Talking to Your Pediatrician

Get tips on how to work with your kid's doctor to address your child's weight issues.

From the WebMD Archives

Childhood obesity is a difficult subject to tackle for parent and pediatrician alike. As a parent, you may feel embarrassed or guilty if your child is struggling with weight issues -- especially if you are overweight yourself. Or you assume that your kid's doctor will tell you if there is a concern.

Unfortunately, that may not happen. Studies show that sometimes pediatricians don't bring up weight issues. Some say they worry about insulting parents. Time concerns are also a factor, and some doctors just don't feel prepared to help.

Today, 17% of kids aged 2 through 19 are obese -- and those numbers keep growing at an alarming rate. While it may not be easy, talking with your kid's doctor may be an important first step toward protecting your child's health.

What You Need to Know About Childhood Obesity

Being overweight isn't something that your child can overcome on her own. She needs your guidance to help her overcome powerful social pressures to be sedentary and eat high-fat foods.

Being overweight tends to run in families. A child with two overweight parents is 80% more likely to be overweight herself. So if you are overweight, your child is also at risk.

Plus, being an overweight child can have serious consequences, even at a young age.

Being overweight sets kids up to be overweight adults. And when you're an overweight adult, extra pounds increase your risk for bone and joint problems, sleep problems, asthma, certain cancers, high cholesterol, high blood pressure, type 2 diabetes, and heart disease.

Problems once only seen in adults are now seen in kids. Alarmingly, many of the weight-related health problems listed above for adults are also showing up in overweight children. For instance, 70% of obese children have at least one risk factor for heart disease.

Kids who are overweight are more at risk for being teased or bullied. This can lead to a realm of problems from social isolation to lower grades to a poor sense of self -- issues that can last into adulthood.

How to Bring Up Your Child's Weight: Questions to Ask

When you see your child's pediatrician, here are some questions you can ask to get the conversation started.

  • Is my child's weight in the right range for his age and height?
  • Should I be concerned about my child's size?

Continued

The pediatrician will assess your child's weight by using his height and weight to calculate his body mass index (BMI). The doctor will also calculate your child's BMI percentile, which compares him to other kids his age and gender. That BMI percentile places your child in a weight range: underweight, healthy weight, overweight, or obese.

But BMI is just a piece of the picture. The pediatrician will also ask you about your weight history as well your mate's, both parents' heights, your family health history, and your family eating and exercise habits. Your child's health care provider uses all this information to decide what to do next if your child's weight is outside the healthy range.

Help for Your Overweight Child: 2 to 5 Years Old

As a parent, it can be difficult to know the difference between overweight and healthy weight in a child this young. Many kids still have baby fat from their infant years, while others may appear thin. One study found that parents tend to underestimate their preschooler's weight. This means that your child could be overweight, and you may not even realize it.

The American Academy of Pediatrics recommends BMI screening starting at age 2, so it's a good idea to talk with your pediatrician about your child's weight at every visit.

Here are some questions you can ask the pediatrician about your 2- to 5-year-old.

  • What can I do to help my child develop healthy eating habits at this age?
  • How many meals a day should my child be eating?
  • What is a healthy snack?
  • What are appropriate portion sizes for my child?
  • How can our family change our eating habits to help our child?

Help for Your Overweight Child: 5 to 12 Years Old

If your grade-school child is overweight, her health care provider will likely recommend that you focus on maintaining her current weight as she gets taller so that she can grow into her weight.

Questions to ask your pediatrician about your overweight child in grade school:

  • How can I get my child to pick healthy foods without nagging her all the time?
  • How can I talk to my child about the food she sees on TV?
  • Can you recommend activities she might like? She stays indoors more and more these days.
  • How can I decrease TV and video game time for my child?
  • How will puberty affect my child's weight?

Continued

Help for Your Overweight Child: 13 to 18 years old

When your teen is overweight, one thing his health care provider will assess is how far along he is in his growth and physical maturity. Teens who still have a lot of growing to do still need calories and nutrients to fuel that growth, so as with younger kids, they may be advised to decrease weight gain or hold their weight steady for a while. If your teen is through puberty or is very overweight or obese, particularly if he has associated problems such as diabetes or signs of diabetes, medically supervised weight loss may be recommended.

These are great topics to discuss with your teen's health care provider.

  • How can I motivate my overweight teen to eat healthier without making him feel bad about himself?
  • Are some foods better than others when he goes out with his friends? What are some better choices in fast-food restaurants or malls?
  • My teenager always seems hungry. Is this normal?
  • How much physical activity should he get per day, and what will help him achieve that goal?
  • How much more growing do you think my teen will do? Will it be enough to help him grow into his weight?
  • Do we need to think about other ways to help make his weight healthier for his age?
WebMD Feature Reviewed by Renee A. Alli, MD on January 11, 2012

Sources

SOURCES:

CDC: "Overweight and Obesity: Data and Statistics."

Perrin, E. Current Opinions in Pediatrics, June 2007; vol 19: pp 354-361.

News release, University of South Florida (USF Health).

Hernandez, R. Clinical Pediatrics, August 2010; vol 49: pp 790-798.

He, M. Canadian Family Physician, September 2007; vol 53: pp 1493-1499.

CDC: “Childhood Obesity,” “About BMI for Children and Teens.”

American Academy of Child and Adolescent Psychology: “Obesity in Children and Teens.”

Michelle Van Beek, MD, pediatrician, Sanford Children’s Clinic, Sioux Falls, S.D.

HealthyChildren: “Is Your Child Overweight?” “Is Your Preschooler Overweight?”  “Optimizing Nutrition for Toddlers,” “Nourishing Your Growing Teenager.”

Karla Harmon, CSW-PIP, mental health counselor, Sanford Health, Sioux Falls, S.D.

Klein, J. Pediatrics, February 2010; vol 125: pp 265-272.

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