The Missing Link in Pediatric Obesity

Artist: Alexandra Haynak

The Missing Link in Pediatric Obesity


“You can’t run away from something, you have to run towards something.”

When we are running away, fear leads us to have a singular focus - to get away - but yet we keep looking back over our shoulders at what we fear. We are expending all of our energy trying to get away, and never know when we have truly succeeded in escaping. And I have to tell you, we can’t run away from the fear of our own bodies.

Instead, what can we run towards?

Having a destination creates a goal. What do you want to create? Where do you want to go? It’s not necessarily the absence or opposite of what you don’t want. Instead of being skinny or having a certain weight, consider: what would healthy habits look like for you and your family? What do you want to think about yourself? What would a positive body image feel like? What would it be like to focus on what is going well, and celebrating steps forward as a family? When we look at what we can change - our thoughts, our feelings, our actions; we create a very different outcome than arguing with the circumstances of our bodies.

As you look towards your goals, what will it feel like to be there? This is the magic of coaching: You can create that feeling now. And we can help our patients find that feeling too. As physicians, instead of advocating for our patients to lose a number of pounds, start a particular diet, or restrict the number of calories to be eaten each day, we can advocate for their wholeness. We can help them focus on what brings them joy, celebrate their body’s capabilities, and help them grow.

Instead of looking at what needs to be fixed, the process of seeing what we want to create is changing the dialogue around what it means to be healthy. Health is not a number on the scale or a particular diet - it is celebrating the whole person, and what it will feel like when we create and achieve goals.

I want to feel strong.
I want to feel amazing in my body.
I want to feel free.

As a certified life & wellness coach for parents of overweight children, and a pediatrician, I am learning what works: reframing obesity, removing the fear and shame to embrace the body as it is, right now. And then creating what you want: freedom, empowerment, acceptance, love --  and yes, health, at any weight.

My clients look at their existing routines and then create healthy habits for the whole family. Those habits are not all about eating or movement or portion sizes. The habits are the beliefs they have about themselves and their bodies, how to fuel themselves physically, mentally, emotionally, and spiritually. The habits are cultivating the emotions of self-acceptance, peace, calmness, and love. The habits are getting restful sleep, prioritizing self-care, and listening to the body. Every client’s journey is different. But it’s amazing how they have such similar results: a feeling of freedom, empowerment, self-confidence, connection, and becoming a role model for their family’s health.

Let’s stop focusing on the weight and instead focus on what makes us amazing, beautiful, unstoppable, perfectly imperfect humans.

Pediatric obesity: we see evidence of it everywhere. According to the CDC, over 35% of American children are either overweight or obese, and American adults are experiencing obesity at even higher levels. News headlines, medical journals, and commercials for weight loss medications/programs all insist that we have something to fear, and it’s time to take action now, before it’s too late.

Fear has been our medical approach to obesity over the past generation. As parents, physicians, and patients, we fear and focus upon obesity and its health consequences. Internalized thoughts about our weight are reflected in our self-identity (I am obese, I am overweight, I am the parent of an obese child, etc.). We restrict junk food, we count calories, we teach our children good and bad foods. As physicians, we refer to endocrinology, therapy, and nutrition and weight loss centers, looking for the fix.

And yet pediatric overweight and obesity are continuing to increase in severity and the percentage of children affected. This is a story of how coaching parents can create a much different outcome, starting with the moment my approach to pediatric overweight changed:

At the beginning of every visit, I would plot the child’s growth on a chart, and look at the curve. Parents would wait with baited breath... What’s the news? I could hear it in their anxious voices, “What kind of parent am I being?” Emily’s mom asked me why I wasn’t having the “BMI chat” with her. I asked, “Why? What is your concern?”

At 6 years old, Emily had always grown consistently over the 85th percentile for BMI. We had already covered that she ate a variety of whole foods at meals with her family, and enjoyed lots of activity over the course of the day. There were no “red flags.” Emily’s mom came to tears. “You’re the first doctor who hasn’t told me I was doing it all wrong because she’s still ‘overweight’.”

Shame is a painful feeling that emerges when we think we have done something wrong, and feel that we are flawed, and it is what Emily’s mom was freed from. It impacts our sense of self and worthiness, and I have seen parents set their worthiness on whether kids are going up or down on the growth curves.

As humans, our emotions drive us to take action, or avoid it. When we are feeling joy and hope and other positive emotions, we lean in and engage. In the discomfort of shame, we tend to withdraw, hide, and seek comfort, which often looks like consuming food or media. Shame does not produce meaningful “corrective” change. Shame and fear of long-term consequences become potent partners in the experience of childhood obesity.

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