This Ask the Dietitian post is hosted by Katie Mulligan MS, RD, LDN, practicing pediatric dietitian since 2003. She received her undergraduate degree from the University of Rhode Island in Dietetics and completed her Dietetic Internship at the prestigious Weill-Cornell Medical Center at New York Presbyterian Hospital in New York City. Katie runs a successful private practice in pediatric nutrition. Check out her blog Nurturing Nutrition Notes.

Q: How do I ensure that my bigger-than-average kid doesn’t gain too much weight or overly focus on food?

A: If your child is “bigger-than-average” the LAST thing you want to do is panic and put them on a strict diet. Instead, request their growth charts from their pediatrician and take a look at your child’s growth trend over the years.

If your child is trending on the same high percentile line since birth then he is likely okay. Childhood overweight and obesity become a problem when children grow “off their curve”. This is when kids follow a nice line on their growth chart for a few years, but then begin to trail upwards into the area of the growth chart where there aren’t any lines to follow. They may also being jumping percentile lines, which means they go from the 75th percentile to the 90th to the 110th and so on. That pattern is not supposed to happen, kids should stay on relatively the same percentile line throughout their childhood.

So, let’s assume you know your child is jumping lines and that his or her weight is in fact going too high too fast. You probably want to stop this upward trend, but without causing your child to be to obsess over food and weight or affect their body image. This is a very common concern for parents and I hear these concerns weekly.

Children will become “obsessed” with food when they feel like that aren’t getting enough to eat or they are being restricted. Trust in feeding begin to breakdown, children don’t trust their parents to give them all the food they need to feel full and as a result they find sneaky ways to get it themselves.

Having reliable access to a variety of food will help your children learn that there will always be something to eat, you will never let them starve and you will always provide them with tasty food choices. A few simple steps and parenting techniques will help you help your child. If you find that you are still struggling or can’t do it alone, seek out the help of a registered dietitian who works with childhood obesity.

-Continue to offer meals and snacks at regularly scheduled times. A typical pattern is breakfast, lunch, snack, dinner and sometimes evening snack.

-Narrow down your children’s food choices and allow them to choose between options you are comfortable with. For example, “Today’s snack is grapes. Do you want chocolate pudding or a cheese stick with that?”

-Help your children focus on their hunger and fullness. When you seen them rummaging through the cabinet ask them if they are hungry or bored? Likewise, when they finish eating, ask them if their hunger is gone. If so, it’s time to stop eating for now, they will have another eating opportunity in a few hours.

-Make a “kitchen is closed” rule. When it’s not snack time or mealtime the kitchen is closed.

-Remove sugary drinks from the home.

-Allow controlled access to “treat” foods. For example, you add 2 cookies to each school lunch.

-Occasionally bake homemade treats or take kids out for ice cream to teach them that these foods are OK to have and can be part of a healthy diet when eaten in moderation.

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.