How To Talk to Kids About Weight
Weight and body size can be a deeply sensitive topic. Many parents and caregivers wonder if it’s ok to talk to kids about weight, and whether discussing weight with their children is even appropriate.
While weight can be a sensitive issue, especially in a society that places a lot of emphasis on body image, it's important to have open and honest conversations about health with children—but not necessarily weight, unless it is to support and honor body diversity.
In general, when we focus on healthy lifestyle choices rather than appearance or weight specifically, we see more positive long-term outcomes on a child’s holistic health and overall well-being.
In any case, in order to help promote self-esteem, conversations with kids regarding health concerns need to be approached with empathy and understanding and an avoidance of body shaming or assumptions.
In this blog post, we'll discuss how overweight and obesity are defined, how to support your children in maintaining a healthy lifestyle, and why it's essential to avoid harmful weight talk.
What Is Considered Overweight In A Child?
The Centers for Disease Control and Prevention provides growth charts that are used to assess a child's weight status based on body mass index (BMI) in relation to their age and gender. According to these charts, a child is considered “overweight” if their BMI-for-age percentile is at or above the 85th percentile and below the 95th percentile for their age and gender. Per the CDC, a BMI greater than the 95th percentile is considered “obese.”
It’s important to keep in mind that BMI does not tell us much about a child. BMI is a measure of body fat based on height and weight at a single point in time; however, it does not distinguish between muscle and fat mass. It’s also important to note that BMI is interpreted differently in children than in adults because their body composition changes as they grow. Because BMI does not directly measure body fat, factors such as muscle mass and bone density should also be considered when evaluating a child's weight status.
In fact, to help put this into perspective, a “new definition has been proposed with Canadian guidelines and the World Health Organization defining obesity as the state of excess adiposity that is associated with adverse impacts to quality of life or physical health. I prefer this definition as it takes a health-focused rather than a weight-focused approach, allowing for “improved sensitivity to the nuance of the relationship between weight and health status.”
While tracking weight and height can be a valuable tool in measuring your child’s growth and development over time, it is more important to pay attention not to the percentile itself but instead to whether your child is tracking along the same curve as they age.
Is it Okay to be Overweight as a Child?
A child can be healthy at any percentile; what really matters is the overall growth velocity and any significant dips or spikes in their growth trajectory along the way.
Remember, BMI is just one indicator of health that is used as a screening tool, not a diagnostic test. It should always be interpreted alongside other factors such as physical activity, diet, and overall well-being.
Everyone's body shape is different, and not all bodies fall within what is categorized as a "healthy" range on body mass index (BMI) and weight charts. And that’s ok!
What Happens if a Child is Overweight?
If you’re wondering when to address your child’s weight, know that it's best to consult with a healthcare provider or registered dietitian who can assess a child's overall health and growth patterns to determine if any actions need to be taken.
What Are The Risks of Being Overweight?
Being overweight or obese as a child can increase the risk of developing various health problems, including type 2 diabetes, high blood pressure, and heart disease.
It is essential to note that being overweight or obese does not mean that a person will develop one of these conditions; however, having a higher body fat composition can predispose a person to develop specific health problems.
Being overweight may also have a significant impact on a child's self-esteem and mental well-being. According to the American Academy of Pediatrics, “Individuals with overweight and obesity experience victimization, teasing, and bullying, which contribute to binge eating, social isolation, avoidance of health care services, and decreased physical activity.”
As a society, there is a great deal of work we have to do to prevent the anti-fat bias and weight stigma which are at the root of these injustices.
What Is Weight Talk?
Weight talk refers to conversations or comments that focus on a person's weight, frequently in a negative or judgmental way, which can include comments about a person's size, appearance, or eating habits.
Why is Weight Talk Harmful for Kids?
Weight talk can be extremely harmful, especially for children, as it can contribute to body dissatisfaction and disordered eating behaviors. It can also perpetuate harmful stereotypes and stigmas around weight and body image.
Also harmful is when children hear adults (especially those who are role models) engaging in negative weight talk about their own bodies, which can become a lense through which children start to view and reject their own appearance
Is it Okay to Talk about Weight with Kids?
Arguably and in general, no—it’s best to avoid it. New research shows that “body image and weight worries start at pre-school,” and almost 50% of caregivers “have witnessed anxieties about body image in children aged 6-10 years old.
Weight talk usually encourages dieting, which has several risks for children and teens. It disrupts a child’s ability to recognize their inner hunger and fullness cues, which can lead to weight cycling, also known as “yo-yo dieting.” Dieting can also cause nutrient deficiencies and a long-term negative relationship with food.
Restrictive diets can prevent kids from adopting healthy eating habits and getting the variety of macro- and micronutrients they need to grow and develop.
Further, a 2016 review found that parents focusing on a child’s weight didn’t prevent weight gain; it was actually associated with even more weight gain throughout childhood.
How to help an overweight child
If you have concerns about your child’s weight, talk to your pediatrician first, without the child present. Use shared decision making with your healthcare team to determine whether referrals to a pediatric dietitian or other healthcare professional are the best path forward for your unique child.
Instead of focusing on weight, we can encourage holistic health in kids while preserving their sense of self-esteem and confidence by taking a family-based approach that looks at a variety of different lifestyle factors which can affect weight.
Reducing screen time, prioritizing sleep hygiene and adequacy, providing daily opportunities for physical activity, taking an all-foods-fit, neutral approach to food, seeking positive role models and prioritizing family meals, and promoting lots of positive and supportive conversations about body diversity are all important ingredients in the process as well.
How To Avoid Weight Talk in the Pediatrician's Office
Visiting the pediatrician or other primary healthcare providers can be a triggering space for many children as pediatricians can unfortunately sometimes be a source of weight bias. I recommend politely asking before the appointment, either over the phone or with a written note, that any weight discussion occur without your child present.
If you're concerned about how weight is being discussed, don't be afraid to speak up and ask questions, even if that means asking for a conversation to end abruptly. Most healthcare providers are more than happy to accommodate requests.
How To Support Body Positivity and Healthy Habits
As a pediatric dietitian specializing in child nutrition with three daughters of my own, I take a non-diet approach to nutrition in my private practice and guide families to promote healthy lifestyle changes rather than focusing on calorie restriction or diets. We can support the health of the whole child by refraining from “weight talk,” and promoting a well-balanced diet, regular physical activity, and adequate, good-quality sleep.
This does not mean that there is no place for evidence-based, supervised treatments to improve health-related outcomes that actively address weight stigma and eating disorder risk. There are invidualized situations where this may be indicated, especially if a child has developing health risks.
Supporting a healthy body and body image for a child involves creating a positive environment that promotes healthy habits. Here are a few tips to promote healthy habits in your home:
Encourage physical activity by engaging in fun activities together as a family
Try to eat family meals together when possible and let your kids help with meal preparation and grocery shopping
Provide nutritious meals and snacks by offering fruits, vegetables, whole grains, healthy fats, and lean proteins
Focus on how foods make us feel and how they help our bodies instead of whether they are “healthy” or “unhealthy”, or “good” or “bad”
Be aware that your child is watching you and listening to you – the way you talk about your own body will become the inner voice they use to talk to themselves about their bodies too, so try to talk about your body positively (even if you don’t feel like it!)
Build their self-confidence and self-image by focusing on who they are as a person and not what they look like
Put away or get rid of any weight scales in your home to avoid tracking weight frequently
Remind your child that all bodies are incredible; they come in all shapes, sizes, and colors and give us many unique skills and abilities. Continue encouraging the whole family to focus on healthy behaviors for the body, mind, and soul. And remember, you’re doing a great job as a parent, too!
And if you're concerned about your child’s growth, appetite, or weight, I am currently accepting new clients in my virtual private practice - book a session at your convenience, and we will explore personalized solutions and ways to navigate your concerns together.