In an effort to have a greater online presence, I’ve been taking advantage of online social media. On Twitter (follow me here), I found Dr. Joanna Dolgoff, a pediatrician whose practice solely deals with child and adolescent weight management. She recently posted this fantastic article that guides parents in speaking to their children about obesity and their own body image:

How do you respond when your overweight child asks if she is fat? Do you sugarcoat the truth and tell her she is perfect? Do you go for the hard love angle and tell her that yes, she is fat? I would advise for something in between.

It is not easy to talk about something as sensitive as weight, particular with a pre-teen or a teenager. Parents must walk a fine line between acknowledging the problem and promoting self-confidence.

Children know they are overweight. And if you don’t mention it, their peers certainly will! If you pretend everything is fine, your child will learn that her weight is a shameful topic that can’t be discussed. She will then try to lose weight with her own methods, usually by starving herself or binging. These are the children who are most at risk for disordered eating. Studies show that if you acknowledge and treat an overweight child in a sensitive manner, you actually decrease the risk of disordered eating!

Ideally, the conversation would go something like this…

“Mom, am I fat?”
“What makes you ask that, honey?”
“The kids on the playground called me names today.”
“Well that is not nice. But maybe we would be healthier if we did learn to eat better. We could all use to revamp our diets.” Notice how I have chosen to say ‘we’ could be healthier and ‘we could all use to…’ This sounds less accusatory and alerts your child that you are both in it together. I have also turned it around to be about health and eating better rather than about fat or thin. This way, even a thin parent can have this conversation. Most thin people I know could eat healthier if they tried. “Why don’t we try to make some changes together. We can learn how to eat right and we can start getting more active. Would you like that?”

I have had many parents call me after this conversation, worried that they said the wrong thing. Often, the parents responded with, “Don’t be silly. Of course you are not fat. You are beautiful.” And then they want to know how they can help their children. It is better off not to lie. If your child demands an answer to the question, I would say…

“Fat is such a nasty word. You look good but you might be healthier if you weighed a little less. Let’s work together to learn to eat better and exercise more.” Notice again that I didn’t say ‘you would look better if you weighed less’. It is important to focus the discussion around health- not around looks. Again, bring it back to the ‘we’ as soon as possible. And always end the discussion with next steps… “Why don’t we go online and look at some websites about healthy eating.” “Let’s call the pediatrician and see if she has any suggestions.” “Let’s go to the supermarket and pick up some healthy foods so we can get started right away.”

Good luck. And if you are still nervous about broaching the subject with your child, feel free to call my office (516-801-0022) or e-mail me (jdmd@drweigh.com) for more advice.