We were out at our favorite Mexican restaurant when the conversation at the next table caught my ear. A young boy, probably about 4, had only eaten half of his rolled taco and declared he was full.

“You have half of it left, look at all that meat inside,” the mom said. “Finish it!”

The boy went on to finish the rolled taco and the dad chimed in with “I’m proud of you, son.”

What these parents didn’t realize was that they are teaching their son that his fullness doesn’t matter — and that eating more is better.

Do parents really want kids to eat like adults?
I understand why these parents did what they did. I’m sure the boy, like a lot of 4 year olds, doesn’t eat many protein foods so the mom feels better even when he eats items like rolled tacos. He probably has days he barely eats and days he eats a lot — they want his eating to be more “normal.”

The problem with normal eating, at least in this country, is that most people have difficulty navigating the current food environment without over-eating.

Yet most kids do well naturally. Research show that kids under 5 regulate their intake very well. Food intake may vary greatly from meal to meal, but young children are masters at getting the right amount of food for their bodies.

That is, if parents served balanced meals and allow children to be in charge of how much they eat.

Why it’s so hard to raise an intuitive eater
I’m the first to admit that raising an intuitive eater is hard. Society tends to accept the story above — it’s pretty commonplace for parents to get kids to eat more, or less if it’s unhealthy fare. According to a 2007 study published in Appetite, 85% of parents they try to get their child to eat more at mealtime by using reasoning, praise and food rewards.

The biggest challenge, I believe, is the psychological one. As parents we want so badly to nourish our kids that we often get lost in that desire. We fail to see the big picture and the negative consequences that our actions can have over the long-term.

I work hard to make sure my 4-year old (Big A) has an appetite for meals at home. But when we go other places, like out to dinner with friends or parties, she often snacks on what I call “appetite killers.”

When this happens — and it’s finally time to sit down to dinner she usually takes a few bites (or none at all) and is done. People often give me the look that says, “You’re going to let her get away with that?!”

But if I make her eat more of the meal, what am I teaching her? It’s better to over-eat? I do talk to her, ahead of time, about saving her appetite for the meal. And when she says she’s done I make sure to ask her if she’s full.

The bottom line: I make a point to honor her hunger and fullness, even the times I’m disappointed she didn’t eat better, because I want her to grow into an adult who does the same.

Use your kids’ eating behavior as a mirror
We are role models for our kids…they are watching us. Big A will usually come up to me and ask, “Why did you stop eating ice cream.” or “why aren’t you eating.” And I tell her it’s because I’m satisfied or preserving my hunger for the meal.

How often do you fill up on food when out, only to go and finish your meal anyway? Maybe these little kids are on to something.

While kid’s eating-behavior can drive us crazy, the emotion it stirs in us can be used as a mirror to what’s really going on. Maybe we are too controlling with our own diet or eat past fullness and ignore our body’s signals?

Either way, we need to remember that we live in a crazy food environment where single food (restaurant) portions are big enough to feed a family of 4 — and appetite killers are everywhere.

We need, more than ever, to preserve kids’ natural ability to regulate food — and to adopt this approach ourselves. We’ll be much better equipped for eating well in the modern world. And if enough people do it, maybe portions (and appetite killers) will shrink too. I can dream, can’t I?

So tell me, how do you handle your child’s ever changing appetite? Any challenges?

References
Orrell-Valente et al. “Just three more bites”: an observational analysis of parents’ socialization of children’s eating at mealtime. Appetite. 2007;48 (1):37-45

I recently took Big A to the hairdresser, and, as usual, she didn’t want to get her hair washed. The hairdresser kept pushing it until I finally said, “Maybe there’s something we could entice you with, sweety.” While I was quickly brainstorming a reward, like a book, the hairdresser quickly chimed in with, “A lollipop — you can’t have a lollipop unless you get your hair washed.”

Before I could say anything Big A moved (more like sprinted) straight into the hair washing seat. As she was getting situated she got scared and told me she didn’t want to do it. The hairdresser said in a sing-songy voice, “Well, then you won’t get a lollipop.” And then Big A checked in with me: “Mom, can I still get a lollipop?”

“Yes, sweety,” I replied. The hairdresser glared at me, with a look of disbelief, and I told her that as a dietitian I can’t use food as a reward and then apologized.

What’s the big deal?
I touched on this topic of using food as a reward in my managing sweets series but I see it happening so often that it bears repeating. The truth? If I didn’t know what I know about nutrition, food and behavior, I would probably reward Big A with food. No doubt it would work. I’m sure she would do lots of things to get the sweet treats she loves — eat broccoli, do chores, be calm at the grocery store and even get her hair washed at the kid salon.

While I think a lot of parents know that using food as a reward isn’t the best strategy – they do it because it works in the short-term. As I discuss in my Best-Kept Secret to Raising Healthy Eaters, when we are short-term focused with feeding, we are more tempted to employ feeding strategies that are counter-productive for kids’ eating down the line.

We know from research that using palatable foods as a reward makes them even more appealing to kids. And on the opposite end, using healthy food as punishment, to get the reward, makes kids less interested in the healthy food.

But the real question, and the purpose of this post, is what does this do for kids’ relationship with food in the super long run?  You know, when they are adults making their own food decisions.

Kids who see food as a reward may turn into adults who seek food rewards
A 2003 study in Eating Behaviors, 122 adults were asked about their current eating habits along with their memories about food rules as kids. The adults who recall parents using food to control behavior through reward and punishment were more likely to use dietary restraint (restricting food practices such as dieting) and binge eat.

As a dietitian who has worked with adults for many years, I’ve seen how this plays out in adulthood. Many of the people struggling with eating and weight often see food as a reward for their hard work and stressful life. In fact, nights, when the busy day is finally done, seem to be the toughest. After dinner, people find themselves back at the fridge often grazing all night.

Is using food as reward or punishment during childhood the cause of this? No. While there is some research showing a link, this doesn’t prove cause and effect. But it makes you think about the association kids make with food, beyond hunger and enjoyment, and how they take this with them into their adult lives.

As parents, we help our kids develop the lens through which they see food. Will they see snacks as something to do when they watch TV or are bored or will they snack as a way to refuel between meals? Will they seek sweets as a reward for their hard work or look for other constructive ways to feel good?

The more frequently parents use food as a reward or punishment, the more likely it is their kids will grow into adults who eat in the absence of hunger. For more on this subject see 5 Times You Should Never Feed Your Kids.

Sometimes parents need a free pass
But just like anything, if we reward or punish children using food once and a while, it probably does little harm. When I was visiting some close friends up in the Bay Area awhile back, I had Big A with me. The kids were done with dinner and getting antsy while the adults wanted to hang out and talk. One of my friends mentioned getting ice cream to hold off the kids. I totally agreed and they joked that Ellyn Satter wouldn’t approve.

I told them she would totally understand that these things happen from time to time. But instead of telling Big A she had to be “good”to get her ice cream, I gave her the choice. I told her we could leave now or we could stay and talk….and get some ice cream of course. And she made the choice to stay.

So tell me, what have your experiences been with rewarding your kids with food? Did your parents do this when you were a kid?

References

Puhl RM, Schwartz MB. If you are good you can have a cookie: how memories of childhood food rules link to adult eating behaviors. Eating Behaviors. 2003: (4) 283-293.

Q: My 6 yr old daughter is not overweight, and is actually tall and quite thin. She LOVES to eat, all the time. She thinks about food and talks about food very often. My real concern is that she always eats 100% of what is given, and if allowed to have more (I usually don’t offer), she seems to honestly have no limits. She especially loves sweets. I’m concerned about how emotionally attached she seems to food, and mostly, that she does not seem to have an ability to notice fullness. Can you help me?

A: I follow the advice given by internationally recognized feeding expert, Ellyn Satter, RD, LCSW. She has some great books available such as Child of Mine: Feeding with Love and Good Sense and Your Child’s Weight: Helping Without Harming. Her division of responsibility (DOR) of feeding is supported by the American Academy of Pediatrics and American Dietetic Association.

If you are not already familiar with it, DOR basically says that parents decide the “what,” “when,” and “where” of feeding and children decide the “how much” and “whether” of eating. The idea is that children know how much food to eat when provided with a variety in structured settings (regular meals and snacks at the table). While most parents complain that their young children do not eat enough, in some cases, a child might need much more food at mealtime.

When children want more and don’t get it, they can become obsessed with food and eat more when they get a chance (especially when parents aren’t around). And sweets are even more attractive because they are rich in calories.

I recommend that you provide meals for your daughter and when she’s done ask her if she wants more. Continue to feed her until she says she’s full. At first she’ll probably eat much more because she can, but after a while she will get the idea that she can have enough food and will eat as much as she needs (which still might be a lot for her metabolism).

The same thing goes with sweets. Offer them once or twice a week (at the table) and let her have as much as she wants. Assure her that she can have more another time.

Research shows that restricting intake and limiting access to sweet foods increases children’s preferences for such foods. What happens is something called “scarcity” where children feel food is scarce and want more. My dad was like this because he grew up poor and didn’t have regular access to food (he ate all of our leftovers). I don’t believe you are overly restricting her, just not allowing her to have more if she wants. But if she has a really high metabolism (being tall and thin) and is still hungry after eating what you serve, this could create scarcity for her.

Children also need a little more fat than adults so it’s okay to have butter with bread and regular cheese. Protein foods (eggs, chicken, fish, meat) are more satiating so you’ll want to make sure you are maximizing these items at mealtime. For example, cold cereal and fruit probably wouldn’t be enough sustenance for her in the morning.

You also can help her realize when she’s full by asking her, when she says she wants more, if her tummy is full. If you see her turning to food to deal with problems, encourage her to use non-food ways to solve them.

Response: I just wanted to tell you, your words really hit me–in a good way. I started that very day asking my daughter if she would like more after she finished her plate. It’s been 3 days, and I have offered more at every meal, and she has said yes each time. I have given more fruit or vegetable, and she eats all of it and then says she’s full now. I really feel a lot better, giving her the responsibility back to make the choice. And I can see in her face a change–she feels like I am trusting her to make a decision. This is really big for our relationship, and I already feel so much better not having food be such a weighty issue between us at this age.

Got a nutrition or feeding question?  Ask Maryann

This information on this site is for educational purposes only and does not take the place of medical advice. Please verify with your healthcare provider.

It’s bath time.  My 3-year old daughter stands naked in front of the mirror dancing, singing and relishing each movement her body makes. One thing is obvious: she loves her body (and herself) in the most pure way. 

I want to keep her like this forever but I know there will come a day when she’ll mutter the dreaded words, “I look fat.”  And then, like millions of people do every day, she might even take action by dieting.

This is the second post in my eating disorders prevention series. The first article provides an eating disorder overview: definitions, statistics and potential causes. Now we are ready to address the first “preventative factor” parents can put in place.

“It’s not just about what parents don’t do,” says Sari Shepphird PhD, eating disorder specialist and author of 100 Questions & Answers About Anorexia Nervosa.  “It’s about the actions they take.”

But Shepphird makes it clear that this is not about placing blame or making parents totally responsible.  Instead, it’s giving parents the tools they need to steer their children in the right direction.

1. Focus on healthy behaviors, not weight:

Abby Ellin was 12 years old when her grandmother told her she had to lose weight before visiting her in Florida.  Like a lot of kids hitting the big P (puberty), she put on weight.   

“I was always told that I had to be thin and beautiful,” she says.  “I became obsessed with food, had days of the week for binging and other days for being good.” She spent 6 years in kids’ weight loss camp, had disordered eating patterns and writes about her experiences in Teenage Waistland: A Former Fat-Camper Weighs in on Living Large, Losing Weight, And How Parents Can (And Can’t). Help

According to a report from the Academy for Eating Disorders, focusing on weight and appearance can encourage eating disordered behaviors and negatively affect self esteem.  Instead, they encourage prevention programs to focus on healthy behaviors, not weight. 

Most health experts agree that weight should be de-emphasized in favor of healthy behaviors such as balanced eating, fewer sweetened beverages, more physical activity and minimal screen time.  This is true for all kids, not just those that carry excess weight. 

But avoiding the topic altogether may not bode well for a kid that is obviously overweight.

“Most of the parents I see are afraid to discuss weight with their child because they fear they will say the wrong thing”,” says Jill Castle, MS, RD, pediatric nutrition specialist and owner of Pediatric Nutrition of Green Hills in Nashville, TN. “Instead of avoiding the subject, they can acknowledge their child’s feelings and help him or her develop a proactive, healthy approach .” 

“I remember growing out of a pair of pants in middle school, and being scared to tell my mom because I knew she’d start with the “I’m not buying you new pants because you need to lose weight” thing. I was never actually overweight, just a little pudgy, and I know now she just wanted me to be healthy, but it put a lot of pressure on me.” Gabriela, 20-year-old college student who has recovered from an eating disorder.

2. Discourage unhealthy dieting:  

According to the Alliance for Eating Disorders Awareness, almost half of 9 to 11 year olds are “sometimes” or “very often” on diets.  But even more of their family members – 82 % — are on-and-off dieters.  And because dieting is the behavior most linked to eating disorders, this is a major problem.

The first step parents can take is to have a diet-free household, meaning they don’t diet or model such behaviors.  According to a study published in the Journal of the American Dietetic Association in 2000, 5-year old girls with dieting mothers were twice as likely to have ideas about dieting.

It’s important to remember that dieting is not good for two reasons. First, research shows it’s ineffective and is associated with weight gain over time.  And second, going on and off diets has a negative impact on quality of life. 

But even if parents don’t diet they might approach food from a diet-type mentality.

“Don’t label food as good or bad,” Castle says.  “Avoid focusing on nutrition numbers like grams of protein, fat or sugar.”

Instead, Castle explains, be neutral about sweets and empty-calorie foods.  Offer them less frequently but don’t make such a big deal out of them.  “What you want is the kid who can walk by the M-n-Ms and not even notice them or take a few and go on his merry way.” 

But even with a diet-free household, kids can be exposed to their friends’ unhealthy dieting practices.  “When I was 15 years old I learned how to throw up from a friend,” says Elisabeth Armstrong, who was diagnosed with an eating disorder in college and chronicles her recovery on her blog, Joggers Life.  “If someone stronger had been there to help me, it would have made a big difference.”

We’ll talk more about early signs and symptoms of eating disorders later, but if you suspect your child is starting down the “diet” road, talk to him or her about it.  Explain the difference between a healthy lifestyle and unhealthy dieting practices.

“I wish my mom hadn’t been so obsessed with dieting and exercise when I was little. I know it’s not her fault, but I grew up seeing food as a reward or a security blanket or even an enemy.” Shelly, college student who is recovering from disordered eating patterns. 

3. Help your child develop a positive body image:

“I think one of the best things parents can do is positive talk. Being told that you’re beautiful no matter what makes a difference!” Caronae, 20-year old girl recovering from depression and poor body image. She blogs at Runwritetherapylife.com  

According to the National Eating Disorders Association, societal factors associated with eating disorders include pressure to be thin, a narrow definition of beauty and cultural norms that value physical appearance over inner qualities. 

But how do we raise children to be satisfied with their bodies in a culture that constantly strives for perfection?

“Sit down with your child and tell them that everyone is built genetically different,” Castle says.  “Some are bigger, some are smaller and some are in between.”

Explain that the images in magazines and movies are unrealistic – and do not represent the population as a whole.  Some women may naturally be that thin, but many are not.

It’s also vital for parents to make sure their children know they are loved for who they are, even if they have a weight problem.  Of course all parents love their kids, but sometimes they can (unintentionally) send messages that make kids feel that their acceptance is tied to looking a certain way.

“My dad once told my sister that I could whoop her in a fight,” says Armstrong.  “I took that as meaning I’m the big, less attractive sister.”  She also says her parents restricted her food intake but not that of her siblings, making her feel like she wasn’t as loveable being overweight.  

And last, and maybe most important, is for parents to be a positive role model when it comes to body image.  “Parents need to do a self-check on themselves,” says Shepphird. “Kids see how parents relate to their own bodies and emulate that.”

This may be the tallest order yet.  What person do you ever hear saying, “I just love my body,” not to mention all the insecurities that come with aging.  When I find myself criticizing the way I look, I try to see myself through my kids’ eyes.  As far as they’re concerned, I’m the be-all and end-all. 

I understand this because I think my mom is one of the most beautiful women I know.  And my husband is even more attractive to me now that he is a father.  I believe the love we have for our kids, and visa versa, can help us appreciate beauty in a more rich way.

Of course there’s nothing wrong with wanting to look our best, become healthier or even lose excess weight.  But there is so much more to life than what someone looks like.  And the sooner we get that message to our kids, the better off they’ll be.

“I wish my mom had known that her lifelong dieting and body-loathing was unnecessary because she is absolutely beautiful the way she is, and the ONLY person who sees something wrong with her is her.” Beth, 17-year old girl from Australia who was diagnosed with an eating disorder last year.

Previous: 3 Things Every Parent Must Know About Eating Disorders
Nect: How to Maximize the Power of Family Meals

Resources
50 Ways to Lose the 3 Ds: Dieting, Drive for Thinness, and Body Dissatisfaction

References
Abramovitz BA, Birch LL. Five-year-old girls’ ideas about dieting are predicted by their mothers’ dieting. J Am Diet Assoc. 2000 Oct;100(10):1157-63.

Mann T, Tomiyama AJ, Westling E, Lew A, Samuels B, Chatman J. Medicare’s search for effective obesity treatments: diets are not the answer. American Psychologist. Vol 62(3), Apr 2007, 220-233.

There’s been a lot of news recently about the growing snack habits of kids – and most of it is negative. A recent study published in Health Affairs found that snacking in U.S. children has not only increased from 1989 to 2006, but accounts for more than 27% of total calories (up to 3 snacks per day).

Now this wouldn’t be so bad if kids were snacking on a variety of food. Instead, snacks mainly consist of salty snacks, candy, desserts and sweetened beverages.

So recent news stories have added snacking to the long list of childhood obesity culprits. But I would hate to see parents make unnecessary changes because all types of snacking have been lumped into one negative stereotype.

So let’s look into what type of snacking is good for kids (and not so good).

Bad Snacking

When my daughter starting eating finger foods before turning one, I remember the afternoon snack fests. All the moms in my playgroup would bring a variety of snack foods – goldfish, crackers, pretzels and animal crackers (me too). Many of the kids would carry the little snack container and feast away. I didn’t think much about it until my daughter started to refuse dinner.

Bad snacking almost always consists mainly of “snack” type foods. While I have no problem with kids eating these foods some of the time, they fail as good snacks for two good reasons. First, they do a poor job of filling little bellies up for long. And second, they don’t help fill kids’ nutrition gaps, which is an important role of snacks.

The bad type of snacking also follows the “grazing model” of eating. This is where children get snacks in a bowl where they can just pick at it as they wish. For older children the equivalent would be letting them go freely into the pantry and picking out snacks anytime they want. (For more on this, see 5 Reasons Moms Should Rethink Food Handouts.)

Both of these snack habits, eating mainly snack-type foods and grazing, fail to help children manage their hunger. They never really fill up, and never really get hungry, so they are more likely to get more, or less, food than they need.

Good Snacking

So after making the realization with my daughter early on, I made some changes to her snack habits. Like her main meals, I began serving her snacks in her highchair. When we were on the go I tried my best to stop, sit somewhere and enjoy the food without distraction. Of course, at parties and play dates we would both graze, but that was more the exception than the rule.

So good snacking is the opposite of bad snacking. There is structure to it. That means eating at the table or some designated place. There is timing to it. Trying to get it right between meals so hunger is managed nicely. And there is nutrition to it. Make nutritious and tasty snacks that fill kids up.

In her books, Ellyn Satter calls snacks “mini-meals” which is how I’ve come to think of them. That means they consist of a couple of different food groups with a combination of protein, carbohydrates and fat. This might be whole wheat crackers and a cheese stick or apple slices with peanut butter or carrots with hummus or yogurt with almond slices. (For more on this, see Top Ten Nutritious Snack Combination for Kids.)

But other, less often times, it is goldfish, animal crackers or some snacky type of food. For example, once a week I plan my daughter’s midmorning or afternoon snack with a trip to the grocery store where she gets a free cookie (she calls it the “cookie store,” thanks Vons!).

And research suggests that more frequent eating occasions can be better for children. A recent review published in Critical Reviews in Food Science and Nutrition reveals that infrequent meals and snacks (including skipping meals) is associated with excess weight in children.

How to break bad habits

A recent article in the New York Times discussed how snacking in school-aged children has gotten out of hand. With all the activities kids have these days, parents are equipped with snack foods that can be consumed by kids in a moment’s notice. Some parents quoted in the article say they aren’t sure how to stop bad habits like the afternoon trip to the vending machine.

I think it’s important to talk to kids about their snack habits and what you plan to do about them. Tell them you want to better plan their snacks so they are timed around the main meals. Tell them you want more nutritious eating but will be sure to still include their favorites.

But more than anything, let them know that you are in charge of what is served at meal time. They may not like it at first, but once they know you are serious they will accept it.

So what are your kids’ snacking habits? Having any challenges? Are snacks away from home a major problem?

References

Piernas C, Popkin BM. Trends in snacking amount U.S. children. Health Aff. 2010 Mar-Apr;29(3):398-404.

Koletzko B, Toschke AM. Meal patterns and frequencies: do they affect body weight in children and adolescents? Crit Rev Food Sci Nutr. Feb;50(2):100-5.

This is a featured guest post written by Kathleen Cuneo, Ph.D, psychologist, parent coach, and mom. Her mission is to empower parents to find their own parenting voice and develop strong connections with their children. Her free report, “30 Things You Can Do To Raise Self-Confident, Compassionate Children,” is available at www.drcuneo.com. Dr. Cuneo is also the director of Dinner Together, LLC which offers consultation to families seeking to have more frequent, successful family meals and deal with the challenges of picky eaters. Sign up for her free e-newsletter at www.dinnertogether.com.

As parents we need to be mindful of not only what foods we choose to offer our children, but also of what patterns and associations between food and emotion we are establishing. When our children are upset, it is natural for us to want to soothe them. Often, by habit and by memory our own childhood experiences, we may be tempted to soothe with food.

Don’t get me wrong, soothing with food is not always a bad thing. I want my children to have positive emotional associations with foods. And I’m also the mom who went through a period of time with an active toddler whom I couldn’t get to sit in her stroller without the reward of fruit snacks. But it’s the overall pattern that’s important, and food should never be the only option for comfort or reinforcement.

Here are some other things to consider:

-Negative emotions are not always a bad thing. They provide an opportunity for learning and for greater understanding. The goal isn’t that your child will never experience negative emotions, but rather that they’ll develop skills that will enable them to be soothed and eventually to soothe themselves and cope with negative experiences.

-Your parenting toolbox can be filled with tools other than fruit snacks and sweets to help your child handle their emotions.

-Know that no one strategy will work all the time or for everybody. You’ll need to observe patterns in what seems to work for your individual child at particular times. As their language skills and ability to make connections develop, talking about your observations with them will be providing them with their own coping tools for the future.

So the next time your child is upset and your tempted to give them a cookie or lollipop to help them feel better, think of trying one of these strategies instead.

1. Physical activity: For many children, physical activity can help them organize and regulate themselves. Often a little running, jumping, yoga, or dancing can result in an improved mood.

2. Music: Calming music can be relaxing for both children and adults. Explore how music may influence your child’s emotional state.

3. Coloring: I’ve worked with several children who soothe themselves by coloring. You can observe their body tone soften just by the act of coloring.

4. Creative activities: For other children coloring might not have any effect on their mood or tone, but perhaps a more creative activity might. Drawing, painting, building, or pretending can be important outlets of expression as well as ways of organizing and calming the mind and body.

5. Reading: If reading is not a struggle or an emotionally-charged activity, it can be a very calming activity for many. If your child is not old enough to read on his own and does not enjoy looking at books by himself, then reading a book together, could be a shared activity that he finds soothing.

6. Cooking together: This can be not only a fun way to connect with your child, but also a way to teach your child valuable cooking skills and healthy eating habits.

7. Calming down space: Rather than a time-out space to go after some mis-behavior, children can also benefit from a designated space to go to calm down and reorganize themselves before they hit that point of no-return. You can designate a corner of a room, a soft, comfy chair, or even an indoor tent as a special quiet space for this purpose.

8. TV/movies: While you have to be careful about over-use, they definitely have their place in helping children calm themselves.

9. Play dough: One of my personal favorites! Playing with play dough offers both a creative outlet and a motor activity combined into one. Many a mood has been improved after a little time with dough.

10. Touch: Maybe the most obvious and potentially quickest fix when your child is upset. Hugs, kisses and back rubs can often do the trick for many children. Other children may respond better to deeper pressure or brushing techniques which may require some instruction from an occupational therapist to be used effectively.

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You’ve probably heard that the first lady is taking on childhood obesity. On Tuesday she announced the development of a task force that will engage both private and public sectors to solve the childhood obesity problem in a generation.

The areas of focus include: helping parents make healthier food choices, making schools a healthier environment, increasing physical activity and making healthy food more accessable. In 90 days this task force will develop and announce a plan of action. I’ll be sure to keep you updated. For more on this, see Let’s Move.

There are some changes that will take place immediately. The American Academy of Pediatrics is joining the cause by enouraging pediatricians to keep a close eye on the BMIs (body mass index) of children. So if there’s a problem they will let you know.

But there is a part of me that is worried that some negatives may come out of all this attention on weight. So I jotted some of my concerns down just in case Michelle Obama — or her task force members– runs across my blog.

1. It’ll take more than healthy eating: Whenever I see a story on fighting obesity, it’s always talks about getting kids and adults to eat “healthier.” There is not a parent alive who doesn’t know that eating more fruits and vegetables is good for their children. So if pediatricians just spout of the same old advice, parents will still face the same barriers they had before, whether it’s getting kids to eat fruits and veggies or finding the time to prepare them.

But what if pediatricians asked families to change how they eat? Isn’t this what has really changed over the last 40 years? We no longer make feeding ourselves — and our families — a priority. Telling parents to start by having regular meals and snacks at the kitchen table is a great start. They can gradually add more variety including fruits and veggies.

But if children continue to graze on food, eat while watching TV, or are allowed to grab food out of the cupboard when they are bored, they are much more likely to get more calories than their bodies need. And why should we wait for a high BMI to give this advice?

2. Keep a watchful eye on eating disorders: According to The Alliance of Eating Disorders Awareness, eating disorders affect 24 million Americans. Young women with an eating disorder are 12 times more likely to die than other women their age. The most common behavior that leads to an eating disorder is dieting. Fifty-one percent of 9 and 10- year olds feel better when on a diet and 42% of 1st and 3rd grade girls want to be thin.

So very young children already have a desire to be thin. We need to watch the way we talk to our children and let them know that health is most important, not looks or weight. Pediatricians also need to be careful in how they relate messages when they find a child is overweight. I will be running an eating disorder prevention series this month to discuss ways parents can help prevent eating disorders in their children so stay tuned.

3. Size discrimination is a problem: The last acceptable form of prejudice is size discrimination. This movement could make people even more critical of those who carry excess weight. We need to educate our children that people come in all shapes and sizes. While BMI can be a helpful tool, some kids may be considered overweight but still be healthy because they are naturally bigger. Just the way some children fall off the growth charts because they are small. What we want to avoid is kids gaining an unnatural amount of weight for their body type.

4. Restrictive feeding practices don’t work with kids: With more pediatricians telling parents their children have a weight problem, some parents may start restricting their kids’ eating, which is really a form of dieting. Research shows such practices backfire, making children more likely to overeat and gain weight.

Encouraging healthy behaviors for the whole family is vital. Singling out an overweight child can do long-term damage to their self esteem, make them obsess about food and increase their risk of developing an eating disorder. All members of the family benefit from healthy habits, whether or not they carry excess weight.

So that’s it. Just some thoughts I wanted to get out there. Now I feel better.

What do you think about all this? Any solutions you want Michelle Obama to know about?

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I have two good reasons to write about weight today. First, it is Healthy Weight Week and second, new obesity statistics (childhood and adult) have been released.  And I want my readers to be in the know.

Obesity statistics published in the Journal of the American Medical Association have been updated to account for the decade that just ended.  Drum roll please… 

There was no change.  Children (except the heaviest boys from 6-19 years old) and adult women had no real increase while men’s numbers went up but from 2003 onward this wasn’t significant.  Still, almost 7 out of 10 adults (68%) are either overweight or obese.  So while the numbers haven’t gone up, most health professionals prefer they go down.   

At the same time these statistics were splattered all over the news, another interesting research study was reported.  According to a study in the Journal of Preventative Medicine, women who have had children are at the highest risk for weight gain over time.  The researchers studied 6478 Australian women and found that over ten years the women without children or a partner gained 11 pounds, those with a partner gained 15 pounds, and with a partner and a child gained 20. 

According to the International Food and Information Council, in the last decade media stories on obesity have skyrocketed.  I often wonder what effect this news really has on people.  Does hearing about weight make them want to jump on the treadmill or give up in defeat?

And if you have an overweight child, how does this news sit with you?  Will you be tempted to restrict your child’s intake?  Take away all his sweets?  All of which are things that backfire.

Clients have always told me “I know what to do, I just don’t do it.”  And this makes them feel bad, lazy even, for not doing what they think they should do.  (For a great reason not to “should” yourself see this article!)

But I think the key is identifying and removing obstacles – real and perceived.  Yes, those of us married with children are more at risk to gain weight.  We are so busy with children and responsibilities that we tend to put ourselves on the back burner.  But there’s so much we can do to help ourselves and our kids if we learned how to look at things differently.

Many of you said time was your major barrier to taking care of your own health.  So stay tuned for tips on how to remove barriers, save time and prove that being married with children does not make unnecessary weight gain inevitable.

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References

Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass Index in US children and adolescents, 2007-2008. JAMA. 2010;303(3):242-249.

Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010;303(3):235-241.

Brown WJ, Hockey R, Dobson AJ. Effects of having a baby on weight gain. Am J Prev Med. 2010;38(2): 163-170.

Q: I have two boys who eat great but they have completely different bodies types (one small for his age and the other more hefty.) The younger, more hefty boy has a sweet tooth and I have concerns about his weight. Do I continue to feed them the same way?

A: Yes. Continue to feed your boys the same way. To explain why this is my answer, let’s consider what would happen if you fed them differently.

If you started singling out your heavier child, he might get the idea you don’t approve of his body size (even though that’s not your intention) and this could negatively affect his self esteem. Additionally, seeing his brother eat different foods – and allowed to have seconds – could make him preoccupied with foods and eat more when he gets the chance. Research shows that restricting food intake in the overweight child is counterproductive.

Another problem with giving your thinner child more leeway when it comes to eating is that he won’t learn the healthy habits he’ll need as he gets older. Healthy feeding strategies help all children grow into weights that are right for them. Some kids will be bigger and others will be smaller and many will be somewhere in between. What you want to avoid is the unnecessary weight gain that comes from overeating and a lack of activity.

Some relevant posts on feeding strategies include, Why Children Thrive on Planned Meals and Snacks, 5 Times You Never Want to Feed Your Kids and the Book Review, Your Child’s Weight: Helping Without Harming.

In addition to feeding you’ll also want to provide your boys with plenty of opportunities for physical activity. Limiting screen time to 2 hours or less per day and only allow sugar-sweetened beverages (fruit drinks, soda etc.) on special occasions.

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The information on this site is for educational purposes only and does not take the place of medical advice. Please verify with your healthcare provider.

My daughter and I went to her friend’s 3rd birthday party. When it was time to sing happy birthday, the kids swarmed to the table full of cupcakes. When an overweight girl asked her dad for another cupcake, he said “no, one is enough.” The girl kept pleading until she was in full meltdown mode.

Around that same time my daughter asked me for another cupcake, when all she had eaten of the first was the frosting. The mom voice in me wanted to say “you didn’t even eat the cake part, no way!” But because of all I know, I said “sure.” She took one lick and announced to me that she was “all done.”

As we were leaving, I could hear the girl still asking her dad for another cupcake while my daughter had already forgotten about them.

The question every parent needs to ask themselves is the way they feed their child effective in the long run? Let’s examine a few examples and see…

1. Being overly strict with sweet foods: I understand why the father did what he did. He’s worried that his daughter is overweight and needs to limit sweets. But while his daughter might have had only one cupcake at the party (win for Dad), she was left obsessing about the sweet treat. What is the long term implication? It’s very possible she’s going to over-eat sweets the next time she gets a chance.

According to a 2007 review study published in the Journal of Public Health, parents often use restriction to help their overweight children even though research shows it backfires and contributes to further weight gain.

Now the answer is not to give your child sweets anytime they want them. Instead of saying no to their requests, tell them they can have it at another snack or meal (example: can I have a cookie momma? I don’t have that planned for today’s snack but maybe next week). Letting them know they will have a cookie at some future date (instead of yelling “no”) teaches kids that eventually they will have a cookie and when they do they can eat until they’re satisfied. For more on this see 5 Reasons Kids and Parents Thrive on Planned Mealtimes.

2. Making them eat “this” before they can eat “that:” My daughter often has cereal with fruit for breakfast. Lately she’s been eating most of the cereal and little of the fruit. When she’s done with the cereal and asks for more my mom voice tells me to say “not until you take a few bites of your fruit.” If I did that she would eat the fruit and it would make me feel better.

But what does this feeding strategy do over the long run? Which food becomes more desirable to kids – the fruit (or vegetable in other cases) or the cereal? Studies show that asking a child eat a certain food in order to get something else makes them less likely to eat the required food when left to their own devices.

And if I know my daughter, she’ll change her eating again soon. Just a few weeks ago she ate 5 clementines and only had a couple of bites of cereal.

3. Having them take a few more bites before leaving the table: Dinner is my daughter’s – and most likely other kids’ – worst meal of the day. When my daughter barely touches her dinner my mom voice tells me to say “take a few more bites.” And when its really being pushy it adds, “and if you don’t there will be no after-dinner TV.” No doubt this strategy would help get her to eat a little more at dinner time.

But over the long run something else may happen. Instead of listening to her body, she’d learn to focus on external cues to decide when she’s done, including the okay from mom or dad. I know a lot of parents don’t consider weight a problem for their picky eaters, but we all need to remind ourselves that 6 out of 10 adults are either overweight or obese. Teaching children to listen to their hunger and fullness signals is vital for their future health.

So I ignore the mom voice (again) and look my daughter in the eye and ask her if she’s sure she’s done. I ask her if her tummy is full – reminding her to check in with herself. Some kids get distracted at meals and need to be reminded of the task at hand.

Of course other strategies like serving fruits and vegetables as appetizers and making sure kids’ afternoon snack isn’t close to dinnertime can help a great deal.

But as parents we need to challenge that little voice that tells us we can control our little one’s food intake. In fact, studies show that being too controlling or permissive when feeding children is not good for them over the long run. There’s a place in the middle and I struggle to stay there every day.

So if you don’t have a feeding strategy, maybe it’s time to get one. I stick with the division of responsibility and constantly remind myself that it’s my job to provide the food – and it’s my child’s responsibility to eat how much she wants.

You’ll be seeing more posts on managing your child’s intake of sweets in the New Year.

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References:

Clark HR, Goyder E, Bissell P, Blank L, Peters J. How do parents’ child-feeding behavior influence child weight? Implications for childhood obesity policy. J Public Health. 2007. June;29(2):132-41.

Tanofsky-Kraff M, Haynos AF, Kottler LA, Yanovski SZ, Yanovski JA. Laboratory-based studies of eating among children and adolescents. Curr Nutr Food Sci. 2007;3(1):55-74.