Parenting an overweight child can be difficult

When it comes to helping an overweight or obese child slim down, parents routinely blow it, pediatric obesity experts say. Some resort to nagging or coercion, others put the child on a restricted diet, and still others issue sweeping bans against foods containing sugar or fat — tactics that are, at best, ineffective and, at worst, damaging.

Increased public attention to the problem of overweight — which affects one-third of Americans younger than 18 — has made more parents aware of the problem but has left them unsure of what to do. Should they intervene early, even in the preschool years, or keep quiet and practice a form of benign neglect, hoping that the baby fat will melt away as a child grows? At the same time, many parents are battling their own weight problems or hang-ups.

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Although a third of kids are overweight or obese, studies have shown that up to 90 percent of parents think their children are just fine.

One Northern Virginia mother, who asked that her name be omitted because she wanted to protect her daughter’s privacy, said she found herself at a loss when her perenially chubby child grew visibly heavier than her middle school classmates. “I didn’t want to say the wrong thing and make her self-conscious, because she didn’t seem bothered by it. But I was definitely concerned this would be a problem, especially in high school,” the mother said.

“It’s not an easy place for parents to be at all,” said Eleanor Mackey, a clinical psychologist affiliated with the pediatric obesity clinic at Children’s National Medical Center in the District.

While some overweight children do slim down as they grow up, the likelihood decreases with age. An obese preschooler has an approximately 30 percent chance of becoming an obese adult, according to the Centers for Disease Control and Prevention, while an obese teenager has a 70 percent chance — 80 percent if one parent is obese.

Following are recommendations by pediatric obesity experts for parents concerned about what — and what not — to do.

The groundwork for obesity can be laid as early as infancy, said pediatrician Nazrat Mirza, who directs Children’s Hospital’s obesity clinic.

Many parents, she said, inadvertently overfeed infants, giving them six to eight ounces of formula or breast milk at a time, instead of the recommended three to four ounces. Others feed an infant every time the child cries — even though crying may be unrelated to hunger — or push food even after the baby has signaled he or she has had enough.

“People like fast-growing babies and regard a chubby baby as a healthy baby, but what they don’t realize is that they’re overriding innate metabolic cues,” Mirza said. Most babies and children younger than 4 or so instinctively know how much they need to eat. And insisting that children of any age finish everything on their plates can lead to habitual overeating, as can overly large portions.

Pediatrician Herschel Lessin, who practices in Poughkeepsie, N.Y., said that many parents misuse food as a reward or a bribe. “I have parents who buy their kids fast food five or six times a week,” said Lessin.

Adults, he said, commonly have skewed perceptions of children’s weight. “Parents worry way too much about a skinny kid and way too little about a fat kid,” Lessin observed.