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Talking to Kids About Weight, Diet and Exercise
Dr. Barlow discusses how to talk to kids about weight, diet and exercise
Featured Speaker:
Dr. Barlow was an assistant professor of pediatrics at Saint Louis University from 1998 to 2007, where she established a weight management program. In 2007, she joined the faculty at Baylor College of Medicine as associate professor of pediatrics and was the director of the Texas Children’s Hospital Center for Childhood Obesity. Dr. Barlow was an investigator on the Texas Childhood Obesity Research Demonstration project, a study sponsored by the CDC that examined healthcare, school, and early childhood education programs for obesity prevention and care in low-income neighborhoods. She was the site principal investigator for the NIDDK-sponsored NASH Clinical Research Network (2013-2016). She joined the pediatrics faculty at UT Southwestern Medical Center in 2016. In addition to caring for gastrointestinal conditions, Dr. Barlow oversees an integrated program in obesity care that spans community programs, primary healthcare and tertiary care.
Sarah Barlow, MD
Dr. Sarah Barlow is the Director of the Children’s HealthSM Integrated Program in Childhood Obesity and Professor at UT Southwestern Medical Center. She received her medical degree from UT Southwestern and completed her pediatric residency at Brown University. Dr. Barlow completed fellowship training in pediatric gastroenterology and nutrition at Tufts School of Medicine, Floating Hospital for Children in Boston, MA. She also earned a Master’s in Public Health at Harvard School of Public Health in 1996. She was board certified in pediatric gastroenterology by the American Board of Pediatrics in 1997.Dr. Barlow was an assistant professor of pediatrics at Saint Louis University from 1998 to 2007, where she established a weight management program. In 2007, she joined the faculty at Baylor College of Medicine as associate professor of pediatrics and was the director of the Texas Children’s Hospital Center for Childhood Obesity. Dr. Barlow was an investigator on the Texas Childhood Obesity Research Demonstration project, a study sponsored by the CDC that examined healthcare, school, and early childhood education programs for obesity prevention and care in low-income neighborhoods. She was the site principal investigator for the NIDDK-sponsored NASH Clinical Research Network (2013-2016). She joined the pediatrics faculty at UT Southwestern Medical Center in 2016. In addition to caring for gastrointestinal conditions, Dr. Barlow oversees an integrated program in obesity care that spans community programs, primary healthcare and tertiary care.
Transcription:
Talking to kids about weight, diet and exercise
Melanie Cole: Welcome. You're listening to Children's Health Checkup where we answer parent's most common questions about raising healthy and happy kids. I'm Melanie Cole. Today we're discussing how to talk to your children about weight. Our expert is Dr. Sarah Barlow. She's the Director of Children's Health Integrated Program in Childhood Obesity and a Professor at UT Southwestern Medical Center. We'll be sharing statistics on obesity in children and why it's important to address unhealthy weight and kids, some of the risks that come with carrying extra weight. And if as a parent you become concerned about your child's weight, what's the best way to address it? Dr. Barlow, I'm so happy to have you join us today. Can you share some statistics on obesity in children, this epidemic that we're seeing and why it's so important that we address unhealthy weight in kids as early as possible?
Dr. Barlow: Sure. So this is such an important topic and about one in five children have weight that we would medically consider to be obesity. Now just to be clear, obesity's extra body fat that causes health problems and what most people might call just overweight, medically we see that, we call it obesity because of the health consequences. So it's just important to make sure that people understand that obesity really refers to even the, what we might consider mild overweight because of the health problems.
Host: Well it certainly does and we're seeing it just so often now. So tell us about some of the risks that come with carrying that extra weight. As a child grows and we're seeing some diseases that we used to only see in adults and we're seeing them in children now speak about some of those for us.
Dr. Barlow: Really almost all the diseases that we know are associated with obesity in adulthood, we are seeing in kids. So that is high blood pressure, cholesterol problems, diabetes or prediabetes. A really important problem that a lot of people aren't aware of that's very common is liver disease, sleep apnea, and in fact, most kids that have obesity have already had at least one medical condition right now. And then those are the medical problems. But there's emotional issues as well cause there's so much stigma that comes with obesity and with stigma there can be bullying. So it's very common for kids who experience obesity to have problems with self esteem and even depression.
Host: If a parent becomes concerned, Dr. Barlow about their child's weight, what's the best way for them to address it with their child? Because we hear that we're not supposed to talk about weight, that it's about being healthy and strong, but this isn't always easy when a parent is concerned.
Dr. Barlow: This is a really tough topic and in fact I've read that parents find it more difficult to talk about weight issues than about the traditional tough topics of sex, drugs, and alcohol. So I think parents really do look for some guidance on this. I would say if the parent is starting the conversation then just as you said, you want to focus on the health issue. And a good time might be after a doctor's visit when there's been, you know, a deliberate assessment of a child's weight. So a parent could say, you know, at the doctor's visit today we found out your body is carrying too much weight for health. That makes me worried. What do you think? So again, you're focusing on the weight, you're talking about weight as separate from the child. So you're not saying you're overweight and of course you're obese, but your body is carrying extra weight.
You've expressed your concern, but you also open it up to hear from the child, what do you think? So I think that's kind of a safe way of expressing the concern, but giving room for the child to react and kind of explain whether they're worried and how they feel about it. I think sometimes the child comes in and starts the conversation with something like, am I fat? And that's an important conversation. Or it's important for parents to figure out how to respond to that. You know, again, the focus should be on health and you can parent can say something like, I'm sorry you're feeling that way. We all come in different shapes and sizes, but as a parent I'm concerned about your health. I'm concerned about the impact of the extra weight and the effect that it might have on your health, but you have to know that your weight is not a measure of who you are as a person. So again, separating the weight from the person, focusing on the weight as a health issue, and reminding the child that their value as a person is completely unrelated to their weight.
Host: Dr. Barlow, where does the pediatrician come into this picture? Because for parents I would think at the pediatric well visit it would be very tempting for the parent to say well, to their pediatrician, do you think that she's overweight or do you think that he has a problem with their weight, which could embarrass the child? How do they start that conversation with the pediatrician or do they at all?
Dr. Barlow: Well, I think the best place to have the conversation is in the pediatric office because it's clear that the focus is on health. So again, I think the parents can use similar language to the doctor. Like how is my child growing? How is the health of their weight right now? And in fact, I think pediatricians may welcome that introduction and can take it from there in terms of you looking at the graphs and looking at the child's growth pattern, both for weight and height and putting that all together for the family.
Host: Well it's such important information and what a great topic. So what are some simple habits that parents can practice at home to promote a healthy lifestyle? We have to be role models, right?
Dr. Barlow: Yes, you're absolutely right. So I think that there's a lot in our world that pushes all of us into unhealthy habits in terms of eating and not enough physical activity. And you know, the home really can be a little safety bubble of health if parents can work in that direction. So I think parents should try to make home a safe place to be healthy, which means taking, you know, keeping the tempting unhealthy foods out of the house. Because it's easier to not have those if they're just not there. And that doesn't mean that people never have soda or they never have ice cream. But those are foods that should be sort of once in a while foods and not sitting in the house staring people in the face and tempting them. So if the parent can keep the soda and the ice cream and the cookies out of the house, except for, you know, the special occasions, I think that's really important step to take. Another important strategy that I really emphasize is eating together as a family.
You know, when my kids were little, we ate together every night and sometimes it was hard and you know, not every meal was perfectly pleasant, but my kids kind of expected that the food was what my husband and I prepared and that we all sat together and had 20 minutes of talking to each other. And you know, not watching TV or looking at our phones. And that was just kind of a habit that we built up that I think really helped us have good healthy meals most of the time. And it does take some effort. But you know, I think that that's really worthwhile. And as you said, we have to be role models, we have to walk the walk and sometimes I think the advantage of that is that when we know we have to be the role model, it can motivate our own healthy behaviors knowing that our children are watching us and we know that they, you know, they learn so much from observing us. Even if they're not admitting that they're learning from us. So it can be a two way street where we're setting a good example for our kids and our desire to kind of teach our kids to be healthy is a good motivator for us to be that role model.
Host: And for parents getting our kids to exercise outside of school where there might not be as much gym and recess as there used to be. What do you want us to know about exercising as a family? It's great to eat together as a family. And what about taking a walk, exercising together as well?
Dr. Barlow: Yes, I think that there's a great opportunity there. I like to talk less about exercise and more about physical activity because sometimes exercise has a connotation of being hard and unpleasant, but that can be, you know, weekend time, carving out time to play together. So with little kids it can be running around in the park, kicking a ball, playing tag Frisbee and hula hoops. It doesn't have to be expensive with older kids, you know, parents can have a really important role in supporting their child being active. It could be a sports team. Some kids are less interested in sports, but they may like martial arts or dance or something that's more individual. Making fun time, not just around meals. Cause that's the typical thing that we celebrate with food. But it could be going to a park or going to the pool or the ocean to go for a swim. Again, consciously building in family time. That's more physical activity.
Host: It's great advice. What forms of support before we wrap, up are out there for families trying to make changes to support the healthier lifestyle that we've discussed here today? And more specifically, what programs does Children's Health offer?
Dr. Barlow: Well, Children's has several different programs to really try to meet the needs of all kinds of families. So we have a Nutrition Clinic and our dieticians are really expert at guiding families at an individual level into moving toward healthier eating and you know, they can adapt to kids with special needs such as kids with autism, ADHD, or medical conditions that might modify their nutritional needs. We also have the Get Up and Go program, which is really an amazing program that children's provides in partnership with the YMCA. It's a 10 week program for kids, six to 14 years, and their families, it's really fun. It's once a week for 10 weeks and there's games, there's learning about healthy nutrition, goal setting, a healthy snack. Most families who start it finish it, which I think really speaks to how enjoyable it is and that's offered free to families. We also have a multispecialty program within our endocrine division called Coach, and we have a psychologist and a dietician and a social worker as well as the medical providers to provide really comprehensive care, especially for more complex settings where there might be a prediabetes or severe cholesterol problems. And then for adolescents who have severe obesity, some may want to consider our bariatric surgery program. This is a program where again with the help of dietician and psychologist as well as the surgeon, families figure out whether this is the right direction for their child. And if it is, then you know, the surgery could be done at a center that is really centered around the adolescent and the adolescents family. So kind of soup to nuts here.
Host: Certainly is. And what a great program. Wrap it up for us, Dr. Barlow, with your best advice for parents about talking to their children about weight. It's so important.
Dr. Barlow: So remember that weight is not who your child is and be prepared to tell your child about all the qualities that you really value in them. Whether it's they're a good friend, they're a hard worker, they're funny, and be prepared to tell them that weight is a health problem. It's not who they are and that you're there to work with them and to support them to get them healthy.
Host: What great advice. Thank you so much, Dr. Sarah Barlow and to the audience for listening to Children's Health Checkup. You can find more information at childrens.com/healthyweight. If you found this podcast helpful, please rate and review or share the episode and please follow Children's Health on your social channels.
Talking to kids about weight, diet and exercise
Melanie Cole: Welcome. You're listening to Children's Health Checkup where we answer parent's most common questions about raising healthy and happy kids. I'm Melanie Cole. Today we're discussing how to talk to your children about weight. Our expert is Dr. Sarah Barlow. She's the Director of Children's Health Integrated Program in Childhood Obesity and a Professor at UT Southwestern Medical Center. We'll be sharing statistics on obesity in children and why it's important to address unhealthy weight and kids, some of the risks that come with carrying extra weight. And if as a parent you become concerned about your child's weight, what's the best way to address it? Dr. Barlow, I'm so happy to have you join us today. Can you share some statistics on obesity in children, this epidemic that we're seeing and why it's so important that we address unhealthy weight in kids as early as possible?
Dr. Barlow: Sure. So this is such an important topic and about one in five children have weight that we would medically consider to be obesity. Now just to be clear, obesity's extra body fat that causes health problems and what most people might call just overweight, medically we see that, we call it obesity because of the health consequences. So it's just important to make sure that people understand that obesity really refers to even the, what we might consider mild overweight because of the health problems.
Host: Well it certainly does and we're seeing it just so often now. So tell us about some of the risks that come with carrying that extra weight. As a child grows and we're seeing some diseases that we used to only see in adults and we're seeing them in children now speak about some of those for us.
Dr. Barlow: Really almost all the diseases that we know are associated with obesity in adulthood, we are seeing in kids. So that is high blood pressure, cholesterol problems, diabetes or prediabetes. A really important problem that a lot of people aren't aware of that's very common is liver disease, sleep apnea, and in fact, most kids that have obesity have already had at least one medical condition right now. And then those are the medical problems. But there's emotional issues as well cause there's so much stigma that comes with obesity and with stigma there can be bullying. So it's very common for kids who experience obesity to have problems with self esteem and even depression.
Host: If a parent becomes concerned, Dr. Barlow about their child's weight, what's the best way for them to address it with their child? Because we hear that we're not supposed to talk about weight, that it's about being healthy and strong, but this isn't always easy when a parent is concerned.
Dr. Barlow: This is a really tough topic and in fact I've read that parents find it more difficult to talk about weight issues than about the traditional tough topics of sex, drugs, and alcohol. So I think parents really do look for some guidance on this. I would say if the parent is starting the conversation then just as you said, you want to focus on the health issue. And a good time might be after a doctor's visit when there's been, you know, a deliberate assessment of a child's weight. So a parent could say, you know, at the doctor's visit today we found out your body is carrying too much weight for health. That makes me worried. What do you think? So again, you're focusing on the weight, you're talking about weight as separate from the child. So you're not saying you're overweight and of course you're obese, but your body is carrying extra weight.
You've expressed your concern, but you also open it up to hear from the child, what do you think? So I think that's kind of a safe way of expressing the concern, but giving room for the child to react and kind of explain whether they're worried and how they feel about it. I think sometimes the child comes in and starts the conversation with something like, am I fat? And that's an important conversation. Or it's important for parents to figure out how to respond to that. You know, again, the focus should be on health and you can parent can say something like, I'm sorry you're feeling that way. We all come in different shapes and sizes, but as a parent I'm concerned about your health. I'm concerned about the impact of the extra weight and the effect that it might have on your health, but you have to know that your weight is not a measure of who you are as a person. So again, separating the weight from the person, focusing on the weight as a health issue, and reminding the child that their value as a person is completely unrelated to their weight.
Host: Dr. Barlow, where does the pediatrician come into this picture? Because for parents I would think at the pediatric well visit it would be very tempting for the parent to say well, to their pediatrician, do you think that she's overweight or do you think that he has a problem with their weight, which could embarrass the child? How do they start that conversation with the pediatrician or do they at all?
Dr. Barlow: Well, I think the best place to have the conversation is in the pediatric office because it's clear that the focus is on health. So again, I think the parents can use similar language to the doctor. Like how is my child growing? How is the health of their weight right now? And in fact, I think pediatricians may welcome that introduction and can take it from there in terms of you looking at the graphs and looking at the child's growth pattern, both for weight and height and putting that all together for the family.
Host: Well it's such important information and what a great topic. So what are some simple habits that parents can practice at home to promote a healthy lifestyle? We have to be role models, right?
Dr. Barlow: Yes, you're absolutely right. So I think that there's a lot in our world that pushes all of us into unhealthy habits in terms of eating and not enough physical activity. And you know, the home really can be a little safety bubble of health if parents can work in that direction. So I think parents should try to make home a safe place to be healthy, which means taking, you know, keeping the tempting unhealthy foods out of the house. Because it's easier to not have those if they're just not there. And that doesn't mean that people never have soda or they never have ice cream. But those are foods that should be sort of once in a while foods and not sitting in the house staring people in the face and tempting them. So if the parent can keep the soda and the ice cream and the cookies out of the house, except for, you know, the special occasions, I think that's really important step to take. Another important strategy that I really emphasize is eating together as a family.
You know, when my kids were little, we ate together every night and sometimes it was hard and you know, not every meal was perfectly pleasant, but my kids kind of expected that the food was what my husband and I prepared and that we all sat together and had 20 minutes of talking to each other. And you know, not watching TV or looking at our phones. And that was just kind of a habit that we built up that I think really helped us have good healthy meals most of the time. And it does take some effort. But you know, I think that that's really worthwhile. And as you said, we have to be role models, we have to walk the walk and sometimes I think the advantage of that is that when we know we have to be the role model, it can motivate our own healthy behaviors knowing that our children are watching us and we know that they, you know, they learn so much from observing us. Even if they're not admitting that they're learning from us. So it can be a two way street where we're setting a good example for our kids and our desire to kind of teach our kids to be healthy is a good motivator for us to be that role model.
Host: And for parents getting our kids to exercise outside of school where there might not be as much gym and recess as there used to be. What do you want us to know about exercising as a family? It's great to eat together as a family. And what about taking a walk, exercising together as well?
Dr. Barlow: Yes, I think that there's a great opportunity there. I like to talk less about exercise and more about physical activity because sometimes exercise has a connotation of being hard and unpleasant, but that can be, you know, weekend time, carving out time to play together. So with little kids it can be running around in the park, kicking a ball, playing tag Frisbee and hula hoops. It doesn't have to be expensive with older kids, you know, parents can have a really important role in supporting their child being active. It could be a sports team. Some kids are less interested in sports, but they may like martial arts or dance or something that's more individual. Making fun time, not just around meals. Cause that's the typical thing that we celebrate with food. But it could be going to a park or going to the pool or the ocean to go for a swim. Again, consciously building in family time. That's more physical activity.
Host: It's great advice. What forms of support before we wrap, up are out there for families trying to make changes to support the healthier lifestyle that we've discussed here today? And more specifically, what programs does Children's Health offer?
Dr. Barlow: Well, Children's has several different programs to really try to meet the needs of all kinds of families. So we have a Nutrition Clinic and our dieticians are really expert at guiding families at an individual level into moving toward healthier eating and you know, they can adapt to kids with special needs such as kids with autism, ADHD, or medical conditions that might modify their nutritional needs. We also have the Get Up and Go program, which is really an amazing program that children's provides in partnership with the YMCA. It's a 10 week program for kids, six to 14 years, and their families, it's really fun. It's once a week for 10 weeks and there's games, there's learning about healthy nutrition, goal setting, a healthy snack. Most families who start it finish it, which I think really speaks to how enjoyable it is and that's offered free to families. We also have a multispecialty program within our endocrine division called Coach, and we have a psychologist and a dietician and a social worker as well as the medical providers to provide really comprehensive care, especially for more complex settings where there might be a prediabetes or severe cholesterol problems. And then for adolescents who have severe obesity, some may want to consider our bariatric surgery program. This is a program where again with the help of dietician and psychologist as well as the surgeon, families figure out whether this is the right direction for their child. And if it is, then you know, the surgery could be done at a center that is really centered around the adolescent and the adolescents family. So kind of soup to nuts here.
Host: Certainly is. And what a great program. Wrap it up for us, Dr. Barlow, with your best advice for parents about talking to their children about weight. It's so important.
Dr. Barlow: So remember that weight is not who your child is and be prepared to tell your child about all the qualities that you really value in them. Whether it's they're a good friend, they're a hard worker, they're funny, and be prepared to tell them that weight is a health problem. It's not who they are and that you're there to work with them and to support them to get them healthy.
Host: What great advice. Thank you so much, Dr. Sarah Barlow and to the audience for listening to Children's Health Checkup. You can find more information at childrens.com/healthyweight. If you found this podcast helpful, please rate and review or share the episode and please follow Children's Health on your social channels.