How Do I Respond to My Pediatrician Who Thinks My Child Needs to Lose Weight?
You may have taken your child in for a routine wellness visit, only to be confronted by a well-meaning pediatrician who is concerned about your child’s weight. As a parent, hearing a healthcare professional voice concern about the trajectory of your child’s weight can be startling, overwhelming, and confusing. You may be told things like:
“Your child’s weight is moving toward the overweight/obese category”
“You need to intervene with your child’s weight now before things get worse”
“You should consider a weight-maintenance program to slow the progress of weight gain in your child.”
“You should help your child modify their eating habits to aim for gradual weight loss”
Many well-intended professionals may piggy-back on the “child obesity epidemic”, citing a number of things you should do to help prevent your child from a host of health problems.
Your doctor may suggest that you carefully police what your child is eating, restrict sweets, limit carbohydrates, or even lecture you on which foods are “good versus bad” when it comes to feeding your child.
You may look at their growth charts but feel unsure about how to decipher all the information you are receiving. In flood the questions, doubts, and guilt. Have you been doing something wrong up to this point? Is your child headed in an “unhealthy” direction because of their weight?
But therein lies the problem: your child’s health cannot be singularly measured by their weight or a BMI calculation.
Weight Loss Is Not a Solution
There are a multitude of factors that contribute to your child’s overall health. Yet parents are often left feeling as though they have to put some kind of control tactics into play when it comes to feeding their child for fear that things could potentially escalate out of control.
Prescribing weight loss as a "solution" for a child who may be in a larger body and justifying it in the name of health is completely unethical and not evidenced based. Fear-mongering tactics intended for spurring change are also misguided and inappropriate, leading parents and children into utter confusion and ill-founded ideas about their overall health and wellness.
If you should encounter a situation where your pediatrician has recommended weight loss and/or dieting for your child, consider the following information when responding:
1. Educate your provider on the dangers of dieting
Implementing any form of dieting or restrained feeding tactics with a growing child are dangerous and associated with a host of problematic behaviors and health risks. Research has found that dieting behaviors in adolescents can result in:
Increased risk for eating disorders, including anorexia, bulimia, and binge eating disorder
Low self esteem and poor body image
An unhealthy relationship with food and their bodies
Increased risk for chronic dieting
Malnutrition and nutrient deficiencies
Inappropriate weight preoccupation
2. Be an advocate for your child
The use of BMI alone as a measurement for your child’s health is misleading. If your pediatrician is questioning your child’s health, you might ask for more evidence to substantiate their concern outside of weight and BMI measurement.
Question what your child’s doctor might recommend for a child with health concerns in a lower-weight body. Just because your child’s body may not fall within recommended “guidelines” does not automatically mean that there is something wrong with their health, nor does it warrant baseless weight loss recommendations (that would otherwise prove to be harmful).
Your pediatrician, like you, wants to help your child be healthy and thrive. Sometimes, advice and recommendations can be misconstrued. Work together with your provider to understand a plan that will best help your child moving forward.
3. Understand your child’s normal growth pattern
Some health professionals may not accurately interpret growth charts and may give you poor advice based on your child’s weight or BMI alone. Many providers look solely at either ends of the growth curve spectrum, often hyperfocusing on the fact that your child might be at the 85th percentile or above or at the 5th percentile or below.
In fact, children growing above the 85th percentile may be diagnosed as overweight and/or obese, whereas children at the 5th percentile or below may be diagnosed as failure to thrive. These faulty diagnoses often lead practitioners to make feeding recommendations that exacerbate the supposed problem it is intended to solve (such as underfeeding or overfeeding).
The more important thing to look at when it comes to your child’s growth is the overall pattern that indicates if they are growing consistently and well.
Growth charts should not be viewed as single plot points on the curve at each appointment but rather the consistency of their growth pattern over time. For example, if a child’s growth charts show that they have been growing at a consistent rate, even if that percentile was high, there is NO weight problem.
Their weight is normal for them. Rather than interfere with their normal growth patterns with underfeeding strategies, it is MOST important to support their continued normal growth and development.
Feed and Parent in the Best Way
As a parent, you are faced with an overwhelming amount of information today regarding your child’s health. The most important thing to keep in mind is that children are capable, and they can be trusted to eat what their bodies need to grow at a place that is appropriate for them.
When you focus on feeding and parenting well, avoid interference, and accepting your child’s size and shape, you can help them grow in a way that is right for them. If you are needing more support with implementing this at home, connect with me today. I would love to hear your story and learn how I can help.