Addressing weight concerns with children

EAU CLAIRE, Wis. (WEAU)- Weight can have a big impact in a person's life, especially for kids who struggle with being overweight.

For parents and healthcare providers, that conversation can be difficult when trying to help kids understand the importance of health while being sensitive to the matter.

Body image is an idea almost every person has dealt with in his or her lifetime, and being overweight or obese can be taken negatively. So, talking to kids who struggle with weight can be difficult, that’s why local experts said wording can have a big impact on reducing stigma. Especially as the CDC reports the percentage of children with obesity in the U.S. has more than tripled since the 1970’s.

“Definitely body image is a bigger problem I think nowadays,” said Elizabeth Ring, a mother to two young kids. “I always teach my kids that everybody is a different size.”

While Ring said her kids may not like everything they eat, she knows the importance of teaching them healthy habits.

“I try to make sure they have all the options they can even if they don't like it,” she said. “I make them take no thank you bites if they don't like so they have an idea of what they like or don't like.”

Talking about healthy eating is one trick local nurse practioner Nichole Marty with OakLeaf Pediatrics uses when talking with kids who struggle with obesity or being overweight.

“I generally don't tend to use the word obesity,” Marty said. “I tend to work in more concrete terms of ‘We're above the 95th percentile for weight that means we're above the weight that's healthy.’ So we want to be more active; we want to eat healthier. I think there's somewhat of an unfortunate stigma with the word obesity and so we try to approach it in more productive terms, in what can we do? What are some goals? Instead of stigmatizing them with that word.”

Marty said obesity is a growing epidemic with fast pace lifestyles and fast food readily available. While she's seen more kids struggle with the issue, it's important not to put a negative image in kid’s minds.

“We try to avoid talking about losing weight with children because we'd rather instill healthy eating habits and healthy activity habits rather than overly worrying about how many pounds on a scale.”

But the number one tip she says for a healthier lifestyle for kids starts with you.

“Be sensitive,” Marty said. “You’re child likely knows they have an issue with their weight. Be sensitive about it, be supportive. The number one thing you can do with your child is to you, yourself be healthy.
So parents who are healthy, are a healthy weight, who have healthy eating habits and stay active, their children are more likely to be in a healthy weight to have healthy eating habits.”

Marty says being sensitive and supportive when talking with your kids about weight is a big key. She adds kids should be active for at least 60 minutes a day, and being involved in an activity, whether its dance, swimming or even bowling, can help.

According to the AAP, they also believe changing the way obesity is worded will help minimize the stigma of obesity. They said, “For children who have overweight or obesity, stigma and discrimination can add to their health problems and harm their quality of life, making them feel isolated, embarrassed and sad. According to research, weight alone can be a predictor for victimization and bullying.

In a new jointly written policy statement, the American Academy of Pediatrics and The Obesity Society offer guidance for pediatricians and health care professionals to reduce weight stigmatization and discrimination, and to educate others about the negative consequences of such actions. The policy statement, "Stigma Experienced by Children and Adolescents with Obesity," will be published in the December 2017 issue of Pediatrics and published online Nov. 20.

"Treating obesity is complex and challenging," said Stephen J. Pont, MD, MPH, FAAP, a lead author of the policy and founding chair of the AAP Section on Obesity Executive Committee. "Sometimes we can forget the burden that weight stigma places on children and families struggling with obesity."

Weight stigma among youth is most often experienced as victimization, teasing, and bullying. In the school setting, weight-based bullying is among the most frequent forms of peer harassment reported by students. In fact, 71 percent of those seeking weight loss treatment say they have been bullied about their weight in the past year, and more than one third indicated that the bullying has gone on for more than five years.

"Youth face weight teasing and victimization at school from peers, but sometimes also at home from parents," said co-author Rebecca Puhl, PhD, deputy director for the Rudd Center for Food Policy & Obesity and fellow with The Obesity Society. "This issue needs to be on the radar for pediatric health professionals, who may be among the few allies who can offer support and help prevent youth from further harm from these experiences."

Weight stigma increases feelings of isolation and sadness, which can lead to avoiding activities, binge eating and additional weight gain.
"Words are powerful and can encourage or do harm, and so when working with families trying to make healthy changes, I remind myself: be nice, be patient," Dr. Pont said. "If we are aware and avoid words or actions that could be felt as stigmatizing by our patients, then they will be more successful."

Both AAP and The Obesity Society encourage health care professionals to model non-biased behaviors and language. For example, AAP recommends using "people first" language, such as "children with obesity" instead of "obese child." Empathetic and empowering counseling techniques are also encouraged, such as motivational interviewing, and addressing weight stigma and bullying in clinic visits.
Health care professionals can advocate for training and education about weight stigma in medical schools, residency programs, and continuing medical education programs. They can also empower families to be advocates to address weight stigma in the home environment and school setting.

"Treating children and teens who have obesity means more than just changing nutrition and physical activity habits. It's also about addressing the social and emotional impact that excess weight can have on their quality of life," Dr. Pont said. "Through these new recommendations, we hope to encourage more effective and empathetic approaches in how we address and care for children and families with obesity.”

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