Here’s how to help the ‘overweight’ child without a restrictive diet, or causing emotional harm.

Weight gain and health problems are a real issue for many kids. Overweight children (those with excess body fat noted by increased weight gain on the body mass index (BMI) growth curves) who have health conditions like high blood pressure or early signs of heart disease (high triglycerides and high cholesterol) are also at risk for low self-esteem and mental health concerns.

The automatic response is to think about putting a child on a diet to lose weight, but I take a different angle. My preference is to work on lifestyle habits for the whole family. Every child benefits from lifestyle changes, including healthy eating, enough sleep, and regular physical activity.

I take this approach because I know these positive changes, when habituated, will do more for a child’s physical health and wellbeing than a diet alone.

As a pediatric registered dietitian who works with children with excess weight, I see the stress and strain parents experience when they’re told their child is unhealthy. Naturally, they want to change their child’s weight quickly.  

Ironically, parents intuitively know it won’t be a quick fix. But they’re uncomfortable with dieting. Thank goodness!

Where should they begin? I believe it’s with healthy habits…not a restrictive diet or weight loss plan.

Mostly, we think of improving lifestyle habits with diet and exercise. But, my healthy lifestyle habits “list” is long. There are several key lifestyle changes to work on when a child is carrying extra body fat. The good news is many families are already doing well in at least one area.

For example, a family might have strong habits in the areas of sleep and family culture, but need an overhaul in their food choices, eating habits, screen use, or movement behaviors. Part of my job is to champion the good habits of a child and their family, while helping them build other behaviors that improve health, body functioning, and emotional wellbeing.

In my experience, when the entire family tackles healthy lifestyle behaviors, everything improves, including a child’s BMI.

Diets are Fleeting, Habits are for a Lifetime

Restrictive diets limit energy through eliminating food groups; enjoyable foods like sweets, fast food, and sugary drinks; or they follow schedules that ignore the natural ebb and flow of growth and appetite fluctuations.

Dieting also places children at higher risk for an eating disorder. This is a genuine concern for today’s children who are vulnerable to, and bombarded by, social media where they see thin, fit, “perfect” bodies and dieting inspiration.

Health habits are the real deal. They improve physical health while protecting emotional wellbeing, which is especially important for children growing up with larger bodies. Cultivating good habits during childhood can minimize health risks, improve body functioning, and protect self-esteem for all children.

7 Habit Areas to Focus On to Help the Overweight Child (and All Kids!)

These are the healthy lifestyle changes I promote whenever I work with a new family. I know these are the essential habits that make a difference in a child’s health, and when implemented with consistency, can help all children achieve better health, especially for the overweight child.

Family Culture

Family culture – the beliefs and values of the family – is the most important culture within which a child will grow up. It sets the norms for how a family connects and treats each other. Families with a strong family culture (and parents who are a good role model) are more likely to have kids who grow up feeling loved, confident, and worthy. They thrive in the world. Children with extra weight need a strong family culture to support them, as the world may not be kind to them because of their size.

How do you know if your family has a good habit? Your family gathers frequently, enjoys each other, supports each other and does not tease, bully, or criticize others (within or outside of the family) about their size. Children feel connected to the family unit.

Sleep

The research on sleep in children is abundantly clear: it’s essential for physical health and emotional wellbeing. Yet, many kids aren’t getting the sleep they need. Optimizing sleep hygiene is a simple place to begin for families. Most kids will need at least 9 hours of sleep a night.

Children with extra body fat may experience sleep apnea which can interfere with school performance, mood, and appetite regulation. If you suspect your child may have significant interruptions in sleep, seek professional advice.

How do you know if your child has a good habit? Your child gets between 9 and 11 hours of uninterrupted sleep and is refreshed upon waking, and pleasant to be around.

Movement

Physical activity. Exercise. Movement. I’m talking about these. Moving the body has a direct impact, at the moment and later, on the physical functioning of the body. It also circulates those positive ‘feel-good’ hormones. A double-edged sword of positive outcomes!

Children don’t have to be sporty or play sports to get the benefits of movement. But they do have to disengage from a sedentary lifestyle — get off the couch, off the digital companions, and get outside or be active inside.

How do you know if your child has a good habit? They move frequently, clocking at least 60 minutes of sweaty movement each day. Start with small changes! The science shows that moving – even small amounts – can improve how the body functions.

Food

Food balance is a key area for almost every family with which I work. Prioritizing balance means there are plenty of fruits, vegetables, whole grains, and protein foods (including dairy or high protein-containing alternatives) in the daily eating pattern. It also means that sweets and treats, fruit juice and other sugary drinks are balanced with these foods – not scarce, nor abundant. Besides that, we work on satisfying, nutritious foods that “stick to your ribs,” fighting excessive hunger between meals and snacks.

How do you know if your child has a good habit? They eat a balanced diet: Three well-balanced meals each day, 1-2 nutritious snacks, and have some room for the sweet stuff.

Eating

Food is what kids eat. Eating is how they consume food. Many of the older kids I see have developed eating habits, like large portion sizes, grazing after school, sneak eating, or fast eating, that don’t serve them well, often resulting in overeating. This is a major focus area for us. I optimize mindfulness and appetite awareness for the child, while helping their parents be consistent with predictable meals, healthy snacks, and setting boundaries for extra eating.

How do you know if your child has a good habit? They can tell when they’re truly hungry and satisfied. They tune in to these signals to help them start and stop eating.

Screen Time

Too much screen time interferes with activity level (physical activities) and sleep. It may also encourage unhealthy foods and too much food intake. For larger-bodied kids, screens may be the vehicle of bullying, and a source of body dissatisfaction. Some kids use screens to escape and avoid emotional discomfort. Others use it to connect with others. Although screens can serve a purpose, spending too much time on them can interfere with good health and emotional wellbeing.  

How do you know if your child has a good habit? They use screens minimally each day and they don’t interfere with getting a good night’s sleep or getting recommended amounts of physical activity during the day.

Build Self-Love

When children are growing up with larger bodies, the world isn’t always kind. This can erode their sense of worth, of value in the world. As a parent, you can counteract this by implementing the 6 habits I outlined above. But you can also actively cultivate self-love by creating a body neutral home, where comments and attitudes about bodies center around what they can do (function) rather than on what it looks like.

How do you know if your child has a good habit? They speak kindly of themselves, care for their bodies, and navigate difficulties with loved ones (instead of holding it inside).

Whether your child is struggling with ‘childhood obesity’ or you just want to make sure your child grows up healthy, cultivating positive lifestyle behaviors early on and reinforcing them throughout childhood will provide the basis for their healthy living in the future.

Resources:

• My book, Kids Thrive at Every Size: How to Nourish Your Big, Small, or In-Between Child for a Lifetime of Health and Happiness, will help you cultivate these healthy habits, whether you’re just starting out or needing an overhaul.
• My private services.
• The Nourished Child Blueprint will help you better understand how to create a balanced diet and feed your child in positive ways.