If you were a doctor dealing with an overweight child...

Would you tell the child they should lose weight? Would you tell the parent(s)?

I seriously would not know what to do. When  I was really little, like, 10, they told me my weight was 'off the charts', showed me a chart, told me to snack less, and wanted to check my cholesterol (I didn't want a needle though.) Then, when I was 16, they told me my weight was STILL off the charts (but apparently not as much so as when I was younger), told me to exercise more, and told my dad. They tested my cholesterol, blood pressure, fine. But it worried me and I ate barely ANYTHING for weeks and have lost a ton of weight (well, abit over 20 lbs... probably nto in a healthy way...) but still, should a doctor tell a child they should lose weight, or not in fear of upsetting the child?

I think they should tell both the child and the parents. Then the doctor, parent and child tackle the issue TOGETHER so the child sees how it will work and is empowered, not scared.

You can't just drop a bomb like that and then leave it to be.

Yep, what cdc said...most of the time children learn about eating through their parents, so it'd be smart to educate the whole family

Original Post by crazydiamondchrysalis:

I think they should tell both the child and the parents. Then the doctor, parent and child tackle the issue TOGETHER so the child sees how it will work and is empowered, not scared.

You can't just drop a bomb like that and then leave it to be.

Yeah, when they said it to me the first time, my parents weren't even in the room. I felt scared...  I don't think they meant to scare me. Plus they were rude if I remember, they just said "Stop snacking." and moved on, and got all worried about my cholesterol, claiming I 'wanted' it tested, when I didn't.... and they didn't test it.

I still don't know what I would do. I wouldn't want to create body image issues in the child. Maybe I would talk to the parent in private.

I agree, that is a horrible way to give the news.

Instead of focusing on the weight, why not sit the child down and say, "You have to start making better choices in your eating and activity level."  Then provide the parents with plenty of literature about healthy & tasty snacks, what kind of food and nutrients you should be getting on a daily basis, and how often you should be getting outside and playing and moving.

The "You're obese and might die" scare tactic might work with some adults (after all other tactics have been tried and failed) but with children that sort of talk is more likely to cause bad habits of yo-yo dieting and shattered body image. 

At sixteen, a person is hardly a child.  Once you hit that age, you should be responsible enough to understand you have the greatest nutritional opportunities in history, and overeating or continually consuming junkfood is just a ridiculous decision, however tempting.  You should also know you need take the steps to control your health, no one else can do it for you.

When a child's younger, though, it's not their fault.  It shouldn't even be brought up to them that they're "extremely overweight", it's damaging and stressful, and entirely the fault of the parents.  Personally, I have never met an overweight kid with parents of a healthy weight.  A doctor should inform the family that they all need to change their lifestyle, and focus on the positives ("do go outside and play more", not "don't eat candy") when talking to the child.

That's my opinion, anyway.

I think as with someone who is underweight it is their job to make the patient aware of it and the health complications at a younger age it should be addressed with the parents.  and for a teenager (they should be asked if they want the parents to consult) if it isn't resolving itself by next visit it should be addressed with the parents.  Healthy low fat, lower sugar, lower calorie solutions of more veggies and fruits, lean meats, whole wheat breads/pastas should be suggested in addition to more activity/exercise most days of the week.  As an underweight patient would be advised to eat more healthy and greater calories.

Don't get upet get more active, eat more healthy don't go too drastic and in several months when you've lost weight you will be happy he did bring it up.

good luck

Haha reminds me of a time when I went to the doctor in my teens for a routine checkup.

Nurse: "You're 5'2"."

Me: "Aww, I guess that makes me still really short."

Nurse: "Actually...you might be above average."

Me: "REALLY? =D"

Nurse: "...No, wait, that's your weight."

-_-"

Young - I'd talk only to the parents and stress the need for a proactive approach, the less the child realizes that there is "something wrong with them" the better.  It's the parents' doing at that age.

Older - I wouldn't let the parents in.  By that point, the teen probably already knows anyway though.  So I'd probably just say something offhand, and ask if they wanted to talk with me about it, that I could give them some advice.

In the perfect world the doctor will sit down with the parents and the child and work out the nutrition plan with them. In the real world he/she doesn't have time. It's best to tell the parents and refer them to a nutritionist.

Young: I agree with tealparadise.

Old: I partly disagree. I'd tell the parents too and ask them to provide a nutrition environment that are healthier. It'll be tough for the child to have discipline when mom leaves her chocolate around and dad have his chips, dips, nuts, and pizza all over the place on football nights.

Ignoring the fact that a child is obese is not an option.  But children are rarely in a position to make the necessary changes themselves.

The most effective methods being employed at tackling childhood obesity today do involve roping the whole family.   Children are not encouraged to count calories but instead encouraged to eat more healthily.  To that end parents are given training on healthy eating, cooking skills and..... very important... portion-control.  The children are offered extra exercise opportunities and, again, the whole family is encouraged to get involved.

This method means that the child is not stigmatised as being the one in a family 'on a diet'.  It doesn't mean that the child is sat in a corner and told to eat lettuce whilst everyone else eats pie and chips.  Instead it's treated as a team-effort, everyone learning how to live more healthily and everyone committed to improvements  - including the child.

My mother was always on some new fad diet and my dad was always overeating and demanding the most fattening foods. So, it was no surprise that I was very overweight at 8, and my mom's solution was to take me with her when she went to Jenny Craig.

Up to that point I was happy being myself and I had friends. The Jenny Craig representative made such a big deal about my weight, 150 pounds, and how fat I was and took a picture of me to show me how fat I was. She got my mom to buy a bunch of their food, and pay a lot of money to put me on some plan.

I have never been right since then. I stopped hanging out with my friends, stopped going outside, I was too ashamed of myself & I felt like I must be a really horrible person. When I was a teenager I dealt with anorexia for a little while, but I needed the comfort of food more.

I still don't have friends, still won't go outside, and have all these self image problems. I think physicians and nutritionists should talk to kids as they would want to be talked to, and there needs to be a much stronger emphasis on health verses fat!

Original Post by cajunrider:

Old: I partly disagree. I'd tell the parents too and ask them to provide a nutrition environment that are healthier. It'll be tough for the child to have discipline when mom leaves her chocolate around and dad have his chips, dips, nuts, and pizza all over the place on football nights.

I completely disagree with this.  My parents are extremely unhealthy in their eating and exercise habits-- that doesn't mean I had to be.

Saying "it's the parents" or "it'll be tough if the parents don't help" at any age over 14 or so, is just promoting a lack of responsibility in competent adults.   Teenagers are far too dependent on their parents, and that debilitating habit lasts.  Teaching early on that if you have a problem, YOU have to step up and fix it no matter what anyone else does, is the only hope we've got for success, as a country, as a planet.  It starts small.

Contrasting, I also agree with gi-jane, that it should involve the whole family when the child is small.  Not the school system, not a government therapy program: the family.

Original Post by lynnlette:

Original Post by cajunrider:

Old: I partly disagree. I'd tell the parents too and ask them to provide a nutrition environment that are healthier. It'll be tough for the child to have discipline when mom leaves her chocolate around and dad have his chips, dips, nuts, and pizza all over the place on football nights.

I completely disagree with this.  My parents are extremely unhealthy in their eating and exercise habits-- that doesn't mean I had to be.

Saying "it's the parents" or "it'll be tough if the parents don't help" at any age over 14 or so, is just promoting a lack of responsibility in competent adults.   Teenagers are far too dependent on their parents, and that debilitating habit lasts.  Teaching early on that if you have a problem, YOU have to step up and fix it no matter what anyone else does, is the only hope we've got for success, as a country, as a planet.  It starts small.

Contrasting, I also agree with gi-jane, that it should involve the whole family when the child is small.  Not the school system, not a government therapy program: the family.

No, it's not the parents but definitely yes it is tough if the parents don't help. As a father of 3 competent adults I can definitely say that my children had far more freedom than most if not all their friends. Yet when they were still with me, I would cook healthy meals for them or suggested healthy dishes when it's their turn to cook. It's not all about setting the rules, or even doing it for them, it's more about providing an environment more conducive to desired behaviors.

Congratulations for having healthy eating habit even though your parents didn't. However, don't tell me that it would not have been easier for you had they had healthier eating habits.