Sunday, March 27, 2016

Overweight Children Part Two: Ten Tips for Parents

David McPhee, Ph.D.

 Fat kids suffer, and not just because other children are mean. Studies suggest  teachers favor lean, cute boys and girls, and assume they're smarter. Many assume obese kids are weak, lazy, and unhealthy. Overweight adults know subtle judgment and rejection, but have grown-up defenses.  For kids it’s harder. For them “fat” is a cruel insult that has no response. Here are my ten tips for parents:
       1. Never reward or punish with food. Give treats for good behavior, especially sweet and fatty ones, and your child will connect fats and sweets with love and approval.  If you withhold food to punish, you’ll reinforce the food-love connection. 
                   2. Be calm about food. It's a law of nature that you pay a lot of attention to a behavior it will increase, even if the attention is negative. Be neutral and matter-of-fact about what kids eat or don’t eat. If a child isn’t eating, stay cool and distant. If kids are eating in a polite and moderate and healthy way, that’s when to show feelings and appreciation. If you get in a power struggle about food you’re sure to lose.
                   3. Model emotionally healthy eating. Let the kids see you eat slowly, with attention and enjoyment. Express delight about tastes and textures and temperatures so that kids stay aware of the eating process without distraction.  By definition, compulsive overeaters don’t pay attention to their food; all they seek is the current fix and the next. Don’t serve food in front of a television or with other major distractions. Mindful eating and compulsive eating are incompatible.

          4. Let eating be a pleasant ritual, a ceremony.  Have the kids set the table and decorate it. Light a candle or two, even on ordinary occasions. Assume that eating is that special place, not in the media room or the bedroom, and certainly not in the bed or the car.  If you have to get fast food, slow it down. Go inside and sit at a table, and don’t teach kids to eat in a moving vehicle.
                    5.  Never use shame to get a kid to stop overeating. It won’t work. Compulsive overeaters already associate food with love and approval. A shamed kid will will just eat more to feel better.
                   6.  Be aware of your kids’ metabolism.  Most children’s blood sugar is a little low when they get home from school. A small glass of juice, or better yet, raw fruit, can help smooth things out.  There is no such thing as a “sugar high” (unless the parents expect it) but big doses of refined sugars like soda pop are not kid-friendly.
                  7.   Please don’t put your kid on a diet. Unless it’s a life-time diet, all you will get is resentment from the child, and short term weight loss. Soon the fat will return.  Deep down we all know that diets rarely work for long-term weight loss. Older kids might want to improve their nutrition and ask for help. That’s different. Research and learn together, when your teen is ready to explore healthier eating for life.
                   8. Don’t provide binge foods. Kids who eat compulsively often have a few items that make them crazy. Like alcoholics, they start and can’t stop until it’s all gone. Chocolate candy bars are a frequent offender: those big molecules of fat feel so comforting in the mouth and the bit sugar hit is so soothing. It could be any food, but it’s likely to be highly concentrated: lots of calories for the size. Just don’t have it in the house.
                   9.  If you’re overwhelmed, get help. Consider sending yourself to counseling instead of your child. You might be your own kid’s best therapist, and the counseling can provide you tools to do it. In my practice I call it "therapy by remote control."
        10. Admit you are ultimately powerless. You can restrict your dog’s food by putting what you want in the bowl, but human food is everywhere. Determined, driven kids will get it, at least when they’re old enough to be sneaky. Start by accepting and enjoying your overweight kid. Start by letting go of all blame and all shame. That's how you'll increase your influence with your child and your ability to help.

I published this article in another form here, in 2012.  David McPhee, Ph.D.