Healthy Weight For Kids: The Carrot or the Stick?

When Dara-Lynn Weiss chronicled the way in which she induced weight loss in her 7 year old daughter Bea in Vogue magazine’s April issue, she set off an avalanche of emotional responses. For the few of you who haven’t read the ensuing blogs and articles in papers such as the New York Times, Dara-Lynn was told by Bea’s doctor that her weight was unhealthy and decided to take a hard line approach.    Ostensibly using the Red Light, Green Light, Eat Right plan developed by pediatrician Dr. Joanna Dolgoff, Weiss describes her use of coercion, embarrassment, and scare tactics to reduce Bea’s food intake.  The method was successful, at least for now.  Bea lost weight.  But has she learned to eat in a healthful manner?  What has been the impact of this approach on her self-esteem?  Will she be able to trust her own judgment and regulate her own food intake without being told what and how much to eat?  Will Bea be able to navigate her teenage years and beyond with the benefit of having a healthy relationship with food?

Evidence shows us that extreme dietary restriction often backfires.  It can lead to a pre-occupation with food, an impulse to binge when not being monitored, and the fear that eating is out of one’s control.  In fact, a love-hate relationship with food may develop, along with damaged self-esteem accompanied by messages such as “I’m only lovable if I’m thin,” and “I am good if I control myself and don’t eat at the birthday party.  If I do eat, I’m bad and something is wrong with me.”  Too often, the result is cycles of restriction and binging, along with weight fluctuations.

So what’s a parent to do when they and the pediatrician become concerned about unhealthy weight gain?  Clearly, parents must help their children develop healthy eating habits.  We know that obesity presents a health risk, and that kids are developing the very risk factors for diabetes and heart disease that we see in adults:  insulin resistance and elevated fats in the blood.  Yet we don’t want to cause equally unhealthy disturbances of body image, an inability to self-regulate (eat when hungry and stop when satisfied), disordered eating (any unhealthy relationship with food), or eating disorders (anorexia and bulimia.)

Healthy eating habits cannot exist without a healthy relationship with food in which food is enjoyed without fear of loss of control and getting fat.  Kids and their parents need to understand that food is fuel, and that children need plenty of energy to grow and play, but also to learn where calories beyond those needs may be coming from.  Over-restriction is not the answer as it teaches kids to ignore their body’s hunger and satiety signals.  Rather, parents need to provide structure for their kids and an appropriate eating environment – in the kitchen or dining room without TVs, computers, or other distractions.  They need to provide a variety of healthy food for their kids and encourage them to eat slowly and mindfully so that they fully enjoy their food.  Junk food should not be the rule, but can be the exception.
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A number on a scale does not measure how healthy your child is.  Body weight issues must be addressed in a manner which builds self-esteem and self-efficacy.  Calories should be addressed only in the context of understanding energy balance – the number of calories needed by a particular child as compared with the number of calories they are consuming.  Randomly slashing calories and imposing restrictions is a recipe for life-long struggles with food.

 

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