As a parent, you care about your child's health. Given the public-health focus on childhood obesity, it would be hard to not be concerned if your child is overweight.
The question many parents in this position are grappling with is "Should I say something to my child about the weight - or not?"
Research suggests you shouldn't, because making comments to a child about weight - whether those comments come as teasing, criticism or "helpful" advice - can be counterproductive.
Rather than leading to healthful behavioral changes, weight-related comments from family members have been shown to contribute to negative body image and eating disorders. This can lead to weight gain, obesity and eating disorders in adolescence and into adulthood, which is exactly what parents don't want to see happen.
Mentioning a child's weight or size, or commenting that the child should eat differently to control his or her weight - even if the child is seriously obese - can backfire.
Instead of encouraging healthful behaviors, it can increase the risk of binge-eating and unhealthy weight-control methods such as meal skipping, fasting, purging or the use of diet pills or laxatives. The emotional toll of weight stigma is stressful and may trigger overeating as a coping mechanism, which can contribute to weight gain.
The side effects of weight-related comments don't affect only children who are overweight. When children of average weight are told they weigh too much, they are more likely to develop poor body image, with all of its potential consequences.
Adolescence is a particularly vulnerable time, because kids' bodies are undergoing rapid changes at the same time their awareness of cultural standards of attractiveness is increasing. A study published in the June issue of Eating and Weight Disorders found that women whose parents commented on their weight when they were growing up were more likely to be dissatisfied with their current weight, even if they were not overweight.
On the flip side, talking to your children about healthful eating, without mention of weight, may reduce the risk of unhealthy eating behaviors. This is something that all children (and adults) can benefit from. Take these meaningful conversations a step further by cultivating habits as a family that encourage both physical health and a healthful relationship with food and eating.
Be a healthy role model
Poor diet quality and physical inactivity contribute to weight gain as well as chronic disease - no matter what someone weighs. Parents are a child's main role models for eating and activity behaviors, and research suggests that when parents make their own healthful food and activity changes, it has a more beneficial impact on their children's weight than direct intervention.
Parents influence nutritional choices through shared meals, by deciding what foods will be available at home and by setting the tone for "this is how our family eats." If you snack mindlessly in front of the TV, eat to soothe stress or routinely clean your plate even if you're already full, how can you expect your child to behave differently?
Limit screen time and sedentary time
Kids need 60 minutes of moderate-to-vigorous physical activity each day for good health. Research suggests that if you want your kids to be more active, what you do is more important than what you say, in part because encouragement to be active can be perceived as nagging, especially if you yourself are not active. Look for more active pastimes the whole family can enjoy, even if it's just walking the dog or going to the park together. Remember that shorter bursts of activity that add up to the daily goal are fine.
Although screen time recommendations are being revised to reflect the smartphone and tablet era, a good goal is to limit extracurricular screen time to less than 2 hours per day. One way to start is to turn off the TV during meals.
Cultivate a healthy food environment
Make nutritious foods readily available. Keep fresh fruits and vegetables at eye level in the refrigerator and healthy snacks where your children can access them. Visit farmers markets with your kids and let them help choose fruits and veggies at the grocery store. Let them help with meal planning and prep when appropriate, and get them excited about all kinds of foods - not just dessert.
Encourage intuitive eating
Pressuring children to eat and restricting intake of desirable foods can interfere with children's inability to regulate their own food intake. Instructions to "finish what's on your plate" or warnings to "eat all your broccoli or no dessert" can condition kids to distrust what their bodies are telling them, to eat when they aren't hungry - and to hate broccoli. Remember that children's growth fluctuates, and so will their appetite and eating. If you suspect that your child wants a snack simply because he or she is sad or bored, ask about it.
Restricting desirable foods can lead to obsession and overeating when these forbidden foods are available (the "last supper" syndrome), often accompanied by shame and guilt, which can trigger emotional eating. Make desserts and other favorite treat foods available on occasion, and let your child choose them when they are available. Healthful diets still have room for treats.