Pediatric offices throughout the country have been busy over the past few weeks as parents have been bringing their children in for annual physicals and immunizations just in time for the reopening of schools. While it was great to see so many of my patients after a year or more, a disturbing trend became apparent. Children and teens gained weight during the pandemic – a lot of it. This is not entirely surprising since school closures, disrupted routines, and increased stress provided less opportunity for physical activity and proper nutrition. On average, healthy children will gain anywhere from four to seven pounds per year depending on their age. During the past year, many children gained in excess of this, some by as many as 25 pounds! Because we know that overweight and obesity negatively impact our children’s health in multiple ways, it’s important to intervene and provide them with the tools they need to successfully achieve and maintain a healthy weight.
The first thing parents need to do is check in with their child’s pediatrician to see if the amount of weight gained is indeed problematic. Your pediatrician can help assess whether your child’s weight gain is just part of their normal growth pattern. Children grow at different rates, and healthy kids come in all shapes and sizes, but there is cause for concern when a child veers off of their growth pattern significantly. For instance, if a child who has been growing consistently along the 25th percentile suddenly jumps to the 90th, that may be a signal that something’s going on. Seeing your pediatrician will also provide an opportunity for your child to be screened for weight-related health complications like hypertension, elevated cholesterol, and diabetes.
It may seem counterintuitive, but don’t focus on the child’s weight – and please don’t tell them that something is wrong with them. When you’re talking to kids, focus on healthy habits, not weight. This is important because weight isn’t as easily changed as behaviors and we are not all supposed to look the same. Bodies do come in all shapes and sizes, and bodies change over time. Focusing on a number on the scale or a specific body type may lead a child to develop poor body image. This provides fertile ground for eating disorders and other mental health issues to take root. The focus should be on developing habits that support health. The ultimate goal is fostering healthy habits that children will maintain for a lifetime.
Do not put your kids on a diet! Restrictive eating is not for kids. Children and adolescents that engage in dieting behaviors are more likely to develop eating disorders. Diets can cause children to develop an unhealthy relationship with food, causing anxiety about meals and what to eat, often leading to unhealthy choices. Restrictive diets can also backfire. In the long run, it actually leads to increased weight gain and it can set children and teens up for gaining and losing weight over and over again, which can have health consequences of its own.
Try to create more structure around meal times. All-day-long, unsupervised grazing became a habit in many households during the pandemic. Boredom and increased accessibility of snacks also contributed to increased intake of empty calories. Creating and sticking to set meal and snack times can help kids regulate their appetites and develop sensible eating habits. A child may hold off on snacking on chips at 4:30 p.m. if they know dinner will be served at 5 p.m. Your job as a parent is to decide when and what kids eat, offering them a variety of healthful foods. Your child’s job is to decide whether and how much to eat. Don’t force them to clean their plate, and don’t be a short-order cook. Provide the food, take a deep breath and let them listen to their body. Ultimately, you want to raise kids who are mindful eaters, who are aware of their feelings of hunger and fullness.
Be intentional about incorporating physical activity into the day. The aim is for children and teens to have a total of 60 minutes of physical activity throughout the day. Set timers to remind children to get up from their desks, put down their devices, and stretch for a little bit. Commit to learning a new Tik Tok dance routine with them. If you’re anything like me, this can take hours of physical activity to master! Schedule time for a walk or to kick a soccer ball outside. The point is to get moving. If you don’t plan for it, it’s probably not going to happen.
Make these changes as a family. No matter what changes you make, make sure you make them as a family. It provides support for your children and gives them behaviors to model. Children pay attention to what you do, not what you say. You can’t expect them to eat fruits and vegetables if they never see any on your plate. They won’t get out to exercise for an hour each day if they only ever see you lounging on the couch watching TV every evening after work. Make a healthy lifestyle a family affair. Show your children how to create a healthy meal. Let them see you drinking water instead of juice and soda. Don’t just send them outside to ride their bike or take a walk. Do these activities with them. It provides a wonderful opportunity for bonding and gives your child healthy behavior to model. If the goal is to raise healthy children, then the changes you adopt should apply to everyone in the family.
Give yourself and your kids some grace. We’ve all been through an incredibly stressful and exhausting year and a half, and it’s not over. Some families have been especially hard hit by this pandemic – experiencing job losses, food and housing insecurity, as well as higher rates of COVID-19. All of these things can make it harder to get back on track with healthy habits. We have to show ourselves a little compassion and realize we’re going to work our way out of this, and it’s not going to happen overnight. That compassion is something we should aim to foster in our children as well. Even if your child didn’t gain excess weight, teach them not to tease others. We’re having children who are scared to go back to school because they now realize that they have changed and they don’t want to meet their classmates. If you hear these fears from your child, encourage them to talk about it. Validate their feelings and offer them support. Ultimately, we want to build our kids up. We want to focus on who they are outside of their bodies.
We’ve survived this very serious time in our history. If that means that people gained more weight than they would have ordinarily, it’s a body’s way of surviving. If you have concerns about your child’s weight or health habits, don’t hesitate to reach out. Remember, your pediatrician is a valuable resource for helping you raise happy and healthy kids.
• Dr. Tamarra Moss is a pediatrician committed to helping you raise happy and healthy kids. You can find her at Dr. Carlos Thomas & Pediatric Associates in Nassau, Lucayan Medical Center in Grand Bahama, or on Instagram @mykidsdoc242.