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Don't Focus On Kids' Weight Gain. Focus On Healthy Habits Instead

Janice Chang for NPR

It's a conversation I've had with many of my fellow parents in recent months, as our children have reunited at park play dates, and soccer matches: We've noticed our kids put on some extra weight during this pandemic, and we're not sure what, if anything, we should do about it.

"You are not alone," says Dr. Sandra Hassink, medical director of the American Academy of Pediatrics Institute for Healthy Childhood Weight. "This is happening to many, many people." She says the pandemic created "the perfect storm for having issues with weight gain," with its mass disruption of school, sleep and physical activity schedules, as well as stress and social isolation.

"I think everybody's shifting upward," she adds. "Kids that were in the healthy weight range are shifting upward. Children with obesity are shifting upward and children with severe obesity are shifting upward."

Weight is an incredibly fraught topic — and an imperfect indicator of health. As parents, a kid's sudden weight gain can be hard to know how to tackle.

The last thing we'd want is to set the stage for poor body image or eating disorders for our children. "If we focus on weight, that can cause so many other problems," says Anna Lutz, a registered dietitian in Raleigh, N.C., who specializes in family feeding issues.

Instead, Lutz and other experts say parents should focus on they're supporting healthy habits in their kids. Here are what doctors and specialists who work with kids say about what to do — and not to do — to get your family back on track.

Do: Check in with your pediatrician to see whether the weight gain is outside the norm

A pediatrician can help assess whether your child's weight gain is just part of their normal growth pattern, says Lutz.

Kids grow at different rates, and healthy kids come in all shapes and sizes, she explains. "But where we might get concerned is when a child veers off of their growth pattern significantly." So, for instance, a kid who has been growing consistently along the 25th percentile and then suddenly jumps to the 90th, that might be a signal that something's going on.

If so, the pediatrician may suggest ways to slow the rate of weight gain so that a kid's height can catch up, Hassink adds.

Your child's doctor might also want to make sure that a child isn't developing health problems like elevated cholesterol, fatty liver disease or sleep apnea. Or, a sudden jump in weight could be a signal of other health issues. "There could be something going on emotionally that's interfering with someone's eating or movement. It could be a change in medication," says Lutz.

"A lot of things happened during COVID to maybe make us a little less healthy," says Hassink. She recommends that parents assess their family routines and figure out what got out of whack during the pandemic.

Don't: Tell kids there's something wrong with their weight

When you're talking to kids, focus on healthy habits, not weight, experts say. This is important because weight isn't as easily changed as behaviors, and "we are not all supposed to look the same," says Lutz. "Bodies do come in all shapes and sizes and bodies change over time."

Focusing on a number on the scale might lead a child to develop poor body image, says Lutz.

"When we start to send our children the message that there's something wrong with their body, we're setting them up for all these health concerns and emotional concerns, self-esteem problems," she says. "Really, focusing on behaviors is what supports health."

And ultimately, the goal is to foster healthy habits in children that they'll maintain throughout their lives, says Hassink.

"This isn't a 10-week program. We're really aiming for these patterns that will start now and go across their lifespan." And it's about more than weight — good nutrition and physical activity are also key to preventing chronic illness, she says.

Sleep, regular meal times and physical activity are a good place to start.

Do: Get bedtimes back on track

In the chaos of the pandemic, and during summer breaks, sleep and wakeup times slid later and later for lots of kids, says Dr. Nazrat Mirza, medical director of the pediatric weight management clinic at Children's National Hospital in Washington, D.C.

"I've had kids [going to sleep] at 1 a.m., 2 a.m., 3 a.m., 4 a.m. And then they nap during the day," she says — instead of engaging in physical activity. Research has linked regular, adequate sleep to improved mental and physical health in kids. "So sleep is equally important," as nutrition and exercise, she says.

If sleep routines have become a problem in your household, Hassink suggests trying to move kids' bedtimes back by 15 minutes every two or three nights. Do the same thing with wake-up times, moving them 15 minutes earlier every few mornings, she says. "Work your way back into a sleep routine that matches what you're going to need for school."

Don't: Put your kids on a diet.

Clinicians who work with kids are unanimous on this count: Restrictive eating is not for kids. "We know that children and adolescents that engage in dieting behaviors are more likely to develop eating disorders," says Lutz.

And restrictive diets can also backfire. "In the long run it actually leads to increased weight gain," she says, and it can set someone up for gaining and losing weight over and over again, which can have health consequences of its own.

Do: Create more structure around meal times.

All-day-long, unsupervised grazing became a habit in many households in the early days of the pandemic — even for trained experts — as many parents found themselves on constant work Zooms.

"It was sort of this buffet-style experience where they were noshing throughout the day," says Stacey Rosenfeld, a Miami-based psychologist who specializes in eating disorders. This was the case with her kids, twin 7-year-old boys, one of whom ended up gaining 20 pounds in six months.

As things calmed down, Rosenfeld decided it was time for a reset, including getting back to more structured eating. While putting kids on a restricted diet can lead to unintended consequences, creating and sticking to set meal and snack times can help kids regulate their appetites and develop sensible eating habits, experts say.

"If a child's not sure if dinner is going to be five o'clock or eight o'clock and they get hungry at 4:30, they might just reach for a snack, not knowing exactly when dinner is coming," Hassink says. "So regular meal and snack times of eating together is a very positive health behavior."

Lutz and Rosenfeld both embrace an approach known as the division of responsibility in feeding: Basically, your job as a parent is to decide when and what kids eat, offering them a variety of healthful foods. The kids' job is to decide whether and how much to eat — so don't force them to clean their plate and don't be a short-order cook.

"Provide the food, take a deep breath and let them listen to their body. Let them do their jobs," Lutz says. Ultimately, she says, you want to raise kids who are mindful eaters, in touch with their hunger and fullness.

Do: Build movement breaks into the day.

The pandemic has had us all glued to screens. Break up all that sitting — and cut back on screen time — with small and frequent bouts of movement, Hassink says. That could be a quick game of tag or an outdoor playdate or walking to the corner store with mom or dad.

Family walks are always a good idea. If you have a kid that is less than enthused about joining you for a stroll, Hassink has some suggestions. For smaller kids, she says a star chart might work. Give them a star for every walk they complete each day, and at the end of the week, they get to pick a fun family activity for you all to do.

For older kids, she suggests having them invite a friend over to play or join you in a family outing, such as a family bike ride. You could sign the kids up for an activity like soccer or swimming, pandemic permitting. Or take your child along for an errand and park far. "The focus is on getting kids moving again," Hassink says, adding, "Any activity is better than sitting at your computer or watching a screen."

Don't: Try to overhaul everything all at once.

It takes energy to make change, and tackling too many changes at once can be overwhelming, Hassink advises. Instead, pick one or two changes you want to make at first to get your family back to healthy habits.

"If you take the first step and then you succeed at that, it gives you energy" to keep moving in the right direction, she says.

Do: Make changes as a family.

No matter what changes you make, make sure you make them for the whole family, experts advise. Why? For starters, you need the support of the people around you, says Hassink. "If you're living in the midst of your family and you're the only one trying to make the change or having to make the change, it's not going to work."

Even if you have multiple children, but only one child gained weight, don't single them out, says Rosenfeld. "I hear so many stories about that backfiring," she says, "stories of kids who say, 'I was the heavier person or I gained weight, and so I wasn't allowed to have desserts and my sibling or siblings were.' Or 'I had to do this exercise.' And I think that can be so damaging."

If the goal is to raise healthy children, then the changes you adopt should apply to everyone in the family, she says. She often encourages parents to ask themselves, "Would I do this if my child were thin? And I use that as a litmus [test]."

Do: Have compassion for yourself, and model it for your kids.

We've all been through an incredibly stressful and exhausting year and a half, and it's not over. And some families, particularly in low-income communities of color, have been especially hard hit by this pandemic, experiencing job losses, food and housing insecurity, as well as higher rates of COVID-19. All of these things can make it harder to get back on track with healthy habits.

"We have to show ourselves a little compassion and realize we're going to work our way out of this, and it's not going to happen with a snap of the fingers," says Hassink.

That compassion is something we should also foster in our children. Even if your kid didn't gain excess weight, teach them not to tease others. Pediatrician Mirza says she's hearing these fears from her patients. "We're having children who are scared to go back to school because they now realize that they have changed and they don't want to meet their classmates," she says.

If you hear these fears from your kid, experts say encourage them to talk about it. Validate their feelings and help them think ahead. If this happens to them, how will they respond?

Ultimately, "we want to be building our kids up. We want to be focusing on who they are outside of their bodies," says Rosenfeld.

"We've survived this very serious time in our history," says Lutz. "And if that meant that people gained more weight than they would have, it's a body's way of surviving."

The podcast portion of this story was produced by Janet W. Lee, with engineering support from Marcia Caldwell.

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Maria Godoy is a senior science and health editor and correspondent with NPR News. Her reporting can be heard across NPR's news shows and podcasts. She is also one of the hosts of NPR's Life Kit.
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