Tuesday, December 11, 2007

Childhood Obesity Revisited

The other day, my kids reminded me of the dessert policy I instituted when they were young. They could choose to either have: 2 small items, like two cookies, or 8 M&M’s. Don’t ask me how I came up with this crazy formula. But I do remember firmly adhering to it and except on special occasions they knew never to even ask for special dispensation.

When they were too young to know any differently, there were no sweets or junk food in our house, at least not for them. As they got old enough to know better, I declared that complete abstinence would create cookie monsters, so “that food” became permissible but only in a natural, controlled rhythm. I do admit to sometimes finding empty candy wrappers and chip bags under couch cushions and under beds, but I allowed these digressions to pass without confrontation. I attributed it to youthful spunkiness and small acts of rebellion - allowing the guilty parties to believe that they had gotten away with something. Instead, maybe it should have been my wake up call.

By the time my kids became adolescents, they could easily have been labeled “chunky”, or “full”, or dare I say, overweight? Although I knew they weren’t skinny, they were very active, avidly playing all kinds of sports and most importantly, they had great self esteem, lots of friends and definitely no body image issues. Today, when I look back at their pictures they were definitely “overweight”. Back then I grappled with how to deal with the problem. Or was it a problem? They were far from obese, lead busy, active lives and quite honestly were very happy. The last thing that I wanted for my kids to believe was that their size mattered. Who's problem was it really?

So we framed it with discussions about eating healthy and the importance of being fit. We always had healthy meals and rarely ate fast food. Removing the sweets and chips from our cupboards was not the answer. I believed that teaching my kids how to eat in moderation and to enjoy food - every type - was a life skill they needed to learn. Removing temptations, instead of learning how to manage them, is no way to enjoy life. Perhaps this approach was a leap of faith, and either it worked or they just grew out of it. As they passed through adolescence, they eventually shed their extra weight.

But how would have I felt if their pediatrician actually labeled them “fat” to their faces at their annual physicals? I am positive I would not have welcomed this harsh reality check. Not only would I have been insulted, I never would have condoned such callous and insensitive behavior from our pediatrician. The American Medical Association has recently proposed such a recommendation:
"We need to describe this in medical terms, which is 'obesity.' When we talk to an individual family, we can be a little more cognizant of their feelings and more gentle, but that doesn't mean we can't discuss it," Washington said. "The evidence is clear that we need to bring it up."

In our ambitious attempt to confront these important issues, physicians still need to be mindful of the power in which they are vested. All adults, for that matter, cannot underestimate the potential damage their words can cause. Stigmatization can do as much harm to children as their overweight bodies. All my kids are average weights now. But they each have gone through different weight phases in their short lives. Had there been intervention by a teacher, a physician or even the government it may very well have had a detrimental affect on them. Who is to say what the best practice is?

It is crucial that we act on the obesity epidemic in our country. However, this call for action needs to be balanced ever so carefully with our responsibility to protect our young people from living a lifetime of never feeling good enough unless they are a size 2 or flaunt a sculptured body of muscle and fine lines. It’s a balancing act on a tightrope that requires master skills to gently make the way unfailingly across that wire or we risk raising an entire population of unhealthy as well as unhappy adults.

Children deserve time to be kids and to not feel like failures because they are overweight - especially when it’s not their fault. Parents, media, schools, economics and social factors are what is responsible for who they are and who they will become. They deserve to be healthy and to have a chance at living happy, normal, productive and fulfilling lives. Fixing the obesity problem in America is far more challenging than we may even begin to imagine.


Karoli said...

I had meant to post a comment on your post yesterday about this and then was rudely interrupted by family matters, so I'm glad you followed up. Both of these posts are great. Right after I read your post, this article popped up in my news feeds, about parents not recognizing obesity in their children. Can that really be true?

Weight is a concern in our family, especially for my daughter and husband, who are blessed with beautiful skin, powerful legs and the ability to gain weight easily. When my in-laws first moved to our town, my MIL would have cake and cookies and all the things that tempt kids that I never have around in the house ready for my daughter when she came over. My SIL has serious weight issues and finally intervened, urging her mother not to make the same mistakes she made with her.

I'm also paranoid about being too focused on weight and causing her to go too far the other direction, into eating disorders. So our solution is to indulge her passion for dancing, which keeps her fit and at her ideal weight.

I think she will always have to be physically active for her health, so I figure encouraging it now with something she loves will go far toward developing adult habits worth keeping.

Leslie said...

Thanks - to your first point - absolutely, I think that study is exactly right. We never saw our kids as overweight until we saw pictures of them after they had lost weight. First of all, I think you just love your kids for who they are and truly you really do see them way beyond the physical impression they may make. And yes.... it really is a fine line between making an issue of it (especially when, as you say they are active and happy) and causing an eating disorder. We can't play into that cultural image of skinny is best. However, there really are serious health implications for the future so the issues are somewhat competing.

... and finding a balance for those enticing sweets is always an issue.

It's great that you are encouraging your daughter to pursue the physical activities she enjoys. We all need to be active in one way or another - finding something she loves to do is great.

Emily said...

I doubt a school or doctor would label a child who is active and healthy and a little on the chunky side as "fat." That would be a poor choice on their part, no? If you had a good doctor, he or she probably heard about a total lifestyle and was unconcerned. However, if the same weight and height came in and listed television as her only hobby, I would hope the doctor or teacher would speak up.

We allow limited sweets. There are always cookies at Shabbat dinner (and candles and DADDY!) If a cookies are given out at playdates, that's fine. And when company comes over, we have dessert. But, the one year old likes cookies and cakes only to crumble, then points over at the fruit and asks for a clementine. And the older one is happy both nights with milk for dessert.

I hope that when they get older, they see sweets as a limited but not taboo part of an otherwise healthy lifestyle. I hope the little one still likes to eat broccoli in front of the TV. But, mostly, I hope that, no matter what they look like, they get out and do fun physical things. Just like your kids!

Don Mills Diva said...

This was really an excellent, thought-provoking post. Of course we want our kids to be healthy but sometimes I think obesity is just one more of OUR fears that we project on our children.

Anonymous said...

leslie, we remember that odd rule about the cookies!

love, katy and syd.

TIV: the individual voice said...

I never let my kids have candy in the house when they were little but somehow they learned how to hide and manage their stashes of Halloween candy for the whole year, as candy wrappers were stuck in every possible nook and cranny in the house, most notably under the bed, which might have accounted for one son's many cavities. He was a chunky kid from birth, but has grown up to be long and slim, after all my years of worry. He was never fat, just "husky" as was my brother as a child before growing into a tall and slim man. I think some kids just go through chunky phases as kids and grow out of it. I don't know how doctors can determine that all kids must be a certain weight at a certain height at certain ages. Fortunately, our pediatrician never made a big deal, since my son fell within the higher end of "normal." Funny, look back at the pictures, he's chunky, but not as bad as I made it. My perceptions were the opposite of that article, maybe because growing up with an overweight mother who was constantly dieting I was literally phobic about having fat children.

Leslie said...

Well, "Anonymous" who signed your names - did I make you abide by the rule when you were in our house? Maybe you were the one's hiding the chip bags and my kids were innocent!