This Ask the Dietitian post is hosted by Katie Mulligan MS, RD, LDN, practicing pediatric dietitian since 2003. She received her undergraduate degree from the University of Rhode Island in Dietetics and completed her Dietetic Internship at the prestigious Weill-Cornell Medical Center at New York Presbyterian Hospital in New York City. Katie runs a successful private practice in pediatric nutrition.
Q: How do I ensure that my bigger-than-average kid doesn’t gain too much weight or overly focus on food?
A: If your child is “bigger-than-average” the LAST thing you want to do is panic and put them on a strict diet. Instead, request their growth charts from their pediatrician and take a look at your child’s growth trend over the years.
If your child is trending on the same high percentile line since birth then he is likely okay. Childhood overweight and obesity become a problem when children grow “off their curve”. This is when kids follow a nice line on their growth chart for a few years, but then begin to trail upwards into the area of the growth chart where there aren’t any lines to follow. They may also be jumping percentile lines, which means they go from the 75th percentile to the 90th to the 110th and so on. That pattern is not supposed to happen, kids should stay on relatively the same percentile line throughout their childhood.
So, let’s assume you know your child is jumping lines and that his or her weight is, in fact, going too high too fast. You probably want to stop this upward trend, but without causing your child to be to obsess over food and weight or affect their body image. This is a very common concern for parents and I hear these concerns weekly.
Children will become “obsessed” with food when they feel like that aren’t getting enough to eat or they are being restricted. Trust in feeding begin to breakdown, children don’t trust their parents to give them all the food they need to feel full and as a result, they find sneaky ways to get it themselves.
Having reliable access to a variety of food will help your children learn that there will always be something to eat, you will never let them starve and you will always provide them with tasty food choices. A few simple steps and parenting techniques will help you help your child. If you find that you are still struggling or can’t do it alone, seek out the help of a registered dietitian who works with childhood obesity.
- Continue to offer meals and snacks at regularly scheduled times. A typical pattern is breakfast, lunch, snack, dinner and sometimes evening snack.
- Narrow down your children’s food choices and allow them to choose between options you are comfortable with. For example, “Today’s snack is grapes. Do you want chocolate pudding or a cheese stick with that?”
- Help your children focus on their hunger and fullness. When you see them rummaging through the cabinet ask them if they are hungry or bored? Likewise, when they finish eating, ask them if their hunger is gone. If so, it’s time to stop eating for now, they will have another eating opportunity in a few hours.
- Make a “kitchen is closed” rule. When it’s not snack time or meal-time the kitchen is closed.
- Remove sugary drinks from the home.
- Allow access to “treat” foods. For example, you add 2 cookies to each school lunch.
- Occasionally bake homemade treats or take kids out for ice cream to teach them that these foods are OK to have and can be part of a healthy diet when eaten in moderation.
For more information on helping your child regulate their food intake, see my book How to Raise a Mindful Eater.