but it can be done.

Whether it's overweight kids, teens or adults it is not fat shaming to confront the problem by bringing it up and suggesting solutions as long as it is done respectfully and sympatheticly. Obesity kills, so you might be saving your child or loved one from chronic sickness and an early grave.

2 ( +2 / -0 )

When I was working in primary care you'd often get children in whose chronic health problems, like diabetes and asthma, were exacerbated by being very overweight. When you would try and discuss the issue with the parents they would often go ballistic, refusing to accept that weight was the issue, in fact many parents would not even acknowledge their child was over weight. Parents often underestimate how much or little they feed their child and how over/underweight they are. Ask any health care professional that works with kids, they'll tell you similar stories.

2 ( +2 / -0 )

Guilt and blame are not good motivators for change," 

Fair enough, doesn't mean parents shouldn't tackle the problem head-on and tell the kid he's eating too much crap, not exercising enough etc.

The 'parents shouldn't be too direct' fluffy approach is imo part of the problem. If mum and dad don't feel comfortable addressing the pbm who will?!

Stop buying his/her fave cookies, peanut butter etc and start running, cycling, playing footy etc with the kid.

4 ( +4 / -0 )

Very very simple : kids are kids, they shall ask before eating anything and same with money about how it can be spent.

No food or money in excess, no overweight.

I always say (sorry for the picture) : you never saw any obese prisoner in any concentration camp.

Parents (or very close family) are the guilty ones,

My parents would never buy junk food in excess (or hide it very well ! Learned that when older).

-1 ( +0 / -1 )

Not enough exercise, too much time sitting still playing video games, watching TV. Too much snack type foods.

2 ( +2 / -0 )

It's a simple one that Japan does, but get them to walk to school. Do not build communities where children cannot do this due to freeways in the way.

Unless it's fake and bulked up with palm oil and sugar, I doubt "peanut butter" is making kids fat. It's a healthy food that should be at least 95% nuts.

As other commenters point out, the problem is likely to be more poor diet than insufficient activity. Its much easier to watch what you eat than do some crappy snack food's worth of running. It will be much further than most people think.

1 ( +1 / -0 )

Tough love is what is required

1 ( +1 / -0 )

as for adults, they,re adults, they can make their own choices. as for children, they,re the future so we need to take care of them and it,s never too late for that. change always need to start at home, parents, family members. education also means teaching them how to have a healthy lifestyle - being able to take care of themselves (their health). at school, same thing. schools and families need to genuinely care about children, that means to make some rules; school lunch for example. at home, parents need to stop buying bad food (at least everyday or almost everyday). also children need to get used to physical exercise, so make some kind of schedule, whether at school or anywhere with family and friends. also, enough with sitting all day long playing games or watching tv (Pokemon Go is a good idea). they,ll get used to it (everyday, little by little), they,ll become more healthy/active. if nobody does anything until they,re pre-teens, then it,s too late to change their lifestyle.

2 ( +2 / -0 )

It's simple---eat less.

1 ( +1 / -0 )

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