I remember when there was only one McDonald’s in the entire state of Connecticut. It was a big treat to go once or twice a year, usually during the summer with my family. There was no drive-through and only a few choices on the menu: cheeseburger for 15 cents, hamburger or fries (just one size back then) for 10 cents and milkshakes (we shared one between four kids….it was the size of a small one today, they gave out tiny water cups). Times have changed but still, going to McDonald’s once on awhile isn’t really that big of a deal when it comes to having healthy children and helping your child grow into his or her own unique normal body size.

I have been plugging away at a book about kids and weight because after working for many years in the world of “childhood obesity” I see parents getting it all wrong. These are good parents who have been informed by their child’s pediatrician that their child is “obese” and so they typically are trying to do the right thing. I would like to share part of a chapter on what I have seen as:

10 Most Common Mistakes Parents Make

 If you are like most parents who are worried about their child’s weight, the logical thing to do is to focus on what the child is doing, right? WRONG! Well, maybe not totally wrong, because you do need to figure out how it happened that your child’s weight has become an issue. What is “wrong” is believing that your child has much power or control over his weight without you. In fact I would dare to say that your child does not ever need to hear the word “weight” to be able to be healthy and ok.

Let me describe a typical scenario I saw often as an outpatient dietitian working primarily with families whose children who were referred for issues with weight. One patient, 8 year old Peter (not his real name) had been referred for being “obese” since at his last physical his BMI was above the 95th percentile. His mother appeared a bit embarrassed as she is clearly tall and thin and it seems she feels a bit uncomfortable with having a “fat” child. She openly let me know that her other child, Suzie, is thin. So yes, they do have snacks in the home and they do get pizza on the weekends, but Suzie needs the snacks and Peter needs to learn to control himself. He also needs to exercise more but he won’t stop playing those video games. Mom often catches him very late at night with his Game Boy under the covers, still playing games at midnight. He just doesn’t listen. Poor sleep, by the way, leads to cravings for fat and sugar, a great set up for weight gain. Mom, I find out does not like vegetables so rarely cooks them. She is a snacker and tends to eat most meals and snacks on the couch in front of the TV. Although she prefers foods like chips, cookies, frozen pizza and wings, she states she is willing to cook whatever he needs for his “diet”. She also is not happy that he refuses to exercise. The family actually bought a treadmill that is in the basement and he won’t use it.

One more scene that is more common than you may think. I once had a patient (we will call her Tammy) who was referred for “abnormal weight gain”. She came to the initial visit with mom and her aunt who helped care for her. Mom was a very busy career woman who traveled often, and dad was a busy executive who worked in a business where health and appearance were important.  Mom appeared slightly overweight and admitted to struggling with weight issues. The aunt did not like to cook and because the family could afford it, she tended to take the children out to eat several times per week. The older sister was thin and gobbled up cookies by the boxful. She also liked teasing her little sister about her weight. When obtaining the history, Tammy made random comments about dad’s “crazy eating”. Apparently, dad believed in a restrictive vegan organic diet and had been following it for years. He pretty much starved himself during the day, worked out daily and then ate the same large vegan meal in the evening almost every day, with occasional binge eating (he clearly had an eating disorder that was not addressed).  Mom also tended to yo-yo diet. Auntie just enjoyed eating out. Mom was in agreement to focus on health and really understood that focusing on the number on the scale was not a good idea (she lived a life of dieting and clearly did not want this for her daughter who was only 12).  Unfortunately, over time Tammy only gained weight. The pressure from dad to diet was a bit too hard to overcome, and Tammy ended up binge eating when no one was around, which contributed to her weight gain. She did see an endocrinologist to rule out any physiological reason for her weight gain, but it clearly was due to the binge eating that resulted from the confusing messages and pressure she was experiencing at home.

My intent in sharing these stories is to help you understand the following 10 MOST COMMON MISTAKES parents make in trying to help their child lose weight. Time to “hold the mirror up” and ask yourself honestly if you have done or still do any of the following:

10 Most Common Mistakes Parents Make

1. Treating your child differently than other children or family members when it comes to food and eating, including commenting on or judging his eating (he is such a good eater compared to you, she is a junk food eater, he always eats too much, etc).
2. Expecting your child to behave any differently than you do.
3. Expecting your child to behave exactly LIKE you do (or like their sibling).
4. Expecting your child to resist any food or beverage that is in the home.
5. Expecting your child to be able to discipline himself regarding any limits on video games or TV (Buying “live” interactive video games in the first place; allowing a TV in your child’s room).
6. Expecting your child to exercise on his or her own (especially if the mode of exercise is your idea and not your child’s idea!).
7. Ignoring or denying your own eating and body image issues (or failure to recognize that you have a problem).
8. Weighing your child, talking about weight loss, a good weight goal, YOUR weight or the weight on the scale in general.
9. Allowing verbal abuse such as name calling (fatso, chubby, etc) by ANYONE in your home or in your presence (or even verbally comparing bodies, such as “his sister’s tummy is flat” or “he has all his weight in his tummy”).
10. Catering to a “picky” eater.

Now we are going to take the time to truly go through each and every one of these ten mistakes in a bit more detail so you can identify if you have fallen into some of these detrimental patterns. Remember, the purpose here is NOT to make you feel guilty! If you are doing any of these things, or if you have been allowing them to occur, it is most likely because you truly do care, or you may be very worried about your child’s health. Also, there of course may be other mistakes many parents make that are not listed here, however these tend to be some of the most common we see that parents may not recognize as harmful.  Many of these simple statements seem like the exact right thing to do. So do not waste a minute blaming yourself or feeling badly! You are reading this book because you care…..so now is the time to set things straight. Let’s go through each mistake to be sure you understand completely.

Mistake #1: Treating your child differently than other children or family members when it comes to food and eating.

This mistake typically happens at the dinner table, but it can happen at other places like school, celebrations, family gatherings, picnics, etc. If it is dinner time, you may have prepared a nice healthy meal that you know your family enjoys. Maybe you put some hot delicious breadsticks on the table. You watch as your family dives in, but then you notice the child who you are worried about, who people may have commented on, or even more importantly, who the pediatrician has identified as “obese” and he has grabbed a second breadstick (as did your thin daughter). What do you do? You feel you need to stop him to help. So you comment “John that is enough! You have already had one!” Or take another scenario: You are so concerned that you have talked to the school nurse and asked her to tell the lunch workers to not allow your child to have seconds, or to have dessert. They are now your food police. You can watch him at home, but now you have someone at school to keep tabs. It goes on and on, but hopefully you get the picture.

How is this harmful? It backfires. Consider this: years of research indicate that even when adults are restricted, they become more obsessed with food, and more likely to binge eat and gain weight not lose it! What do you think will happen to a child? Paying so close attention and singling out a child like this not only makes him feel embarrassed and like something is wrong with him (not good for building self-esteem), it makes him want those breadsticks even more. So when you wrap up those breadsticks and put them away, Johnny is still thinking about them after he goes to bed. He gets up when everyone has fallen asleep and sneaks down into the kitchen, quietly unzips the plastic Ziploc bag holding the forbidden breadsticks and begins to eat, when he should be sleeping. He eats in solitude, where no scolding eyes can see him. He eats, because he knows tomorrow will bring another day where all eyes at the dinner table will be on him. And he continues to gain.

Commenting on or judging your child’s eating, or in fact ANYONE’s eating is also not a good idea.  It seems to me the entire population has become totally wrapped up in eating, body size, and even health (which sounds like a good thing, but extremes of anything are not healthy and definitely not normal). Commenting on the way people eat and on bodies has become a social norm. Think about any time you go to a social gathering, especially where there is eating involved. Comments such as “she can eat whatever she wants, and be skinny! I’m so jealous!” or, “You look so good! What diet are you on?” At home it may sound like this: “Mary eats her vegetables, why can’t you?” Or consider a sibling complaining to mom that Johnny ate all the ice cream again, and he is not supposed to have it!

How is this harmful? When we talk about people’s eating as if it is a character judgment (he is good; she is bad) it has the potential to really mess up a child’s relationship to food. It becomes a judgment on character, not a naturally healthy behavior (enjoying eating). It can absolutely ruin a child’s natural ability to self-regulate (listen to his body signals) and creates great confusion about what to eat, whether to eat or how much to eat. So saying “he is such a good eater compared to you, she is a junk food eater, he always eats too much”, or any other judgmental comment is not helpful.   It makes children feel bad. It even makes adults feel bad, not a way to develop a healthy and normal relationship to food.

Mistake #2: Expecting your child to behave any differently than you do.

The truth is, parents who expect their child to behave differently than they do is more common than you could imagine. We see it every day while working with parents who truly do care about their child’s weight and health. It may seem like a no-brainer to some of us who understand that children tend to do what we do; however it clearly is an issue that many parents are not even aware of.

Here is a very common scenario: Mom sits down in the counseling room with 10 year old Joey who is overweight. She wants me to tell him that he needs to start eating vegetables. He also needs to stop drinking soda because the doctor said he had elevated insulin levels and should not have sweetened beverages. After going through the diet history, the reality is that mom hates vegetables also and does not eat them. She may cook them for the family on occasion, but neither she nor Joey eats them. In addition, it appears that she has a Coca cola habit. She starts drinking it in the morning because it gets her going, similar to those of us who love our morning coffee. But she does not have any weight issues or anything wrong with her insulin, so she feels she can drink her soda. He (10 year old Joey) should have the will power to skip the soda and he needs his vegetables (not sure why mom doesn’t feel she needs them, but it seems because she is an adult, she has earned the right to eat whatever she wants).

How is this harmful? The old saying holds true: The apple does not fall far from the tree. Your child will do what you do, not what you say to do. Your child just will not believe you. Why should they? Your actions speak louder than your words. So many clichés, I know, however in this case, all true. If you really want your child to eat vegetables, you need to not only prepare them, you need to eat them. If you don’t want your child to drink soda, you may need to stop drinking it too. (Note: nothing wrong with enjoying a soda but if you were told your child has hyperinsulinemia or pre-diabetes, a healthy move would be to decrease it).

Mistake #3: Expecting your child to be exactly like you (or like their sibling).

What does this look like? It may involve body size, eating or exercise. Imagine a tall thin dad and a tall thin mom. Then Betsy is born. She tracks at the 95th percentile for weight and at the 50th percentile for height for most of her young years. She does not appear tall and skinny like her parents. Then her brother Brian is born. He falls at the 10th percentile for weight and the 75th percentile for height most of his young life. He looks skinny, just like mom and dad. All of Betsy’s young life the difference between them is pointed out. In fact, her parents have tried to work with her to lose weight as she appears chubby next to her brother and they feel they can fix this.

Not only is Betsy different in body size and shape than her younger brother, he absolutely loves sports and competition, “just like his dad”. Betsy, on the other hand, prefers art and reading. Her parents however force her to join the basketball team and she dreads every minute (although she does enjoy after the games when she gets to run around and just play with her friends on the court for fun!) She just hates the pressure of competition. Brian, on the other hand, thrives on competing. He is not only plays basketball but also plays hockey, soccer and lacrosse.

How does this harm? Expecting a child to change their genetic body type and tendency is impossible. It instead typically makes a child feel “less than” and contributes to low self-esteem.  As mentioned earlier, it also tends to backfire, and causes a child to become more, not less obsessed with food and eating (remember, restriction leads to “food insecurity” and food obsession). So, we tend to see the “chubby” child slowing become even more overweight, and eventually going off of their growth chart due to sneak eating, etc.

Expecting a child to be active like you or a sibling sets up all kinds of problems. Forcing a child to do something they do not feel comfortable doing may alienate them from all activities and being active in any way. Even worse, they may grow to really dislike that sibling who you seem to accept just because he is like you.

Mistake #4: Expecting your child to resist any food or beverage that is in the home.

Do you just love your potato chips? Do you need your chocolate fix? Gotta have that caffeinated soda to keep you going? Many parents are of the mind-set that their children need to respect them by not eating “mom’s chips” or drinking “dad’s soda”. Or, they feel a child should be motivated to resist the goodies that are there for the other thin people in the home. I am so baffled by people who expect a child or even a teenager to have “willpower” when even adults do not have the ability to resist foods they love.

How I explain it is usually like this: Imagine your very favorite food. For me, it may be white chocolate mousse, which is very hard to find. For someone else it might be Godiva chocolate or even something luxurious such as lobster. Now imagine that someone brings it home, and puts it in the fridge. Everyone can have some except for you. How would you feel? What would you do? I can tell you what I would do, and that is wait until nobody was around, then take some! Starting to see a theme? Not only does restricting food make you want it more, having it around and expecting a child to have willpower is not going to happen.

Mistake#5: Expecting your child to be able to discipline himself regarding any limits on video games or TV (Buying “live” interactive video games in the first place; allowing a TV in your child’s room).

I feel bad for the children and teens today because it is not their fault they were born into this era of technology. Ask yourself these questions: Does your child have a TV in his or her bedroom? Do they have an IPod? An IPad? Or how about a notebook or laptop? Smart phone? Are you even aware of how many hours your child or teen is on these devices? Do you allow them to have them in their bedrooms at bedtime? Does your child tell you the TV helps him fall asleep? Do you trust your child to turn off the device and go to sleep on his or her own? Big mistake!!

Why is this a problem? Children who do too much screen time get affected in so many ways, but one of the major issues in how screen time, TVs in the bedroom and video games interfere with sleep.  Because poor sleep has been identified as one of the major contributors to childhood obesity, I sometimes say “fix the sleep problem first” as the other issues are almost impossible to address without adequate sleep. And if you think your child is turning off the TV or Game Boy or laptop to go to sleep, you are kidding yourself. These devices are sometimes addicting and simply, just way too much fun. Don’t expect your child to control themselves.

Mistake #6: Expecting your child to exercise on his or her own (especially if the mode of exercise is your idea and not your child’s).

Often we see parents who are extremely physically fit, into a sport, or maybe dad works out at the gym and does marathons. Or mom goes for a walk or jog after work every day while their child or teenager prefers to sit on the couch and read. Or watch TV. The word “lazy” comes up frequently.

Consider this scenario. Everyone in the family is sedentary. A family of couch potatoes, some thin, some not so thin. When “Jose” is identified as “obese” at his doctor’s visit, he is now expected to exercise (that is what the doctor recommended) while the rest of the family continues in their couch potato mode of living.

Or how about this situation: mom is an avid tennis player who belongs to a league. She meets her friends at the club almost daily after work. “Steven” comes home to an empty house almost every day during the week, because mom is at tennis. He is supposed to be exercising. When mom gets home at 6:30 pm to cook dinner, she is appalled that again he did not use the treadmill. Again, this is a case where the teen has been identified as obese and mom is taking this seriously (or so she says). So seriously that she invested in a treadmill for him. It was not cheap and she is pretty disgusted that he can’t discipline himself to use it.

What is wrong with this picture? You can’t expect a child to do something he does not enjoy, and you certainly can’t expect him to do it without your support. It is unfair to require one child to exercise while another is allowed to sit on the couch just because of differences in body size. It is understandable that a parent would not want to give up their fun or exercise (such as the example of the mom tennis player) however if we want our children to develop healthy habits, we may need to sacrifice, or at least compromise. Again, role modeling is good, as children eventually do what you do (not what you say), however they don’t drive cars, can’t take themselves to the gym and so they need your support.

Mistake#7: Ignoring or denying your own eating and body image issues (or failure to recognize that you have a problem).

This may be one of the most important mistakes parents make. Answer these questions honestly:

1. Do you weigh yourself every day? If not, do you talk about your weight or your body? ”I need to lose this stomach! I’m not putting on that bathing suit until I lose ten pounds!”
2. Do you count calories? Measure portion sizes? Talk about “bad” foods or being “bad” because you ate something unhealthy?
3. Do you have a history of an eating disorder? Have you ever received treatment?
4. Are you a slave to your exercise routine? This means you just have to do it almost every single day or you feel bad. Or, you go to extremes (run for 2 hours on a treadmill, or outside, but do not enjoy it at all)
5. Do you use food for comfort? Were you rewarded with food when you were a child?
6. Did your parents restrict your food intake as a child, or were you put on a diet?
7. Were you forced to eat everything on your plate as a child and feel that all children should clean their plates?
8. Do you ever binge? This involves eating a very large quantity of food (such as a box of cookies or half gallon of ice cream) and feeling very out of control.
9. Do you feel like you had a binge (felt out of control) even if the amount of food you ate would not be considered too much by most people, but felt like too much to you? Such as eating a grinder or finishing an ice cream cone. This is sometimes referred to as a “subjective binge”. It may not be a lot of food, but how you feel about it is similar to those who have an “objective binge” which means pretty much everyone would say it was a large amount (such as an entire package of something).

This is not a test, where if you answer “yes” to 2 out of 9 you may have issues. These questions are only meant to help you reflect on your own history with food, body image and eating so that you may start to understand how you may be affecting your child. Certainly, if you had an eating disorder such as anorexia nervosa or bulimia nervosa when you were young, and never received treatment, or even if you did, it is important to be aware of your relationship with food now that you are a parent. If some of these statements resonate with you, chances are you may have some work to do, or at least should really pay attention to what you say or do in front of your child.

Mistake#8: Weighing your child, talking about weight loss, a good weight goal, YOUR weight or the weight on the scale in general.

It amazes me how socially acceptable weight obsession seems to be. It also strikes me that so many people, parents, teens, health professionals and even children seem to be so intensely interested in that number. Ask yourself, what answer does that number give you? Does it tell you if you look good? Does it tell you if you are healthy? Does the number measure how much fat you have? Why is it that a mother would be so focused on the weight of an eight year old, when they have so many more years to grow? Why do so many of the young women I have seen for eating disorders want to weigh 100 pounds? Why do people think their weight is going to possibly stay in one place on that scale? Why do people weigh themselves so often, as if something big could change in one day? Or one hour? I actually have had one mother tell me she weighs herself before and after a shower because she often loses a pound! Wow, that’s a lot of dirt!

Why is it a bad idea to focus so much on a number, on the scale, on weighing yourself or your child so often? Why is it bad to openly ask the doctor “how much did he weigh?” Well, your anxiety and worry over that number teaches your child about what is important. They will begin to worry too. When they see YOU feel bad after you get off the scale, or talk about your weight, they learn it is very important and they need to worry about it too. They may attach a lot of meaning to it, just have you may have learned to do. You may have heard the slogan “Don’t weigh your self-esteem, it’s what’s inside that counts”……well, focusing on that number on the scale is bound to make you feel bad, not too good for a child’s self-esteem. Not too good for a parent’s self-esteem either.

I know what you may be thinking. I hear it all the time! “Then how am I supposed to make sure he is not gaining too much weight?” Ask yourself, has this helped? Does it motivate your child to want to eat healthier? The opposite tends to be true. Just like adult “weight watchers”, children tend to become more, not less focused on food. The scale (and that darned number) tends to go up, not down. Yes, it is ok, and definitely a good idea to be aware of your child’s growth pattern. You do want to ask the doctor to see the growth chart. But be sure to do this privately if possible. You can check to see if your child is trending off of the curve or not. Then, it is time to focus on health and what YOU can do as a parent to be sure your child stays on track. Your child does not need to know the number. The “talk” should NOT be about weight! Talk about healthy eating, talk about being active for a healthy heart, but please, do not talk about weight. If you absolutely cannot get rid of your scale, consider at least not leaving it in a family bathroom. Please do not weigh yourself when your children are present. And absolutely do not complain about or even talk about your weight. Do you really want your children to have the number attached to the force of gravity on their body be a priority in their life?

Mistake#9: Allowing verbal abuse or name calling (fatso, chubby, etc) by ANYONE in your home or in your presence (or even excessive “body talk”-she is so skinny! Wow, he gained a lot of weight!).

Bullying is front page news these days. We all have heard the horror stories of people who have been bullied, and the sometimes extreme consequences. Bullying is taken so seriously in some states that it is even against the law in schools, and violation of the anti-bullying laws may result in a permanent bad mark on a school record or transcript.

Why is it that teasing about weight, especially in homes often goes unnoticed? Why is calling your sister “fatso” ok in some households? I have heard parents say, “oh we tease her all the time. She doesn’t care, she knows we are just kidding!” Seriously?

It is not that family members or friends are intentionally trying to hurt someone they love. It seems to me that it has just become socially acceptable to tease in this way. I also believe, as I stated in Mistake#9 that it is harmful to regularly engage in “body talk”. Body talk involves making comments about someone’s body, either your child’s, your own, your neighbor’s, your spouse’s, or even a movie star or someone you don’t even know. How is this harmful? When we talk so much about bodies, it just reinforces that body size is what is important. Or body shape. It suggests to a child that HIS or HER body size matters to you.

Avoiding talk of bodies is not an easy task. Think about someone you know who has lost a lot of weight. Of course you want to say “you look great!”  What could be so bad about this? You are trying to pay a compliment to someone who clearly has been dieting and exercising and working really hard to change their body. But how do you know what they did to lose the weight? What if it was not a healthy way to lose weight at all? What if they are suffering from disordered eating and feeling imprisoned by their disease? Hearing comments like “you look so good!” just serve to reinforce the bad behavior and eating disorder (a disease that people die from). So what should you do in this case? Well, if you don’t know the person well, why even comment? Why risk the chance that this person may not be healthy at all, not in a good place, and you just did your part in keeping them unhealthy. Compliment her hairdo, or dress, or shoes if you feel the need. “That color looks so beautiful on you!” feels good to say, yet does no harm.

What if, on the other hand, the person who lost weight is a good friend and you know they have been working on getting healthy for a long time. Instead of focusing so much on talking about weight and body size, why not compliment how hard they worked, or ask how they feel? Have they started doing yoga? Zumba? Walking? Are they sleeping better? Feeling energetic? Why not enjoy talking about all those good things? Yes, it does feel good to be able to fit into clothes you may not have before (especially if they are clothes you used to wear, and can now wear again because you got back to your original healthy lifestyle). But our culture unfortunately places way too much emphasis on bodies and if we want our kids to be healthy and fit, talking about body size is not the answer.

Finally, another reason to avoid complimenting weight loss is that often, those who do succeed in losing weight also succeed in gaining it back. How do you think they will feel next year when you see them again and they found the weight they lost? I see this happen over and over, and I am sure you do too.

As for name calling in your home, I always recommend forbidding it. What do you do if your child swears? Just laugh it off?  Typically there are consequences for inappropriate behavior (good parenting). Name calling is like swearing, but worse in my mind, as it hurts someone. Hold the mirror up: what have you allowed to occur in YOUR home?

  Mistake # 10:  Catering to a “picky eater”.

This big mistake may surprise you. How could being picky with what you will eat affect your child’s weight? If anything, most people think picky eating actually may make it harder for a child to gain appropriately. This may be true when a child is very young, however as time goes by and if the issue is never addressed, it often promotes too much weight gain.

Here is what we tend to see happen with many picky eaters. It starts out when a child starts to refuse foods (at a young age, such as 2). They typical scenario is that mom and dad get a bit worried when Johnny won’t eat anything on his plate. How is he supposed to grow? So they make him his macaroni and cheese because they know he loves that and will eat it.  He also likes McDonald’s chicken nuggets and fries, so dad often picks that up on his way home from work, since he knows Johnny will never touch the chicken, carrots and potatoes mom has prepared.

Fast forward 10 years. What do you think happens to Johnny by the time he has turned 12? Without any vegetables whatsoever, very few fruits, and even limited protein foods (well, except chicken nuggets and maybe some bologna and salami), his diet is not too good. He does not consume enough fiber, is constipated, and because his diet is predominantly starch and fat, he has gained an excessive amount of weight, and now falls far above his normal growth curve for weight. Some lab values may be slightly elevated now (related to abnormal weight gain and poor diet). Are you starting to get the picture?

What then is a parent supposed to do?  There are some excellent resources by experts on this topic such as Ellyn Satter website as well as Give Peas a Chance, a wonderful book written by dietitian and feeding expert Kate Samela, MS, RD, CSP. These will give you some great strategies to deal with this very common problem.  In the meantime, tell your doctor about your child’s picky eating as soon as you notice it. Your pediatrician may be able to refer you for some specialized help (such as feeding therapy).

So there you have it, just a few things to reflect on to hopefully help you help your child have the healthiest body they can have while maintaining a great relationship with food, eating and YOU! More to come on actual strategies and ideas to help, but in the meantime, keep loving your child for the wonderful person they are growing up to be. And that has nothing to do with the number on that dumb scale.