Your Child’s Chubby Belly: Should You Worry?

hoola-hoopLast week I saw a little boy in the Feeding Team where I work at a children’s hospital who was referred for food refusal, picky eating, failure to gain weight and a host of other issues. We went through the visit, did our assessment and made our recommendations. At the end of the visit, the mom said to me “I probably should bring my daughter here. I am worried about her, she is only 9 years old and she has cellulite on her stomach! What should I do?” Seriously….my veins actually got this weird feeling. I really understand how they got the expression “that makes my blood boil”.  My blood boils a lot these days….

Anyway, I could tell this poor mom was really concerned, and I was pretty sure she bought into the cultural mantra that being fat is bad and thin is good. And here she was, with her one and only daughter, at the ripe old age of  9 with a chubby belly. And she was worried, but I was not sure why. Was she worried about her health, or that she may end up with a fat child and wouldn’t that be horrible? I did not want to lose this chance to possibly have an impact on a young girl’s self-esteem and body image, and I knew I had to control myself. I needed this mother to buy in to what I had to say in these last few minutes of our appointment time.

So I took a deep breath and asked “How old is your daughter?” and she told me. I then went on to explain normal development and how all children are different in the way they gain weight and grow. Some kids are scrawny much of their young lives, even into their teen years, and only gain weight in their 20’s or even later. Others tend to be a bit chubby and often that fat can be in the tummy, but this is very normal. “Just remember” I said, “how small your daughter is, and how much she will be growing in the next ten years…..her body needs some fat so she can produce the hormones that are going to transform her into a young woman.  Do you really think having a chubby belly at her age is important?” That mom stopped to think. So true! She has a lot of years to go before she ends up with an adult body. So if she should not worry about her daughter’s belly fat, then what should she worry about?

I went on to introduce her to the idea of promoting family health. NOT focusing on one child’s body or weight, but instead, caring about the health and happiness of everyone in the family. That includes dad who is in the habit of drinking soda, and the skinny brother who lives on potato chips and Oreo cookies. How can the entire family be healthier? I gave her a few handouts and websites on promoting a healthy feeding relationship ( is my favorite). I suggested that she try not to talk about her daughter’s belly, or her body, or anyone’s body in the household and instead work on family health. Getting enough sleep. Limiting screen time to 2 hours or less. Cooking more at home with more family meals, less eating out, more fun outdoor play. That kind of thing. Giving your children the gift of a healthy lifestyle is something we all can work on. Trying to change someone’s genetics is fruitless at best, and worse, so damaging to self-esteem and body image (yes, we are all different, look around you, even elite athletes have different body types, yet all healthy). Your child may indeed turn out looking too thin or too large by cultural standards, but don’t you want them to be themselves? They can still be healthy, depending you what you teach them.

Anyway, I am not sure if I had an impact, or if she bought into the message I was trying to send, but at least I tried.

So, to answer the question: should you worry about your child’s belly? The answer is NO. Non. Ne. Nei. Nie. Nada.

FYI I am the champion

Instead, go Hula Hooping. Now that is important.


Flat Belly Syndrome

cartoon bellyMade ya look! That is what my kids would have said…I am guessing just the words “flat belly” attract a lot of attention. As far as “Flat Belly Syndrome”, well, I made that up.  Those words seem to describe what I have seen way too many times over the years.If you look at the actual definition of “syndrome” in the Merriam-Webster Dictionary, the description fits.

By definition a “syndrome” is:1) a group of signs and symptoms that occur together and characterize a particular abnormality and 2)a set of concurrent things (such as emotions and actions) that usually form an identifiable pattern. Typically the signs I see are extreme body checking coupled with trying to do something about it, such as diet. 

So after an email from a fellow dietitian asking about what I say to patients who ask about getting rid of belly fat, it got me thinking. We both felt we would be millionaires if we got a dollar every time someone asked that question.

But what DO I say?

From my experience with both adults and children (yes, children), it seems there is a very extreme and weird focus on bellies. Be honest, do you look at yourself sideways in the mirror? More than once in awhile? It made sense to me with my eating disorder patients, that they would focus on a particular body part, that is part of the illness. A distraction from something much more important (easier to fret about a belly verses a bad relationship). But when an 11 year old boy sits in front of you and looks totally distraught, just because he is beginning puberty and has some belly fat, well, it saddens me. Where did this come from? Why is this important to a child?

I believe it is our culture of course which is reinforced unfortunately at home, where parents and relatives don’t think before they speak. About their bodies and what they don’t like, and how big their bellies are. Advertisements are everywhere, it is almost comical when you get in line to check out at the grocery store. Take a look at the magazines. I bet more than half of them have some ad or mention of “How to get a flat belly” or “Lose that belly fat!”, you get it. Have you ever stopped to ask “why?”. Personally, it angers me. They are trying to sell magazines, and those stupid ads work. Ugh.  As if all those people in the world who have a “flat belly” or 6 pack or whatever the goal is….are they happy now?

And what DO I tell my patients who ask about that. This is what I tell them:

1. Where you carry your body fat is genetic. Some people (if you look around) have very slim legs and larger bellies, some have not much of a belly but larger hips and legs. We are all different.

2. Imbalanced nutrition does not help you reach the healthiest body you can have. We all need protein and adequate fluids (or you may retain water which can make you feel bloated and if you are obsessed with your belly, well, that does not help). Extreme dieting also does not help. Poor eating contributes to digestive issues (constipation?) and that never makes you feel good.

3. Doing 100 crunches may make your tummy muscles strong (since I am not a fitness expert, you may want to consult one regarding if 100 crunches is even a good idea. I think not.). Anyway, strong stomach muscles are fantastic (good for the back according to my husband’s doctor), however they do not affect the fat on top of the muscle. So talk to a fitness expert (American College of Sports Medicine or ACSM certified is your best bet) to see about the right amount of exercise to strengthen your muscles. Getting stronger is a good goal. Trying to achieve a certain stomach if it is not in your genes is not a good goal.

4. Finally, how much time are you spending on trying to have the perfect belly? If you are thinking of this on a daily basis, it could be a red flag. Are you going through something you really don’t want to deal with? If so, please consider chatting with a professional, just to be sure (such as a therapist). A flat belly won’t help anything.

Finally, can you entertain the idea of focusing on being healthier? Being healthy is a good goal, and adopting healthy behaviors such as eating healthier, moving more, getting enough sleep and addressing your real issues will most definitely help you fight the stupidity about 6 packs.

In my day, that meant beer.