With so much talk about childhood overweight and obesity, it's natural to have concerns as a parent. But be wary of weight loss programs for kids—or health professionals who put the focus on your child's weight and not his health, cautions Rebecca Scritchfield, RD, author of Body Kindness. She recently sent up a red flag about new guidelines proposed by the American Psychological Association for overweight and obese kids.
The guidelines recommend a minimum of 26 hours of family treatment for weight loss, started at the earliest age possible, when children are deemed overweight or obese based on Body Mass Index (BMI).
Though she agrees that some kids may need help changing self-care habits, Scritchfield says she's worried about the APA's approach. Some weight loss interventions can feel like dieting—something kids should never do, she says. "Even though the intent may be to help kids improve mental and physical health, they can actually do harm by putting some kids at increased risk for eating disorders, body image issues, and weight gain," she says.
Using BMI to decide who needs help is also a bad idea, she says. "Children's BMI scores are compared to how children grew in the 1970s," she says. "So if your child grows faster than typical 1970s kids, his BMI may be a higher percentile just because of the type of measurement used. BMI is just a guide. Your family's habits and your child's lab values like his blood glucose level are also signs of physical health." What's more, children at lower BMIs can have abnormal health behaviors like eating disorders or binge eating disorder. "Kids needing psychological support aren't necessarily at a higher weight, and kids at higher weights don't necessarily need psychological counseling," she says.
If you have concerns about your child, Scritchfield offers these words of advice:
Pay attention to your child's habits, regardless of size: Do they generally feel good in their bodies? Do they move joyfully, engaging in sports or activities they like? Do they generally eat a variety of foods they enjoy? Of course kids will like cookies and chips, but do they follow family patterns of eating at mealtimes and choosing foods they like, including healthy foods?
Practice compassion. Weight alone is not an indicator of health. Kids naturally grow in size, especially before puberty. They can gain 20 pounds before the hormones kick in. If mom and dad come from families in larger bodies, of course the child is likely to have a larger frame and body.
Make changes as a family. Family meals, snacking mindfully, and getting enough sleep are behaviors that help everyone in the family.
Speak to kids kindly. Let them know their body is worthy and "good" as it is, but that the family values self-care. Give your kids time to try different behaviors without too much pressure from you. If you push, they will pull away. Instead, let them know you love them and you want them to succeed at feeling good about their habits. And if you think your child would benefit from professional help, seek out a practitioner who is "weight neutral" or "weight inclusive" in their work—someone who seeks to improve physical and mental health, not reach a certain number on the scale.
Sally Kuzemchak, MS, RD, is a registered dietitian, educator, and mom of two who blogs at Real Mom Nutrition. She is the author of The Snacktivist's Handbook: How to Change the Junk Food Snack Culture at School, in Sports, and at Camp—and Raise Healthier Snackers at Home. She also collaborated with Cooking Light on Dinnertime Survival Guide, a cookbook for busy families. You can follow her on Facebook, Pinterest, and Instagram. In her spare time, she loads and unloads the dishwasher. Then loads it again.