Becky Cohn has worried about her daughter’s weight since she was a toddler. Molly would eat “anything and everything,” her mother says. “She would eat salads, but she would want three salads. She would eat broccoli but want seconds.” The child was completely unlike her older siblings that way — and once she hit school age, Mom felt powerless to control the problem. “She’d go to school and eat her lunch and everyone else’s,” Cohn says. “I went to the pediatrician and said, ‘I feel like I’m watching my daughter drown.'” Molly was nevertheless physically active and had no social problems with other kids. But by age 10 — at 4 ft. 11 in. and 134 lb. — she was already heavier than her mother and clinically obese.
It’s one of the hardest talks a doctor can have with a family: how to deal with an overweight kid. By all accounts, it’s equally frustrating for pediatrician and parent — a battle that plays out in doctors’ offices across the U.S. “My doctor, whom I love and have a lot of respect for, kept saying the same things,” Cohn says. He would ask what on earth she had been feeding her daughter and suggest that Molly needed to exercise more and eat less. The Cohns never found that rote advice specific enough to be useful.
For their part, doctors say families as concerned as the Cohns are unusual. Most parents have a woeful lack of knowledge about basic nutrition. Doctors tell stories about patients who feed French fries and Cheetos to their children before their first birthday, for example. What’s worse is that many families with overweight or obese children aren’t even aware there is a problem.
In 2007 a national poll from C.S. Mott Children’s Hospital at the University of Michigan asked parents to report their oldest child’s weight and height and then gauge whether he or she was a healthy size. “About 40% of parents of obese children ages 6 to 11 perceived their children’s weight status to be ‘about the right weight,'” says Matthew Davis, the University of Michigan pediatrician who directed the poll. A further 8% believed their child was actually underweight. “It’s almost as if parents don’t know what obese looks like in that school-age group,” Davis says.
That may be precisely the problem. Today roughly 17% of American kids and teens are obese, and parents cite obesity as a top concern for their children’s health. Yet with so many other overweight kids in the class, it appears that parents can’t recognize — or admit it to themselves — when their child is too heavy. When they do realize it, like Becky Cohn, parents often are upset or don’t know how to implement pediatricians’ vague orders about exercise and diet — much the way overweight adults are flummoxed by the same recommendations. Adding to the quandary, doctors may be reluctant to raise the issue in the first place. Checkups are typically too brief to allow a doctor to broach the topic tactfully and work out a detailed, practical weight-loss plan. Some doctors fear they will worsen the problem by embarrassing the child and instilling shame instead of empowering him or her to get healthy. And doctors worry about turning off Mom and Dad as well. “Every parent feels guilty that their child has a weight problem,” says David Ludwig, the director of the Optimal Weight for Life Program at Children’s Hospital Boston and the author of the kids’-weight-management book Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World. Kids aren’t the ones buying family groceries, after all, and parents often struggle with being overweight themselves.
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