“She’s Not fat. She’s Big boned”
Let’s talk about being chubby!
by Tonya Holden RN and David Matthews MD
The Children's Clinic
Tonya: It’s Saturday morning, the sun has barely peeked over the horizon. I jump out of my bed not realizing the time. I rush in to wake my mom, who is clearly in her good sleep pattern. I shake her --“Mama, get up I’m hungry, can I have some cereal?” She mumbles, “Girl, go and lay back down. It’s 6:30 in the morning.” I don’t give up, I continue pestering her. She finally gives up and sets up on the side of the bed. After making sure she is good and awake, I skip to the kitchen and sit at the table to wait for her to fix my breakfast.
When breakfast is over, I get dressed and scurry out to the playground across the street from where I live where I find my cousins Darlene, Hazel, Lisa, Lynn, Jack, Sam and Michael. We are ready to begin our adventures for the day. It’s barely 8 a.m. I was part of a dance group, music choir, kickball and softball team during the course of the summer, all in that park. This was our summer routine, dawn till dusk. The only times we would go home would be to use the bathroom and get a quick drink of water.
In the 5th grade, video games entered the world, changing my life, forever. My friends and I went from playing outside to becoming couch potatoes. Times on the park became limited. All of a sudden it was “too hot” to play outside. I never really became that good at playing video games, but I mastered the habits that accompanied it-- eating and snacking. An only child, I did not have the company of a playmate in the house and eating became a way of life for me.
David: Belief #1: It’s too hot to play outside.
Tonya has put her finger on one of the fundamental contributors to childhood obesity. She experienced the change from an outside, active lifestyle to a sitting, inside lifestyle.
Humans have incredible ability to handle cold and hot extremes—from Iceland to the Sahara. Tonya describes the childhood version of “cocooning” in our homes. Her loss of playtime resulted in eating as her comfort. She is not alone in this.
Tonya: Over the years, eating was no longer for nourishment. Eating was a habit. I grew up living next door to my grandmother, my babysitter. It was common to eat fried chicken, mashed potatoes, macaroni and cheese with homemade buttermilk biscuits several times a week. I was never made to eat things I did not want to eat. If my mother tried to push the issue my grandmother would simply say, “Leave that baby alone, that is just baby fat, she will lose that weight later.” Keeping the peace, my mother would simply let it go. I was never forced (in the presence of my grandmother) to try veggies or new foods. My grandmother would say, “Don’t force her to eat that if she doesn’t want to.” Not realizing it then, this was creating unhealthy eating habits and continued bad food choices.
David: Belief #2 “She asked for it; she must be hungry.”
Children are motivated to ask for food by commercials, seeing other people eat, a habitual time of eating, and true hunger. Deciding which of these is true hunger is a parent’s challenge.
See if the request just followed a commercial. Children see 40,000 commercials on TV every year. TV should be limited to 3 hours daily, at most.
If your child has eaten in the last 2 hours, and someone else is now eating, delay for about an hour, unless the prior meal was very scant. Watching someone eat, like watching someone yawn, is a contagious behavior. Children usually need food about every 3 hours.
Belief #3 “Leave that baby alone, She’ll lose that weight later”
80% of obese children persist into obese adults.
An expectation of what is “good” food and what “full” feels like is set early, and stays fairly fixed. In slim families, the sensation of “I’m stuffed” isn’t pleasurable. So teaching a child to overeat will teach her that overeating is right.
Tonya: Over time, my weight increased, and my self-esteem decreased. By the age of 30, I was a mother of three, well over 300 pounds and unable to walk to my mailbox at the end of my very short driveway without being extremely winded. I was unable to play simple games with my infant and toddler. I watched as my daughter began experiencing the weight problems that I had growing up. Something had to change. And the change had to begin with me.
David: Belief #5 He’s just a growing boy!
This line has excused many children from the help they desperately need. The BMI assessments in school have documented that 25% of our children are at risk for obesity related problems such as diabetes and high blood pressure.
Limiting nasty food, such as high carbohydrate + fats food, changing the school lunch program, and adding intentional exercise to the school rhythm has already been documented in Arkansas to stabilize and then decrease our children’s BMI. Growing children need great nutrition. If you can afford it, buy the better food, not the larger package.
Tonya: I realized that most of my life was spent making bad food choices, not trying new foods, therefore allowing the quotes such as “she’s not fat, she’s just big boned,” or “she must be hungry she asked for it” to control or excuse why I was becoming so chubby. Most people allow excuses to encourage bad decisions.
David: Belief #6 I didn’t think he would like it; I don’t like it and he didn’t when he was 3!
Here’s a cool tidbit—children’s taste preferences are stable for about 8 years, then their tastes change to more adult preferences. Has your 7-8 year old begun using your mint toothpaste instead of that sweet baby toothpaste? That is the time a taste for spicy food comes in, vegetables get reevaluated, and what that toddler wouldn’t eat can be tried again. The fussiest of eaters at 4 years old demands the Fire Sauce at 8 with his friends at Taco Bell. Don’t base your food preparations for life based on this first 8 years. Expect adventure.
And if you don’t care for certain foods, that means nothing about your child liking it! Give her a chance to find a wide variety of foods she likes
Tonya and David: Here are a few other beliefs that we find in our practice that hurt weight control in children.
Belief #7 It is just cheaper to do drive through every day, and everybody is happier.
Go rent the movie Supersize Me. It is not just MacDonald’s that requires assessment of the food quality and portion size. All the fast food restaurants do. Each has found a way to make us think the value of fast food is greater than home food.
However, when we find families who were obese and are now slim, limiting eating out at fast food places played a huge part in their change. Permanent right weight requires permanent changes in behavior. Fast food should be limited to once or twice weekly for a child.
Belief #8 I fixed it just for you! Why won’t you have another piece?
Have you ever noticed that those who feed us high calorie food are often the same ones who nag us for being overweight? And if we are trying to change our child’s diet, this situation becomes very charged. What to do?
This person must be brought into the helper mode. This person can thwart EVERYTHING. They love to cook and love to have approval for their cooking.
Tonya talks about her grandmother and mother’s interactions with great clarity. What could have helped?
Having an honest conversation in advance of being at their home is the best answer. Ask them, to cook fantastic fruits, veggies, and meats, and lighten up on the carbohydrates and potatoes. If they refuse to change their behavior toward your child, you may have to limit meals at their home until they are willing to be part of the team. This is HARD, but this step is crucial.
Belief #9 He is hungry right now!
Who doesn’t expect their child to be hungry and demanding food about 3 hours after eating? Especially if they are playing hard, running fast, riding bikes. When they run out, they are really O--U--T!
Allowing a child to get hungry and then scrambling for the quickest food is always a disaster. Plan your next meal. Get the food ready in advance. Higher quality food does take a bit of planning to get done right. But this is just a behavior change on our part. Be ready with the nutritious food you know they need.
Tonya’s statement haunts—Most people allow excuses to encourage bad decisions. These are actual statement we hear and have experienced our own lives. Each lead to continued obesity. Knowing these exist and thwart wise eating can help. Change is hard, we know. But we have to change. The old ways are too destructive to our children’s future!
Tonya Holden RN has chosen to have gastric bypass to adjust her weight, and struggles daily with excellent nutrition choices for her and her family.
David Matthews MD has been a variably faithful adherent of Weight Watchers since 17 years old, when his family realized a fundamental change was in order and they, in total, lost 250 pounds.