Posts Tagged ‘ nutrition ’

When Will “SHOCK” Parenting Go Out Of Style?

Saturday, March 31st, 2012

Here we go again – another parent makes a big splash with outrageous claims about her parenting methods. This time it’s that Vogue article about one mother’s reaction to hearing that her daughter was obese – which turned out to be a pathologically inconsistent set of messages and dietary practices. I have three reactions to all this.

First, IF the claims are true, then I agree with the take offered by my fellow Parents.com blogger Heather Morgan Shott. Heather tackles this issue much better than I could.

Second, IF this story was embellished, then I suggest in the future articles of this nature come with a warning label that says: “The truth has been stretched – and then some – in order to gain viewer’s eyes, make their blood boil, and give them something juicy to talk about.” This is especially relevant since the author of the Vogue article has a deal in place to expand her thoughts in a book. I don’t know if you recall what transpired when the Tiger Mom book came out early last year, but the sequence was roughly this: 1) the most outrageous quotes from the book were used to publicize it, 2) the author then suggested that those lines were clearly not to be taken literally, and 3) then it was suggested that the book was really just a memoir and not an endorsement of any type of unhealthy or damaging parenting practices. When all was said and done, we could look to recent research for some sanity, as it demonstrates what we would expect: 1) parents who push their kids really hard to achieve success without providing warmth, love and support place their kids at risk for depression and other not so great outcomes, and 2) it is possible to set high standards for your kids and help them be achievement oriented and actually act in a loving and supportive way at the same time. So to me the simple warning label suggested above would certainly help me figure out what the real message is the next time a SHOCKING book or article comes out.

Third, rather than focus more on this Vogue article, I’d love to hear real stories about real parents who are digging deep and trying hard to do the best for their kids. It’s not easy getting the balance right with respect to body image and health these days: we’re stuck between a multitude of social forces which, on the one hand, promote obesity, and, on the other hand, push kids toward eating disorders. Many parents struggle with their own histories of eating issues and body image concerns, and they are hopefully finding ways to promote realistic healthy eating habits and corresponding physical and cognitive pathways to positive self-esteem. I’d love to hear stories about how real parents handle these challenges. So consider this an invitation to share your story about how you balance all these concerns and what obstacles you face – we need to focus on REAL parenting rather than SHOCK parenting.

Image of shocked women via Shutterstock.com

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An Enlightening Story About Extreme Childhood Obesity: When It’s Not Just Parenting

Tuesday, November 29th, 2011

Yesterday, after I blogged about using foster care as an intervention of last resort for extreme childhood obesity, I spent the afternoon in a juvenile court. I was working with a judge and clinicians to help develop a platform for making family-centered interventions available for teens who are in need of services for a variety of issues (typically delinquency and substance use). We ended up talking about the obesity debate – and I heard a story that was an eye opener. Here it is. 

There was a child who was placed in foster care because of extreme obesity and the parents’ lack of compliance with medical recommendations. During the time in foster care, the child lost 60 pounds. He was then reunited with his parents. The parents were working with a nutritionist and made lots of changes to the child’s diet. Even though they had limited resources, they found ways to purchase fresh foods and made healthy meals at home, all under the guidance of the nutritionist.

Despite this, the child started to slowly gain back weight, and after a few months, had put back on 30 pounds (half of the weight that he lost in foster care). Everyone – including the nutritionist – was baffled. Then someone finally figured it out.

The cause? The meals provided by his school. Yep, it was primarily the school lunches that were putting the weight back on.

So in this one case, the foster care model (which I don’t favor) actually did work, and in-home intervention (which I do favor) actually did work – but these accomplishments were undermined by the school system.

If we trust schools to educate our children, shouldn’t we trust them to also feed them properly? I’ll state the obvious – the obesity epidemic in this country is not just about parenting.

Image: Double Cheeseburger via Shutterstock

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Obese Third Grader Placed In Foster Care: The Debate Continues

Monday, November 28th, 2011

Today there is a reported case of an obese third grader being placed in foster care. The rationale for this is that when a parent(s) ignores or doesn’t properly follow medical recommendations – and their child continues to suffer from extreme obesity – then the appropriate agency can petition a court and cite “medical neglect” as a rationale for temporary placement in foster care. 

I discussed this issue this summer in response to a thoughtful and provocative editorial published in the Journal of the American Medical Association. But now that we have a current news story in front of us, it seems appropriate to continue the debate.

To start, let’s be clear about one thing – a third grade boy who weighs over 200 pounds and is suffering from sleep apnea requires immediate intervention (we’re not talking about a kid who is a little heavy for his age). The health risks – both immediate and longer-term – are too great to be ignored. Let’s add to this that fundamental changes in the child’s caretaking are necessary (we’re not talking about occasionally eating too much junk food and not getting quite enough exercise) – especially since they have not happened despite medical advice.  And even if there is a medical basis (including rare but powerful genetic conditions) underlying the obesity, major lifestyle alterations will need to be made with respect to diet and activity. So the issue is how best to deliver an intervention that will be successful.

I continue to understand the frustrations of practitioners who are trying to (quite literally) save a child’s life, and watch as their suggestions are not followed. But I still disagree with the idea of taking the child away from the mother, especially since the goal is to return the child at a later time. Simply put, I think administering in-home intervention that will help teach the mom and her son how to break the extreme habits that have been formed would serve as the best platform for long-term change. As someone who is currently conducting research on family-centered interventions, I know first-hand that this is easier said than done. But to me there is much more potential for improving this family’s life – and this boy’s health – by keeping them together and devoting all the potential resources to deliver in-home care to get this family to make the changes they need to make. Sometimes families need help, and by bringing medical intervention to them in their home environment, perhaps we can make more progress in the fight against childhood obesity.

Image: Healthy Diet Via Shutterstock

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Preventing Obesity Without Promoting Eating Disorders: What’s A Parent To Do?

Thursday, July 21st, 2011

heather morgan shottThis week, my fellow blogger Heather Morgan Shott asked a really good question, partly in response to my recent post about severely obese youth: should we only feed our children healthy food? And I would add: if so, do we run the risk of promoting eating disorders? Stay with me here as I walk through the issues.

The obesity epidemic in this country (it’s estimated that 1 in 3 adults will have diabetes in the year 2050) clearly suggests that many children (and adults) are not eating properly. From a research and clinical perspective, there are of course many factors at play  – genetics, lack of exercise, sleep deprivation, socioeconomic contributions — but without question unhealthy eating is rampant in our society (both in terms of what we eat, and how much we eat). So it should not be a controversial statement to say that, as a population, we need to eat healthier.

One way to achieve this is to just eat healthy foods. From a health and nutrition viewpoint, this would clearly be a good thing to do. But there are two issues to consider.

First, many of us seem to like less healthy foods as well (I do). And as babies turn into toddlers, and toddlers turn into children, they are going to be exposed to a variety of foods that we as parents can’t control. It could be at a birthday party, at a friend’s house, or as they turn into teens, out at the mall with their friends. One consistent finding from research is that overt restriction by parents often backfires — kids can crave what they can’t have and go nuts for it once they get it. Which leads to the second issue: the roots of eating disorders are often planted in childhood. Again, strategies like banning and restricting can, in some cases, create food issues which lead over time to the onset of maladaptive eating behaviors.

So it’s not easy to figure out how to get it right for kids. I don’t have specific answers, and I trust parents to wade through these issues themselves and come up with their own algorithms of what’s healthy, what’s tolerable, and what’s not acceptable for their own kids. But I think the key is for parents to be educated about kids’ food choices, so that they can give their kids tools to make good decisions and develop healthy habits. So, this means knowing how many calories are in a fast food meal, or how much sugar and fat is in a dessert, so that if you permit your child to indulge, they can regulate portion sizes and understand why these foods are to be consumed only occasionally.  And if you don’t want your child to eat certain types of food, you can convey why that is and what they might turn to as healthier alternatives (rather than just banning them).

But all that said, there is no substitute for a core diet of delicious and healthy foods — which is why I enjoy following Heather Morgan Shott’s blog for recipes!

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Does Severe Childhood Obesity Warrant Separation From Parents?

Friday, July 15th, 2011

If a child is severely obese, and facing immediate health risks (such as onset of Type 2 diabetes), should this be considered a form of child abuse or neglect? Should the child be placed in foster care to promote substantial weight loss?

As many of you know, an essay published earlier this week in the Journal of the American Medical Association (JAMA) suggested that, in some rare cases, the answer is yes. (Do keep in mind that the paper was an opinion expressed by researchers and not a formal statement by any professional organization or JAMA).

I say no. But before I share why I came to this conclusion (it took me 3 days to figure out exactly what I think about this complex issue), let’s consider the many important points raised in this paper.

First, I appreciate how the authors articulated the responsibility that parents have these days to understand the very real risks for obesity for youth in a culture that the Centers for Disease Control and Prevention has labeled “obesogenic.” These include: too much unhealthy food, not enough sleep, and not enough exercise. It’s a challenge for all of us parents to keep up with the many factors (obvious and subtle) that continue to push kids into unhealthy lifestyles.

Second, I firmly agree with the authors that educating parents about lifestyle choices is imperative, especially if kids are edging towards very real health issues that are related to weight. As they point out, it is possible to intervene and try to prevent problems before they happen in youth — immediate weight reduction could prevent onset of Type 2 diabetes in severely obese youth.

Third, I also respect how the authors suggested that only a very few clinical cases (the most severe and extreme) would warrant consideration of separation from parents. And I get the frustration that health care providers experience when they see a child heading towards potentially irreversible diseases, yet observe no changes happening with respect to parenting.

All that said, I still think that are emphasis should be placed on developing interventions to help families lead more healthy lives (especially since our culture is full of risk factors that impact parents as well as their children), and to find methods to help parents help kids achieve immediate lifestyle changes when necessary. Although the clinical perspective may lead some to want to impose temporary interventions to protect children, the broader public health mission is to put more resources into ways to educate both parents and their children as a unit to support each other’s transition to healthier lifestyles. Let’s try to keep families together and help them develop into healthier families.

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