My overweight child seems to be losing interest in school and activities. Can you help me understand what's going on?
School-aged kids, in general, know when they are overweight. They may not discuss their feelings with their parents. They may avoid the issue altogether. They may even go so far as to deny it bothers them at all.
Perhaps it doesn't. Some kids, just like some adults, don't seem to mind toting around some extra pounds. However, these are the exception rather than the norm.
You might be surprised to learn studies show that for kids, the psychological impact of childhood obesity is as great as – or greater than – having cancer. The reason is simple. A diagnosis of cancer, although devastating, brings empathy and emotional support. Generally, families come together to encourage, love and support a child with cancer.
In contrast, an obese child is often singled out and ridiculed by classmates. Thinner siblings may add fuel to the fire. Parents, in an attempt to motivate the child to do something about the extra weight they carry, may make rude comments about food choices.
Obesity can result in a sad, lonely journey through childhood.
Overcoming Social Stigma
Not surprisingly, guilt often accompanies obesity. Society views overweight individuals as having poor self control. Obese people are often thought of as bringing the problem on themselves. Kids often internalize these feelings and beat themselves up over their perceived gluttony. It is a very unhealthy, and unhelpful, mindset.
My first step in discussing obesity with children is to try to get them past the guilt. I do this by letting them know that being overweight is not their fault. That simple statement, "It is not your fault," has evoked more tears of relief in my office than any other uttered phrase.
Understanding Genetics
I tell them scientists have found half a dozen or more genes that predispose people toward obesity. I explain that their body was created with a predetermined set point for weight that is higher than the average person's. In other words, due to genetic factors, their body wants to be obese.
In the distant past, before well-stocked hypermarkets, our forefathers struggled to find food. Carrying extra weight was a genetic advantage. You never knew when you would get your next meal. In today's society of processed carbohydrates and high fat foods, that genetic advantage no longer exists.
The bottom line is, your body wants to be heavy. That is the way you were made. It is not your fault.
Once you can help a child move past some of the guilt, I find they are much more enthusiastic about working for a solution.
Moving Toward Solutions
The point then becomes, "It is not your fault, but you can do something about it." The focus turns away from guilt and toward a plan of action. That may be a trip to the library to learn more about nutrition, a phone call to the child's physician to discuss weight issues, or the decision to sign up for fall soccer.
Either way, the parent and child have a healthier and more productive attitude toward a common, and serious, health problem.
Pierre Manfroy, MD, is a local pediatrician with Northeast Pediatrics, serving as an editorial consultant for Young and Healthy.
