It can be one of the more difficult conversations for a pediatrician: how to tell parents their child is overweight or obese and that something needs to be done, said the chief medical officer for the Southeast for UnitedHealthcare.
“It is a very tricky thing,” said Dr. Catherine Palmier, a pediatrician. “Parents don’t see children through the same eyes as the physician would or someone else because it is their child.”
Parents and their child’s doctor can work together to find ways to help, she said.
Georgia parents will likely have to confront their child’s weight this year when state school systems begin to gather and report body mass index, a measure of height and weight expressed as a percentage of all children.
Those higher than 85 percent, or in the top 15 percent of all children’s BMI, are considered overweight and those over 95 percent are considered obese, Palmier said. The news is not likely to be good for many parents – in the most recent National Survey on Children’s Health in 2007, Georgia ranked behind only Mississippi in the rate of childhood obesity, at 21.3 percent.
The first step to dealing with a child’s weight is to establish a relationship with their pediatrician during well-child visits or checkups and to have an honest conversation. For obese children, that can mean checking for additional problems with blood pressure or even diabetes or prediabetes, Palmier said.
“That kind of guides how urgent a problem this is,” she said.
A child’s age and growth rate are also very important – some children might need calorie restriction while others who are only slightly overweight and growing fast might just grow into the weight, she said.
Parents can help by modeling healthy behaviors themselves and getting children involved in activity, such as the family taking a walk or going for a swim together, Palmier said.
Sitting down to eat meals together has been shown to result in generally lower BMIs and better nutrition. It is important for parents to monitor not only nutrition but also portion size, which is often too big, she said.
“I think the thing that is shocking to parents is that a serving of an item, like meat or vegetables, is typically the size of the child’s hands,” Palmier said. “I think many adults suffer from the impression that somehow little children need to eat as much as we eat, but they have very small stomachs.”