It’s not easy watching your own history repeat itself. At first, Jo–a 49-year-old mother of two from Georgia–thought she would be spared having to witness her children relive her long struggle with obesity. Indeed, when Jo’s second child Renee was born 12 weeks early, weighing just 2 lb. 11 oz. , obesity was the last thing on Jo’s mind. Today, things are different. Now 11 years old, Renee weighs 126 lb. and stands 4 ft. 5 in. tall–and Jo worries about obesity all the time. She worries about the health consequences of Renee’s weighing too much, the ones she has experienced throughout her own life. She worries about her daughter’s being teased or ostracized on account of her weight, just as Jo was teased and ostracized as a child. And she worries that she’s not doing enough–or that she’s doing too much–to change things, as she tries to avoid the mistakes she feels her parents made during her childhood. Most of all, Jo worries about losing sight of Renee amid all her own concerns surrounding her daughter’s weight. “I feel like she’s experiencing my weight issues all over again, living my obsession with food,” Jo says. “I feel like I’m watching a train wreck, and I can’t do anything about it.” She’s not alone. As more and more kids pack on more and more pounds–climbing inexorably from a healthy weight to excess weight to full-blown obesity–parents find themselves grappling with questions they never had to deal with when the only weight problems they had to think about were their own. How do you effectively control another person’s eating behavior? How do you motivate someone–especially a young, impulsive, pleasure-driven someone–to make smart food choices, to get up off the couch, to turn off the television? And how do you accomplish that without making that young person feel deprived, coerced or–worse yet–judged and found wanting? Perhaps most vexing for parents who are themselves veterans of weight-loss wars, how do you credibly persuade a child to take hold of an issue that you may never have been able to control yourself? The stickiness of the childhood-obesity problem begins with a simple truth: most of us just don’t think our kids are fat. It’s right there in the stats; one study found that only 36% of parents of overweight or obese children ages 2 to 17 identified them as such. An Australian group found that only 11% of parents of overweight 5- and 6-year-olds and 37% of parents of overweight 10-to-12-year-olds were aware that their children had a weight problem. And a 2005 British study found that fewer than 2% of parents of overweight kids from ages 3 to 5–and just over 17% of parents of obese kids of the same age range–saw things for what they were. Part of this blindness may come from parents’ not really believing that kids–especially very young kids, swaddled in no-longer-quite-so-delicious layers of baby fat–can actually be obese. Part of it may have to do with our fears about using such pejorative terms about our children, especially if they were once hurled at us by playground bullies. And part of it may be that, in a society in which obesity is omnipresent, a slightly hefty child looks pretty normal, relatively speaking, says psychologist Susan Carnell, the lead researcher for the British study on parental perceptions, who is now at the New York Obesity Research Center at St. Luke’s–Roosevelt Hospital. “The parents are likely to be overweight. The clinician who sees the child could well be overweight. It’s a sensitive issue from all sides.” All of which might begin to explain why so many physicians report finding it difficult to talk to parents about their child’s weight. According to a 2005 study, only 12% of pediatricians admit to feeling effective about a child’s weight problem during office visits, even if that problem is an obvious one. For many practitioners, there’s a fear that not only are the parents unaware of the situation but also they will be angered or upset by the information. More worrisome is how the news will make the child feel, particularly during the emotional storms and ego swings of adolescence. The problem is, with such a huge and growing population of overweight kids, sparing a family’s feelings may be a luxury we can no longer afford. That’s why obesity experts believe that not only does the message have to be delivered but it also has to be delivered in a way that is sure to get through. In 2007 a group of pediatric-obesity experts convened by the American Medical Association and co-funded by the Department of Health and Human Services and the Centers for Disease Control and Prevention issued a report on childhood obesity, which included a strong argument that the language of weight gain had to change. A decade ago, kids whose body mass index tracked at or above the 85th percentile for their age were dubbed “at risk of overweight.” The new recommendations urge doctors to cut to the chase and simply call such children overweight. Similarly, a child with a BMI above the 95th percentile–who would previously have been labeled overweight–would now officially be called obese. The idea behind the language discussion in the recommendations, says Dr. Samantha Rosman, a fellow in pediatric emergency medicine at Boston Medical Center and a trustee of the AMA, was to make sure parents hear what their kids’ doctors are telling them. “The stronger wording was a call to action,” Rosman says. “This is a really important health problem that has the potential to be devastating to our society if we don’t do something about it.” Doing something about it, of course, is going to take more than a vocabulary lesson. But the time is now. According to the HHS, 7 out of 10 overweight adolescents will become overweight adults. If the adolescent has an overweight parent, that figure rises to 8 out of 10. Parents have heard the recommendations a million times: Children should be eating five or more servings of fruits and veggies daily. They should be eating breakfast. They should be getting at least one hour of moderate physical activity each day. They should be spending fewer than two hours in front of a TV, video or computer screen each day. Or, rather, the entire family should be doing these things. In fact, if you were to boil down the myriad recommendations for preventing and dealing with childhood obesity to a single word, you would come up with this: modeling. We need to think about the messages our behaviors send to our kids, the experts insist. If your daily diet revolves around bologna, potato chips and Ben & Jerry’s Chunky Monkey ice cream eaten straight out of the carton, guess what Junior’s going to start craving? And if you can name every celebrity from the past five seasons of Dancing with the Stars, chances are your kid can too.
