How to talk to your child about weight: Tips from a family medicine physician

It might be difficult for a parent or guardian to talk to a child or teenager about their weight. But if approached with respect and compassion, the conversation can have lifelong health benefits.

“Kids want guidance and suggestions; they learn so much from us,” said Charles F. Mitchell III, MD*, a family medicine physician with UChicago Medicine Medical Group. “If we give them love and the tools to succeed now, we’ll set them up long term for a better success rate.”

An increase in children and teenagers with obesity or who are overweight has led to more diagnoses of Type 2 diabetes, high blood pressure and high cholesterol in young people, Mitchell said.

Obesity is found in almost 20% of the pediatric population, affecting 14.7 million children and teens, federal data show. Among Black and Hispanic youths, the rate rises to 1 in 4.

Still, Mitchell is enthusiastic when it comes to talking openly about healthy eating and exercise — and setting achievable goals that families can work toward together. He offered advice to approach the issue with your kids.

How to talk to your kids about weight

Parents can talk to children as young as 3 or 4 years old about the value of good nutrition and exercise, said Mitchell, who sees patients at UChicago Medicine’s South Loop location. He suggests the following steps to get started:

• Meet eye to eye. Get on your child’s physical level to chat.
• Take a positive approach. Focus on encouragement; hold the criticism. “Children don’t respond to us when we say, ‘You need to exercise and lose weight,’” Mitchell said. “You need to positively lead them to healthy habits.”
• Ask open-ended questions. Prompts may include: “What are some things you eat that are healthy?” or “When you eat this type of food, what do you think will happen as you grow older?” Remember where your child is coming from. Some kids know certain foods aren’t good for them; others may not have access to fresh foods.
• Be a role model. Set a good example for healthy eating and exercise. “You can’t say, ‘don’t eat those chips’ and then eat chips,” Mitchell said. “It’s confusing.”
• Be patient and neutral. Children might not respond as you want, but don’t overreact or make the situation uncomfortable because this will cause a barrier in future communication.

What are the dangers of obesity in children?

Children who are overweight in kindergarten are four times more likely to have obesity by eighth grade, according to the Centers for Disease Control and Prevention, which predicts a majority of today’s children and adolescents (57.3%) will have obesity by age 35.

There are physical and mental consequences to obesity in childhood. “A lot of people who struggle with weight have a constant feeling of inadequacy, which can lead to low mood and higher levels of anxiety,” Mitchell said.

It also increases the risk of serious health conditions in children and teens that can later lead to sleep apnea, early osteoarthritis, heart failure and stroke. Plaque can begin developing in arteries as teenagers, Mitchell said.

The body mass index (BMI) is a calculation of height and weight, and it’s a metric doctors use to determine a person’s level of body fat. Per CDC guidelines, obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex.

But a spike in BMI might not tell the whole story about a child's overall health. “It’s a warning light that tells us to dive deeper into what’s going on in a child’s life,” Mitchell said.

Minimal exercise and low access to healthy foods are factors, but Mitchell said many complex issues are at play. A reduction in physical education classes as well as increased sedentary activity due to screen time can contribute, as can safety concerns that keep parents from sending their kids outside to play.

What families can do to help kids with weight

• Get active — together. Make time to go for a walk or play with your child, even if you’re busy. “If kids don’t get the love, mentorship and attention from you, they’ll seek it elsewhere,” Mitchell said.
• Consult your child’s doctor. Regular checkups are key but call your provider privately if you notice warning signs of weight gain or obesity — including struggling to breathe during exercise, dark skin around the neck, complaints of chest tightness, wheezing and/or formation of unhealthy food habits.
• Seek out community resources. Tell your doctor if access to healthy food and safe places for kids to play is an issue. They can recommend food banks and other low-cost options, as well as venues that offer other free camps or exercise options.
• Stick to a routine. Beyond putting regular physical activity in your family’s calendar, make sure kids maintain a consistent sleep routine. “Good sleep helps prevent diseases,” said Mitchell, who also advises parents to serve sensible portions at mealtime.

*Dr. Mitchell is a UChicago Medicine Medical Group physician. UChicago Medicine Medical Group is comprised of UCM Care Network Medical Group, Inc. and Primary Healthcare Associates, S.C. UChicago Medicine Medical Group providers are not employees or agents of The University of Chicago Medical Center, The University of Chicago, UChicago Medicine Ingalls Memorial or UChicago Medicine South Loop.