Rona Ewart, MEd, RDN, LDN

Many parents are concerned about their child’s weight, and for good reason. Research indicates that one in three kids ages 10-17 are either overweight or obese. These conditions are defined by a body mass index (BMI) at or above the 95th percentile, which is typically calculated by a pediatric provider.

Child and teen obesity is a medically recognized, complex disease resulting from a combination of social, economic, environmental, and genetic factors. The medical risks include developing high blood pressure, pre-diabetes or diabetes, high cholesterol, fatty liver disease, sleep apnea, asthma, depression, and anxiety. Obese kids typically already have at least one of these medical conditions. Kids who are overweight or obese are also often the victims of bias, stigma, and bullying, and may suffer from poor self-esteem or a lack of confidence.

Talk with your child’s provider to discuss concerns about weight and strategies for treatment. Weight can be a sensitive topic, and pressure to lose weight can result in resentment, rebellion, lowered self-esteem or confidence, and an increased risk of eating disorders. It’s important to focus on improving health, working on it as a family, and not singling out a child about their weight. The goal is to help empower kids and teens to learn to make healthier choices for themselves.

When talking to children and teens, focus on topics related to overall health, including healthy food choices and how they affect the body, getting input on menu ideas, shopping for and cooking food, and new ways to become more active. Don’t talk about numbers on the scale, dieting, eliminating entire food groups, labeling foods as good or bad, or criticizing how anyone’s body looks.

Creating a supportive, trusting environment and listening to feedback without judgment helps kids feel more comfortable talking about their feelings, concerns, and the changes they are interested in making. Kids also tend to respond positively to health changes when their parents set an example by actively working on their own health without focusing on weight and appearance.

Develop a Family Meal Plan

It is the responsibility of a parent or caregiver to offer regular meals and snack options with a variety of healthy foods to meet a child or teen’s nutritional needs. Visit MyPlate.org as a starting point for including foods from all the major food groups in appropriate portions. Make a list of balanced family meals and snacks that your family already enjoys, and add new menu items over time.

A family approach can help inspire kids and teens to try new foods and work towards better health. Whenever possible, make sure to include children and teens in meal planning, selecting, and preparing food. Include the fun factor, such as a trip to the farmer’s market, theme nights, playing “restaurant,” or planning dinner and a movie on the weekends.

Aim to have family meals all together at least three times a week. Include light conversation and do not bring screens to the table. Family meals help build strong connections and can help kids manage their weight, while improving confidence and self-esteem.

Offer Healthy Snack Foods

Replace snack options that are high in fat, salt, and sugar (chips, cookies, snack cakes, donuts, etc.) with healthy options for after school, evenings, and weekends:

• Add more whole grains, including bread and wraps, crackers (whole wheat Ritz), cereals (Cheerios), and air-popped popcorn.
• Add protein for longer staying power, including cheese, lean deli meat, peanut butter, hummus, hard-boiled eggs, and Greek yogurt
• Include fresh, frozen, canned-in-water fruit, or 100% fruit juice in limited amounts
• Add more vegetables, including raw carrots, cucumbers, celery, broccoli, cauliflower, pepper strips, etc.

Explore quick alternatives to processed frozen snacks:

• Make a mini pizza: split a whole wheat English muffin in half, top with spaghetti sauce, cheese, deli ham, or turkey, and heat it up!
• Create kabob skewers with cheese, meat, fruit, or veggies
• Roll up deli meat or cheese and vegetables such as spinach, lettuce, cucumbers, etc., in a whole grain tortilla
• Whip up a smoothie with fruit, Greek yogurt, and low-fat milk
• Make half a sandwich or a small bowl of high fiber, whole grain cereal (Cheerios, Bran flakes) with a serving of fruit

Eating Out

• Find food options that are not fried (grilled vs. fried chicken tenders)
• Explore opportunities to include more fruit and vegetable sides
• Drink water, low-fat milk, or sugar-free drinks
• Teach kids to be aware of food portions

Increasing Physical Activity

• Go for a walk, hike, ride, swim, head to the playground, or make up a nature scavenger hunt
• Fly a kite, draw with sidewalk chalk and play hopscotch, hit at the batting cage, play kickball, badminton, basketball, etc.
• If it’s raining, have a dance party in the house, make up a short routine (squats, jumps, wall pushups), or find an active video on YouTube
• Join a team – sports, dance, cheer, etc.
• Have an active chore list (sweep, dust, vacuum, wash the car, etc.)
• Limit screen time (other than homework) to two hours a day

Better Sleep

• Aim for kids to go to bed and get up at the same time each day, even on weekends
• Take screens out of rooms at least 30 minutes before bedtime
• Include wind-down activities: warm bath or shower, reading, stretching, soft music, etc.

Take time to notice any positive changes your kids make. Give praise and encouragement, and use non-food-related rewards to help reinforce change. Keep appointments with your child’s provider and ask for referrals to a counselor or a registered dietitian/nutritionist as needed. Kids struggling with weight issues can be a challenge, and support is crucial in the process.

Working toward better health is a journey, and setbacks can also be a part of the process. It’s easy to get off track with vacations, holidays, schedule changes, or during times of stress.  Work together with your child or teen and help them transition back to a healthy lifestyle as soon as possible. Focus on the positive outcomes, such as having more energy, improved mood, and the ability to handle stress better when you and your child take better care of yourselves. Helping kids learn to take charge of their health is a lesson that will benefit them for their whole lives.