Preventing and managing overweight: A family approach

Gretchen is becoming concerned about her daughter’s weight: “She has always high on the height/weight charts (weight a little higher than height), but now she is almost off the weight charts. I think she generally eats healthy foods, but she does eat a lot! So are there any suggestions as to how I should treat this issue? I really don’t want to make things worse by focusing too much on food.”

Weight concerns are common, and rightly so: about 1 in 3 school aged children are overweight, and most of these kids will remain overweight or become more obese as adults. Our children live in a toxic environment with excessive calories galore and far less routine physical activity than kids enjoyed in prior generations. Our portions are too large; we eat too often at restaurants with huge serving sizes; and we inundate our children with media imagery and advertizing that glorifies calorie-dense (and nutrition poor) foods. Few children walk or bike to school, and few children spend their afternoons playing outside.

The good news is that for a preschooler, parents have many years to help form good healthy eating and activity habits. We’re not talking “diet” here—that’s a term that’s never been any help to anyone. The very concept of “going on a diet” implies that you’ll someday “go off a diet.” What you want to instill are healthy habits that will last a lifetime, not a diet that will last two weeks.

As you say, you don’t want to go overboard with this, and you don’t want to over-emphasize food and eating issues to the point where your daughter gets self-conscious. So do not mention weight, and don’t set any sort of “weight goals.” The best ways to help a child learn healthy eating habits don’t focus on individual foods, “diets,” or weight, but rather on healthy habits for the whole family.

Family meals are essential. We know that children who eat with their families make healthier food choices and are far less likely to become obese adults; they’re also more likely to get good grades, and less likely to experiment with drugs.

Beverages can be a hidden source of many calories. Children should routinely drink only skim milk (by age 2, and maybe earlier) and tap water. Save soda and fruit juices for snacks. If you can’t live without flavored drinks, go with a no-calorie substitute. Some people are leery of artificial sweeteners, but I promise for most people they’re far less harmful than high fructose corn syrup. Drink water before, during, and after meals.

Do not watch TV while eating. Kids will absentmindedly eat more, and they won’t even notice or enjoy the food. Eating should not occur anywhere other than at a table in the kitchen or dining room.

Try to cover as much of the plate as possible with foods that have less caloric density. This includes whole grains, fresh fruit, and vegetables. The highest-calorie foods are meats, cheeses, peanut butter, and other protein- and fat-rich items. These should not be the “centerpiece” of any meal.

Eat slowly, and have a nice conversation during dinner. Don’t talk about the food, other than to compliment the chef. Don’t use language that puts extra value on eating and food, like “You’re such a good eater!” People eat far more if they eat quickly—slow it down!

Avoid food contingencies, like “If you eat the broccoli, you’ll get a brownie.” In the long run, these kinds of statements elevate the brownie (making it more attractive) and denigrate the broccoli. What you’re saying sounds like “No one would ever eat that yukky broccoli unless they got a yummy brownie afterwards!” Kids who grow up in households with food contingencies are very unlikely to continue to eat the healthy food, but will continue to crave the reward food.

Snacks are fine, as long as they’re the same healthy kinds of foods offered at mealtimes. Avoid using the phrase or buying into the marketing concept of “Snack Food.” There is no snack food—it’s just food. Unfortunately, the term “Snack Food” really means “Crap Food”, and you don’t need to help the advertising companies get your children addicted to it.

Think about portion sizes when you shop. Huge bulk purchases may seem like a money-saving idea, but not if they encourage parents to prepare and serve more food than is healthy to eat.

This may sound looney, but it works: use smaller plates. A normal-sized portion on a dinner plate will look small, especially to those of us used to restaurant portions. Studies have shown that people will serve themselves less, eat less, and be fully satisfied with eating less if they use a smaller plate.

What other healthy eating tips have been helpful for your family? Post a comment here!

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Tags: child, diet, mealtimes, obesity, overweight, weight

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