Child obesity: Is it ever okay to put your kid on a diet?

Here’s how to help your child with their weight while building their self esteem.

Ella* is an active, intelligent and outgoing 6-year-old who rarely cries or complains – apart from when she sees her reflection in the mirror. “She keeps telling me that she’s fat and that she wants to lose weight,” says her mother, Lara. “I’m terrified of taking her to see a specialist as then she’ll think it’s a real problem, but the fact is she is bigger than her friends. They’re all stick insects and she’s chubby and of course she’s noticed.”

The problem is, Ella enjoys eating, and doesn’t know when to stop. Lara, who has an average BMI herself, feels she should put her on a diet but her GP warned her against it. “He told me I had to work at building her self-esteem and encouraging a healthy approach to food. It’s easier said than done as everywhere she looks – on the TV, at school – are pretty, thin girls that make her feel out of place.”

Lara, who is so concerned about Ella’s weight that she can’t sleep, is one of millions of British parents desperate to help their children lose weight. According to new figures released this week by the National Child Measurement Programme, almost 40 per cent of children are above a healthy weight. The figures are slightly down from last year, but are still higher than pre-pandemic.

There are currently around 450,000 children with severe obesity in the UK, two million with obesity and two million in the overweight category. More than 60 per cent of the population as a whole is now classified as overweight. By the time our children are adults obesity will be the leading cause of death – and yet most health professionals are convinced that, for a child like Ella, dieting is not the answer.

“You need to seek professional help early on to help your child understand the relationship between their body and food,” explains Dr Ashish Kumar of the Royal College of Psychiatrists’ Faculty of Eating Disorders. “They need to eat healthily, with normal portion sizes, and they should exercise regularly. Weight loss is a question of shifting eating patterns from unhealthy to healthy, combined with physical activity.”

If this sounds remarkably like a diet, it’s because really it is, according to Professor Paul Gately, a professor of obesity and exercise at Leeds Beckett University. While most doctors in his field refuse to use the “D” word, Gately is pragmatic: in order to lose weight, an overweight child will need to eat less. “Their energy output needs to be higher than their energy input,” he says. “It’s a fundamental principle of how you manage weight.”

“You can’t just put a child on a diet: you have to help them lose weight while raising their self esteem."

Gately agrees with Kumar that this must be based on healthy, normal eating principles combined with plenty of physical activity rather than aggressive food restriction. He founded MoreLife, a weight management and health improvement programme for children and adults, which is now an NHS partner. Young people like Ella are treated by dieticians but also psychologists, therapists and fitness experts.

“You can’t just put a child on a diet: you have to help them lose weight while raising their self-esteem,” he says. “Obesity is a very complicated issue and most parents don’t get the right support: if you go to the doctor with a child with a broken arm or asthma you immediately get referred but, if your child is obese, you can’t talk about it in case you damage your child.”

It angers Gately that society has become so afraid of addressing the topic of weight that parents such as Lara feel paralysed into doing nothing. “We want our children to talk about their feelings but not their weight, which is surely a very mixed message,” he says. “The fact is there are half a million children out there whose weight is so dangerous that if they were adults they would be eligible for surgery. We urgently need to talk about obesity.”

Given that anxiety and depression are on the rise, not just among teenagers but very young children too, along with eating disorders including anorexia and bulimia, one can understand medical professionals’ fear of diets. “I had children as young as 9 coming to me with eating disorders during lockdown – it’s heartbreaking to see,” says Kumar. There are also plenty of studies to show that restricting the food children love only encourages them to eat more of it. Research also suggests that labelling foods as “good” and “bad” can encourage disordered eating – and eating disorders – among children.

Honey Kinny Ross, the activist and plus-size model, has spoken out against the “absolutely toxic” diets her parents, Jonathan Ross and Jane Goldman, suggested to help her lose weight when she confessed to hating her body. She believes parents must not shame their children into weight loss, warning them to “keep as far away as possible” from that topic.

Ross believes parents must not shame their children into weight loss, warning them to “keep as far away as possible” from that topic.

Christine, a mother of two girls in Wiltshire, agrees that enforced diets in childhood haunt you in later life. Her mother, who is a different build to her entirely, put her on various regimes when she stopped being skinny aged around 9: one required her to eat bran for breakfast and lunch, another banned carbohydrates including bread and pasta.

“I became a secret binge eater,” says Christine. “At friends’ houses I’d steal food; at school I’d double up on biscuits and snacks. As an adult I struggle with my weight; I turn to food and alcohol for comfort and still, aged 42, I feel my mother’s judgement whenever I eat in front of her.”

Yet Belinda from Manchester, whose 9-year-old son, Jack, has recently been discharged from the MoreLife programme, is certain that, in the right environment, calorie control can be wholly positive for children and their parents. A team of specialists helped her make healthy changes to Jack’s diet, while also supporting his mental wellbeing, helping him to become confident enough to get involved in a multitude of activities including football, basketball and swimming.

“I was scared about the effects it would have on him but it was such a relief when Jack quickly started making such positive steps,” Belinda says. “He quickly realised that all the changes were for his own benefit and was therefore willing to try new things. I didn’t know what would happen when he was discharged but he’s continued to be a healthy weight and although he sometimes gets frustrated as like any child he likes to eat the sugary stuff he knows it’s better to eat it in moderation.”

“Feeling ashamed of your size is a legitimate experience – that with the right help, you can put behind you.” Photo / 123RF

Cornwall-based Steph Barton-Johnston is also convinced of the benefits of a weight-loss programme for children. She suspects she was obese as a child and yet her parents never took her to see a doctor as they were concerned it would “hurt her feelings” when she was already ashamed of her size. When, aged 16, she was finally taken by her mother to see a dietician she had such low self-esteem that she was continually making poor choices academically and in her social life.

“I was diagnosed with a wheat intolerance and put on a weight-loss plan – within two months I’d lost three stone and the weight continued to shed over the coming year. I wish my parents had been onto it earlier – my own daughter is only 4 but if she starts putting on too much weight I’m not going to waste a second before getting help.”

Professional help is key. Both Gately and clinical psychologist, Dr Rachel Rodgers, a specialist in body image and eating concerns, are adamant that, due to the complexities of the parent-child relationship and the numerous outside influences (advertising, social media, peer pressure) that affect a child’s sense of body image, parents shouldn’t try to help them alone.

Their advice to anyone whose child is uncomfortable with their weight is to find a specialist who will listen to their concerns; with the right help, destructive thought patterns regarding body image can be prevented. “We mustn’t stick our heads in the sand,” Gately says. “Feeling ashamed of your size is a legitimate experience – that with the right help, you can put behind you.”