What Should You Do if You Think Your Child Is Too Fat?

Maybe it's just baby fat, but how do you know?

Posted Nov 08, 2016

Chubby babies are cute. So are roly-poly toddlers, but when do folds of flesh become less adorable, and maybe a reason for concern? Research from the Centers for Disease Control and Prevention (CDC) shows that, among toddlers, 93 percent of the obese boys and 73 percent of obese girls will become obese adults but the increased health risks start long before adulthood. Other studies have found that 60 percent of obese children have one risk factor for cardiovascular disease while the risk of Type II diabetes (formerly called adult onset diabetes but renamed because so many kids were affected) has increased 10 fold in the last decade. How can you tell if you should be concerned about your child’s weight?

Body Mass Index (BMI) is an imperfect measure that might be useful for adults but it doesn’t work for kids because they grow at different rates. Fortunately the CDC has an online calculator at: http://bit.ly/1pmKFtK that uses the child’s height, weight, and age to calculate a percentile which will compare your child to other children of the same age and gender. The calculator will help you determine if your child is overweight (85th percentile) or obese  (95th percentile). If your child is below the 85th percentile you probably can relax, but if your child is overweight or obese make sure that your legitimate concern doesn’t make things worse.

When you’re a parent it’s heartbreaking to watch your overweight child experience stigma and ridicule because of their weight. It starts early; in one study of six year olds, their thinner peers described overweight kids as ugly, dirty, and stupid. Unfortunately, it only gets worse as the child gets older. While you have reason to be concerned if your child is above the 85th percentile, there are potential risks if you put your kid on a diet or become too involved in helping your child lose weight.

Research suggests that many bulimic adolescents have a history of having a weight conscious mother who was overly involved in their daughters eating and dieting. In my experience working with this population I’ve frequently heard stories of mother-daughter dieting, or either parent over emphasizing the need to lose weight ultimately contributing to an eating disorder. Other studies have demonstrated that overweight high school girls who go on a diet actually gain more weight compared with equally heavy girls who don’t diet. Putting a kid on a diet is counter-productive! The good news for parents of overweight kids is that their child doesn’t need to lose weight. If they just maintain their weight and continue to grow the overweight child will slim down so he or she won’t become obese!

If you shouldn’t put a child on a diet, what’s a concerned parent to do? First, use the CDC calculator to see if there’s a problem. If there is reason for concern you can make changes in the child’s environment to reduce eating and increase activity without dieting. Two practical resources that can help are my book, It’s NOT Just Baby Fat!: 10 Steps to Help Your Child to a Healthy Weight  or David Ludwig’s Ending the Food Fight. Dr. Ludwig’s book is more comprehensive including recipes while mine is shorter and more specifically focused on behavior change.  Look for a few tips in my next blog post.