Archive for the ‘Weight Management’ Category

Children mimic your behaviors!

Contrary to popular belief, children hear what you say and see what you do.  Your behaviors and comments can leave a lasting impression.  Even your body image or weight concerns can be passed on to your kids.  Evidence shows that stressing thinness and weight control promotes eating disorders, low self-esteem, decreased body image, and weight bias in children.  Furthermore, eating behaviors linked to a higher risk for obesity are known to develop very early in life.  A 2001 study showed family food environments and attitudes around food and eating affect even preschool-aged kids’ eating behaviors.  You may think youngsters don’t pick up on your drastic dieting or negative comments you make about your body like older children, but they do!

Several studies show that restrictive feeding can impair a child’s ability to regulate their intake, resulting in overeating and weight gain.  Worrying about your own weight can influence your feeding style.  For example, forbidding high calorie foods or sweets in your home can result in your child sneaking food or feeling deprived and overeating when given the opportunity.  Overly controlling or eliminating fun foods simply doesn’t work with kids – balance is key.

Have you ever found yourself saying out loud:

“I have got to lose weight, I am getting so fat”

“I am going to be good and skip lunch today”

“No more desserts for me, I don’t deserve it”

If so, you may want to censor your comments and think before you speak.   Remember, your words could promote your child’s weight gain!

As a parent, you can model  “good for you” behaviors without fixating on weight.  There’s nothing wrong with guiding your child towards adopting healthy habits that will benefit him or her – that’s part of your role!

Fortunately, there are several steps you can take to promote a healthy weight for yourself while empowering your child.


  • Be physically active and limit your own sedentary activities
  • Aim to eat when feeling physically hungry
  • Have a neutral view about all foods
  • Stock a range of nutritious foods in your home and choose these options more often
  • Offer balanced family meals as much as you can
  • Choose to talk about yourself and others with respect and appreciation


  • Get caught up in the latest fad diet or encourage your child to diet
  • Skip meals
  • Eliminate all sweets or high calorie foods from your home
  • Use food for rewards or punishments for yourself or for others
  • Eat while standing up or distracted (may lead to eating mindlessly)
  • Emphasize effects of unhealthy eating
  • Focus on anyone’s weight, especially yours or your child’s

Bottom line:  You are your child’s biggest role model – do you want your child viewing and treating their body the way you do?

Contributing Author:  Katherine Fowler, MS, RD, LDN


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At a young age, health habits develop and can affect your child throughout their lives, especially when it comes to eating and physical activity.  You are the fundamental decision-maker when it comes to the well-being of your child and can help him or her make healthy decisions from early on.  Take advantage of your role and foster your child’s 7 healthy habits…they can make a lifetime of difference.

Healthy kids get physical activity every day!

Healthy kids: 

  1. Get at least one hour of physical activity daily.  Shorter bouts of exercise that tally up to 60 minutes count! Strive for vigorous activity at least three days per week.  Try to make physical activity a part of your family’s fun routine and schedule activities together.
  2. Limit “screen time” to less than two hours per day.  Researchers show a strong correlation with the number of hours spent watching TV to increased rates of obesity in children.  Regulating the amount of time your child spends in front of a screen like television, video games and computers, promotes less sit-down time which can result in more activity and less overeating.
  3. Avoid sugar-sweetened beverages.  Urge your child to drink water, 100% fruit juice or low fat milk instead of soda, sugar-sweetened fruit drinks, sports drinks, and sweetened iced teas.  These sugary drinks offer little nutritional value and excess calories that can contribute to weight gain.  Limiting sugary drinks in your home can support your child in choosing healthier options.
  4. Eat five or more cups of fruits and veggies daily.  Fruits and vegetables are nutrient-dense, low calorie foods that provide fiber, promoting fullness after meals.  Reaching 5 cups per day can be accomplished by serving fruit at every meal, and a vegetable at 2 meals and/or snacks.  If you want more fruits and veggies to be eaten, make sure you have ample choices in your kitchen.
  5. Eat 5 family meals weekly.  Eating meals together gives you a chance to help your child develop a healthy attitude toward food. It also allows you to serve as a healthy eating role model, make sure your kids are eating nutritious foods, and introduce new foods.  Set aside your meals as family time and eat together as often as possible.
  6. Eat nutritious snacks.  Plan meals and snacks to occur every 3-4 hours.  Skipping meals or snacks can be a trap for overeating later on.  Help your kids by having wholesome power snacks on hand that defy hunger.  Opting for whole foods will give your child a rich source of nutrients and will help them be physically satisfied.
  7. Eat “fun foods” in moderation. There are endless opportunities for fun foods like sweets, soda, and fried foods. Balancing “fun foods” with a variety of whole, natural foods from the new food guide (more on this soon) is the key to healthy eating.  Aim for 1 to 2 “fun foods” daily—it’s a good rule of thumb.  Help your child make decisions about what is most special!

The best time to start instilling these behaviors in children is when they’re young, before unhealthy choices become bad habits.  Research shows children are more willing to eat healthy foods and be active if they see their parents doing it first.   Just telling your kids what to do won’t work (that’s the Authoritarian way)—they need to see you choosing healthy behaviors!

The American Dietetic Association offers a free healthy habits for healthy kids guide and healthy habits quiz you can take here to find out if your family is on track.

Summer is a great time to work on the 7 Habits!

Contributing Author:  Katherine Fowler, MS, RD, LDN

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In a culture plagued with weight problems and thin idealism, it’s no wonder kids are asking their parents, “Do you think I’m fat?” In fact, according to a 2008 Canadian survey, 37% of ninth grade girls and 40% of tenth grade girls believed they were, in fact, too fat.

Many parents are blind-sided with this question and are left stumped into silence or heading to Google, the doctor, or a friend for advice. According to Laura Newton, a psychotherapist and eating disorder specialist in Nashville, TN, the timing of this question is an important factor in deciding how to respond. “If this is the first time this question has come up, tell them they look fantastic, and make sure to stay away from using words like ‘big’ or ‘small’, ‘thin’ or ‘heavy’,” states Newton. If this is not the first time this question has been asked, then this is a real concern that needs your time and attention. “Sit down with your child and have a conversation, beginning with, “you have asked me this question a couple of times—what’s this about?” advises Newton.

Newton states that kids get these questions from a variety of influences, including their own parents, peers, and the media. Coming up with a thoughtful and meaningful response depends upon the influence your child is concerned about.

The Parent: Without even knowing it, parents pass on their own body image and weight concerns to their children. “If you find yourself asking, “Do I look good?” or “Do I look fat in these jeans?” to your hubby or other family members, you may want to temper those questions in front of the kids,” says Newton.  Rather, Newton suggests parents consider using this mantra for themselves and their family, “Enjoy your own body, as if your body is more than a clothes hanger. Revel in the beauty of a functioning body, which is the vehicle that will take you where you want to go in life.”

The Peers: Children surround themselves with their friends and find themselves in situations where body comparisons come naturally, such as the gym and the locker room. And particularly during pre-adolescence, the child has a developmental urge to find out if they are normal. “Answering the question, “Am I normal?” is developmentally on target and relies, in part, on looking at others and comparing oneself with others,” states Newton.

The Media: The ‘thin is in’ ideal makes its mark on children, too. And when you combine media power with a general desire to fit in, it’s easy to see how questions about self-worth and inadequacy can surface.

So what can parents do?

Most importantly, your child needs to hear that you accept and love them regardless of what they look like. No matter what. Period.

Here are some other things Newton encourages parents to keep in mind:

Respect and Honor your own body, no matter what the size or shape it is—it is your body after all…and the body that produced your child, and takes you where you want to go.

Tolerate normal child growth.  Pre-pubescent girls and boys gain weight in preparation for the rapid growth of the teen years—this is a normal process.

Focus on your child’s inner qualities. Begin pointing out inner qualities as early as possible, to help build self-esteem and worthiness.

Limit media influences. Think twice about buying that fashion magazine for your 11 year old and be sure to scrutinize the TV shows your child is watching.

Attitude is everything! Everybody has value, no matter what it looks like.

When your child asks “Do you think I’m fat?”, she is asking you to discuss your values and ideals about body weight, shape and size. He is also giving you the option to debunk media messages, thin idealism, show your acceptance and assure love. Seems like a golden opportunity to me.

Have you had this question? If so, how did you respond?

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With growing concern and rising numbers of eating disorders in our youth, we are launching our 3-part series on Eating Disorders, written by eating disorder specialist and colleague, Katherine Fowler, MS, RD, LDN.

I am sure you have heard discussions about diets and resolutions of weight loss in past weeks.  Your child is probably listening to these conversations and may be thinking about going on a diet or losing weight.  Did you know that dieting is linked to disordered eating behaviors?  Studies have found that young dieting girls are seven to eight times more likely to develop an eating disorder than girls who do not diet.  Because dieting talk is everywhere this month, I thought this an appropriate time to launch a series on the parent’s role in preventing, identifying, and treating this growing problem.

So what exactly are eating disorders? They are a serious disturbance of eating behavior.  Eating disorders are not diet strategies or trends, rather, they are serious psychological disorders that have the highest mortality rate of any mental illness. There are many types of eating disorders and they are not limited to gender, age, socio-economic status or ethnicity.

This issue is affecting kids at younger ages than ever before.  According to the National Association of Anorexia Nervosa and Associated Disorders Ten Year Study, 10% of those affected report an onset before the age of 10 years or younger. Not a surprise considering one study found 81% of 10 year old girls are afraid of becoming fat.  Kids’ exposure to thin idealism and dieting from TV, movies, magazines, and the Internet is not fading anytime soon. The National Eating Disorders Association’s description on factors that may contribute to an eating disorder provides more information.

There are three categories of eating disorders; you can view the DSM-IV criteria for eating disorders for more details.

1. Anorexia nervosa (AN)

Refusal to maintain body weight at or above a normal weight for the child’s age and height; an intense fear of gaining weight or becoming fat.

2. Bulimia nervosa (BN)

Uncontrolled or binge eating accompanied by behaviors to prevent weight gain, such as self-induced vomiting, laxative use, fasting, excessive exercise, and others.

3. Eating disorders not otherwise specified (EDNOS)

Disordered eating that meets some, but not all, of the criteria for anorexia or bulimia; includes more uncommon eating disorders.  Binge eating disorder (BED), or compulsive overeating without behaviors to prevent weight gain falls into this category. Most people with BED are overweight or obese.  Binge eating is often done alone and parents may not be aware their child’s weight gain is related to binge eating.

Even though EDNOS is not as “well-known”, it can still be just as serious as anorexia or bulimia.  Complications of eating disorders can create countless health consequences that can be lethal in severe cases.

The most important thing you need to know is that parents can help prevent eating disorders in their children. And, the earlier treatment is sought, the higher the likelihood of a full recovery.

Raise awareness by sharing this post with other parents!

Stay tuned next week for Part 2 of this series, Warning Signs Parents Need to Look For.

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I am not  a fan of diets.  They don’t work.  Especially with kids.

Many adults argue that a calorie-restricted diet is just the nudge they need to launch their new eating habits and the resulting weight loss they desire. But for kids, restrictive approaches to weight management just don’t seem to work well. Maybe it’s the aspect of hunger, or the emotional responses that erupt, the growth influence, or just human nature that complicates weight loss for kids.  I suspect many adults would agree that some of these obstacles exist for them when using restriction as a diet attitude.  Maybe that’s why ‘diets’ aren’t working in a lasting way for adults.

We know that there are significant risks associated with dieting in teens, such as increased eating disorders and disordered eating, continued weight gain despite efforts at weight loss, and lowered self-esteem.  Diets dish up a mind-set of  “I can’t have this…”.  Human nature shows us that when we cannot have something we want, we want it even more…in the case of dieting and children, you can see where this path leads to: overeating. Having worked with many children and teens who need and begin the path to a healthier weight, I know first-hand how difficult and frustrating the process can be. And how much time it can take.

But I am here to tell you, be patient, healthy weight loss takes time. Especially for kids.

As we all get ready to begin the year 2011, I have compiled an analogy to describe the process and patience required for you and your child as you better your eating habits and your lifestyle.  It’s the Garden-Planting Analogy. I won’t get into the details of foods, portions, exercise, TV/screen time here, because you can find that in my Why Weight? blog series from last year, and the Family Pocket Guide that resulted from the blog.

Real change takes time. Whether it’s starting a new exercise routine, trying to be a better mom or dad, or getting to church regularly, making real change in your life requires a commitment to practice new behaviors every day. This is true for new health behaviors as well.  So how is planting a garden similar to waiting for weight loss? Let’s take a look, step by step:

The Garden-Planting Analogy

STEP 1: Prepare the soil Just like you prepare the ground to plant your crops, your child’s body must prepare for weight loss. This means getting rid of excess nutrients (like calories, sugar, and fat) and including nutrients that are missing from their diet.  Start a movement program that your child (and family) can stick with.

STEP 2: Plant the seeds Seeds are the nuggets of information from which change can root and thrive. Educate your child with credible nutrition advice that includes what to eat, hunger management, and fun, healthy activity. Educate yourself with how to feed your child, using positive attitudes and actions that include role modeling, daily movement, and meal routines that support healthy eating.

STEP 3: Water regularly Crops die without regular water and nutrients.  So will your efforts at weight loss if you don’t pay attention to your healthy behaviors every day. Practice good nutrition, adequate sleep and physical activity daily.

STEP 4: Wait for the roots to take hold Herein lies the frustration.  We want to plant the seeds and see an immediate garden.  But you and I know, an abundant garden requires daily care.  This same nurturing and care-taking is needed for child weight loss too.  It takes time for nutrition education and daily health practices to synchronize and internalize. Practice your health management techniques everyday, and wait.

STEP 5: Watch the plants bloom and grow Before you know it, a plant sprouts and takes hold.  The same will happen with your family efforts for better health. Soon, kids will be sleeping better, be more active, and eat healthier. And the scale will begin to move (or stay the same, depending on the weight goals for your child).  But even better than that, your family will have practiced and adopted skills and health behaviors that can last a lifetime!

A cup of  “Good things come to those who wait” blended with a pound of  “Practice makes perfect” and you’ll have a recipe with the right attitude, level of commitment, and patience to see your child (and your whole family) succeed with weight loss.

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My pediatric clients know how difficult it is to go to parties, celebrations, or gatherings that have food as a central focus.  This is a problem with which adults are often challenged, but is a growing reality for many children, too.

School parties, birthday parties, end-of year celebrations, holiday festivities and sporting event gatherings are just a few of the regular party events that children face.  And many of the parents I work with are frustrated with the number of food-focused events their children have to tackle, especially if healthy eating is a priority, or weight is an issue.

“I can’t decide what to eat…I want it all!”.  “There are so many desserts and they all look good…”.  “All my favorite foods seem to be at parties.”  These are real sentiments from real children.  

True, it seems that parties and celebrations are loaded with temptations and often offer all the “fun” foods that may be regulated or infrequently found at home.  While you or your child may feel that attending a party is a lost cause when managing the balance of healthy eating during festive events, there are some strategies that can be useful in approaching the party scene.

Here are some approaches to think about BEFORE you get on the party eating circuit:

  • Survey the foodscape.  Check it all out (the food that is) without eating anything.  Look at all the offerings, make mental notes of what you’d like to eat, what looks interesting, and what is an absolute no-go.
  • Select the most important and special dessert (or junk food item) –the one you cannot leave without eating!  Being good or selecting the “healthier option” may leave you feeling deprived and unsatisfied.
  • First Course: Fruits and Veggies.  Fill your plate with fruits and veggies first (and eat them).  You will have started to quell the hunger pains, and contributed to the overall health of your day.
  • Don’t be a cow! Cow’s are notorious for grazing…eating all day long.  Individuals tend to lose track of how much they have eaten when they graze;  the same goes for drinking calorie-rich beverages.  Rather, be a dog–make your plate (or bowl!), eat it, and move on!
  • Limit your sodas.  The calorie and sugar content of sodas and other sugar-sweetened beverages are significant and can add up, especially when children are having a good time (and not paying attention to how much they are drinking).  Remember, all sweets are treats and count as “fun foods”, even the ones you drink.
  • Eat like a Spaniard…on a little plate, with a little portion.  Savor the flavor of little bites of different foods, rather than a large portion of one food.

These strategies may help your child be more thoughtful in their food choices, and make good decisions at parties. It also gives them strategies to use when faced with tough decisions: which “fun foods” and how much?

You wouldn’t give your child an unlimited budget for a shopping spree!  Take the same approach with smorgasbords– teach your child how to manage “fun foods”, especially at parties, for a lifetime of smart spending.

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Dining out as part of a healthy lifestyle is often difficult for most people.  But, it doesn’t have to be impossible.  Try some of the tactics below the next time you are at a restaurant.  Your body, and your taste buds, will thank you!

Cancel Your Membership to the Clean Plate Club   Most restaurants, with very few exceptions, serve at least double or triple the recommended portions for every food item.  Divide your plate in half before eating, and take the rest home for a second meal. 

The Lighter Side of Lunch Portions    Many restaurants offer smaller lunch-sized portions or “small plates” in addition to the full-sized meals.  But, they may not offer this up as an option unless you request it.  Be sure to ask if a smaller portion is available.  Just keep in mind that it still may be more food than recommended for one meal.

Modify Your Meals    Invisible fats, such as butter and oil, are often added to dishes without the diner even knowing it.  Even vegetables are not immune.  Don’t be afraid to be a little picky when it comes to how your food is prepared.  Butter and oil can be left off of vegetables and meats without sacrificing flavor.

Don’t Fall Into the Salad Trap    This menu item can be somewhat of a wolf in sheep’s clothing. Salads are often among the most fat-laden items on most restaurant menus.  You can’t make a meal healthy simply by putting lettuce under it.  The toppings make all the difference.  And they can add up quickly, especially if creamy or other high fat dressings are used.  At the very least, dressing should be served on the side and toppings chosen in moderation.

Don’t Blow it with Beverages   It is all too easy to double the calories in a meal by drinking soda instead of water or unsweetened tea, especially with unlimited refills.  And the caffeine in soda actually makes you thirstier, so you drink even more.   Keep in mind that water is a beverage, and soda is a treat that you drink.

Avoid the Appetizers (or eat your own)    Free baskets of food aren’t free of calories.  Pass on high fat items, or enjoy a little if you like. Having a small snack of fruit or nuts before leaving home is also a great way to control poor choices caused by hunger.   

Careful with Condiments    These “little” additions can pack a big punch.  If used inappropriately, they have the ability to turn a healthy meal into an unhealthy one.  But, chosen wisely and used sparingly, they can be wonderful flavor enhancers.  Try low-fat options, like mustard or salsa.

Work It Off By Working Out    To maintain a healthy weight, you have to use up as many calories as you take in through physical activity.  That’s the bottom line.  Think about how much you are willing to work before eating something.  You can decide whether or not it is worth the extra effort, and budget accordingly.

Healthy eating in any situation is simpler with the right tools.  Knowing what to do and how to do it is important, but implementation is key.  How effectively, and how often, you use them will determine the overall impact on your health.  Even small changes can add up over time.  So take action now.  Don’t put off until tomorrow what you can do today.  Conscientiousness, commitment, and consistency will get you a lot further in your healthy life than contemplation.

Contributing Author:  Cami Ruark

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