Preventing Obesity in Young Children
By Cathy Strahl
Do you have a young child whose weight or eating
habits are out of control? Need some real world help with ‘taming
the cookie monster'? Here are some things that worked for our
Our daughter, now 14 years old, was plump from birth
and thrived happily for her first year on a combination of breast
milk and formula. When she was completely weaned and eating only
solid foods, however, she began to gain a great deal of weight at an
unhealthy rate. This continued for the next year until, on the
advice of her pediatrician, we began to modify our daughter's eating
habits. She was barely two years old, but her doctor felt strongly
that we should make some changes before her weight became a lifelong
problem. The goal was to prevent further weight gain until her
height could catch up with her weight, without depriving her of
nutrition or having her feel deprived of the comforting aspects of
I'm happy to report that our daughter is now a
slender, healthy teenager with good eating habits and no ‘food
issues', but learning how to modify our family's eating behavior
was a long trial and error process. Because she was still mostly
pre-verbal, discussing nutrition or reasoning with our toddler was
not an option. We kept trying new things and learned over time what
worked for her. (These tips should prove useful with older children
as well but are NOT meant to replace professional advice: Be sure to
talk to your pediatrician before changing or restricting your
Here are some important lessons we learned:
Enlist the cooperation of ALL family members and
Chart your progress over time.
Eat what your child eats
Get creative in dealing with your child's
Don't starve your child!
Be patient and expect resistance and setbacks
Enlist the Cooperation of ALL Family Members
The first step is to explain thoroughly to
grandparents, daycare providers etc., your concerns and those of
your pediatrician's, pointing out that overweight children move more
slowly, get less exercise and therefore develop less body
confidence, often have social difficulties in school, and frequently
become overweight adults.
Reassure them that you will follow good nutritional
practices, that your child is under the care of a competent
pediatrician, and that you will take special care to fill her
psychological need for food in more appropriate ways.
Explain your goals for your child's weight (e.g.
zero weight gain until weight catches up with height), and tell
staff your child should not be praised OR punished where food is
concerned, only encouraged to eat slowly and move on to another
activity when a reasonable-sized meal has been eaten.
Chart Your Progress over Time
Once a month weigh your child and measure her
height, being careful not to express displeasure if her weight has
increased. Instead, praise her, saying 'how proud you are of the
ways she is growing'. Get a copy of your child's growth chart
(weight-for-height) from her doctor, and keep it updated monthly.
This gives important feedback regarding whether your methods are
working, and you can adjust meals, activity levels, etc.
accordingly. Never scold your child for overeating or being heavy:
Our daughter went through the chubbiest part of her childhood
completely unaware that she was in any way 'different', and
eventually succeeded in achieving a healthy weight.
Eat What Your Child Eats
This requires commitment and discipline! You will
only make things much, much worse if you single out a child to eat
differently than the rest of the family. The whole family should be
working toward healthy life-long eating habits and it's your job as
parents to make sure this happens. I do know it's HARD to not order
pizza when you are too tired to cook, but make it a once a month
treat instead of a mainstay meal.
Do the obvious things to cut down on fat in your
diet, including switching to skim milk, eliminating butter, cutting
back on cheese and fried foods, and cutting out desserts altogether.
Snack only on fresh veggies or fruit, and an occasional Popsicle
treat (no fat!). Serve water as a beverage with dinner, (think of
milk as a food rather than a beverage) and allow unlimited
quantities of steamed or raw veggies (no butter, no 'dip'). You as
parents should decide how much 'main course' of a meal your family
should have. Serve the heavier foods directly onto plates from the
stove rather than bringing piles of food to the table, so there is
less temptation to have seconds. Make sure portions are generous
enough to satisfy true hunger, but not excessively large.
If seconds are requested, ask your child to wait a
few minutes to 'let her food settle', or until everyone else has
finished, and then give her a smaller second portion, and no third
portions for anyone unless it's a low-fat Item. Do the same
yourself, and save any 'Ben and Jerry's' binges for after your kid's
Get Creative in Dealing with Your Child's
Sometimes waiting a few minutes in between servings
did the trick and our daughter realized she was full before gobbling
up a whole second helping, but she would often feel torn about
leaving any food on her plate, and stuff herself to the point of a
tummy ache just to finish what she started. (This happened even
though we NEVER insisted she 'clean her plate', a misguided and
outdated parenting policy!).
To help her 'let go' of a meal we promised that we
would 'save it for her' in the refrigerator, and then wrap it in
plastic and let her see us put it away. This really seemed to do the
trick: She got to remain 'in charge' of 'her' food, but didn't have
to feel any sense of loss if it went uneaten.
We did the same kind of thing with candy, too.
(People love to give chubby kids candy!). We had a 'candy jar' on
top of the fridge, where we put any gifts of hard candy she received
(we weeded out the chocolate after she went to bed). After dinner,
to help her know that 'eating time' was finished, she was allowed to
choose one piece of hard candy for dessert. This solved the
in-between- meal whining for candy issue as well as gave an endpoint
to the meal without serving a heavy dessert.
If your child has some quirks around food (and don't
we all?) think hard about what need the food may be filling, and try
to meet that need more appropriately. Common needs are Control,
Boredom, Anxiety, Anger, and Loneliness. Get creative and keep
trying new things. The consistent message you should be sending is
that her needs are important and you will help fill them, without
using food as a substitute. Your child should always feel that she
will get enough to eat when she is hungry, and if you don't keep
junk food in the house, she will learn to eat healthy food to feel
Don't Starve Your Child!
It seems obvious but it's worth mentioning. Even the
chubbiest kids get hungry and need to eat to keep up their energy
levels. Regularly scheduled low-fat between-meal mini-snacks can
help with this. The worst thing you can do (in my opinion) is make
such an issue out of food that it becomes an unpleasant weapon of
control. Your child should always feel in charge of her eating, and
your job is to help her learn the best possible eating habits.
When you child does ask for food always offer
something from the 'unlimited' list: a steamed or raw veggie, or
occasionally some fruit, unless it's obviously NOT an appropriate
time for snack (just before bedtime, or moments before a meal is
Consistently attempt to replace your child's need
for comfort food with some activity that she enjoys: Say "Let's
read that new library book together first!", and offer a snack
AFTER the activity. In this way you can gradually learn to tell when
your child is actually hungry and when she has some other need, such
as feeling tired, bored, scared, sad, or just wanting some
attention. Gradually she'll learn to tell the difference, too, and
slowly stop using food as her first 'fill the need' strategy.
By consistently offering only healthy food in
reasonable quantities, with 'seconds' allowed of the heavier foods,
and some 'unlimited' foods always available, your child will retain
a great deal of control. She will get to decide how much 'unlimited'
food to eat, and won't constantly hear 'NO' when asking for more.
("You've already had seconds on the chili, honey, but you can
have more carrots if you want").
Allowing a snack when requested eliminates the
chance of anxiety developing over NOT getting something to eat when
your child actually IS hungry. By stalling the snack for a few
minutes to read with your child or play a game, you send a message
that food will always be available, but it's really not an urgent
problem, and in the mean time there may be a better way to comfort
Be Patient and Expect Resistance and Setbacks
Changing family eating habits can be difficult,
especially when food has been used as a source of family comfort or
entertainment (and it occasionally is, even in the most 'perfect' of
families!). Expect your overweight child and other family members to
resist changes in eating habits, especially older children who have
had longer to become entrenched in the junk food life. Keep firm in
your knowledge that you are doing your best for your family, and
even if it doesn't always go smoothly you will KEEP TRYING. Don't
become discouraged or feel like a failure when your child gains
weight or begins 'sneaking food'. This isn't a reflection on your
worth as a parent, but instead shows how difficult this problem can
be. If a family crisis or change in routine (i.e. vacation) throws
you back into bad habits, start again. This is a PROCESS and is the
best gift you can give your child.
Cathy Strahl, M.P.H., is the mother of two and the owner of
an on-line retail store featuring hand-selected developmental and
educational toys for infants and children through age 13.