Peer Reviewed Article on Why Not to Call a Teen Fat
The Checkup
How Not to Talk to a Child Who Is Overweight
I counterbalance my words (pun intended) every time I address the topic of a child's obesity in the test room. Yeah, I know, yous probably desire to tell me that I shouldn't use that discussion — "obese" — and I promise that I don't. But in the child's electronic medical record, that's the official coding if the child'south body mass alphabetize is at or above the 95th percentile for age and gender. And medical providers, simply similar parents, may discover themselves walking a difficult line equally they try to discuss this fraught subject area without increasing the distress that many children are already feeling.
"Guilt and blame don't motivate change, they just make people experience bad, and when people feel bad, they don't tend to be motivated toward good for you behavior," said Dr. Stephen J. Pont, an assistant professor at the Academy of Texas Dell Medical School.
Dr. Pont is 1 of the lead authors of a new policy statement issued jointly past the American Academy of Pediatrics and the Obesity Gild titled "Stigma Experienced by Children and Adolescents With Obesity." The statement, published online Mon in the journal Pediatrics, advises pediatricians to use neutral words like "weight" and "torso mass alphabetize" rather than terms similar "obese" and "fat." The authors as well suggest we use language that puts the person before the condition, equally in, "a child with excess weight" rather than an overweight or obese child.
More broadly, the authors suggest that medical practices demand to look carefully at their procedures and their attitudes to make sure they aren't building in biases against overweight children, and beyond that, they want united states out there advocating confronting this kind of stigma in club. And they put this advice in the context of an extensive enquiry literature on how very common it is for children to be teased and bullied because of their weight, and how very counterproductive that is.
For all the attention paid to weight and its wellness effects in medical settings, the social and emotional side is often neglected, said Rebecca Puhl, a clinical psychologist who is a professor in the department of homo development and family studies at the University of Connecticut, and the other lead author on the policy statement. "Weight is at present ane of the most frequent reasons kids are teased or bullied," she said. In addition to the well-documented effects on children's mental health and self esteem, she said, research has shown very harmful furnishings on children's eating behavior, and increased risk that they will stay sedentary and gain weight.
In a study published earlier this year in the periodical Preventive Medicine, Dr. Puhl and her colleagues looked at the longitudinal effects of teenagers being teased nigh their weight. The written report involved over 1,800 people who had been followed for fifteen years and are at present in their mid 30s.
"Weight-based teasing in adolescence predicted obesity, and also eating food to cope with emotions," Dr. Puhl said. "These teasing experiences have long-lasting implications for health and for health behavior." For women specially, these adolescent experiences of teasing by peers or family unit members were associated with rampage eating, poor body image, obesity, and a higher B.Yard.I. 15 years later, she said; for men there were some of the aforementioned associations, including obesity as adults, if they had been teased by their peers as adolescents.
Research shows that two-thirds of adolescents in weight-loss camps study being bullied or teased near their weight, over 90 percent of the time by their peers, Dr. Puhl said. A third study that they are also teased by family members. "Pediatric health professionals may be 1 of the few allies to offering support and endeavor to prevent harm."
My colleague Dr. Mary Jo Messito, the managing director of the pediatric obesity program at Bellevue Hospital, said, "the worst thing to do is go into the room with an 11-year-old girl and say, your child is obese, the child will start to cry." She recently saw a boy whose mother kept bringing up, "'You don't want to be like uncle so and so, he had to have this operation, he almost died' — the kid is now terrified."
Katherine Bauer, an epidemiologist who is an assistant professor in the department of nutritional sciences at the Academy of Michigan School of Public Health in Ann Arbor, cited what she called "the prevalent belief that people don't know they're heavy, and if we but inform them they will magically be motivated for beliefs change." In fact, she said, weight stigma does exactly the opposite; criticizing and inducing shame only brand people feel terrible most themselves, non motivated or capable of making changes.
Nosotros are all, including our children, living in a civilisation that is profoundly critical of excess weight and at the same time constantly offering opportunities and advertisements for overindulgence. "Information technology'due south important to focus on positive reinforcement and not bound to negative," Dr. Pont said. What this means, for parents and for health providers, is to make sure nosotros see the child, not just the number on the scale. "Recognize that a child is far more than than what their weight is, praise them for all the positives, then when we get to some of the more than challenging topics, they tin all the same maintain their self-esteem," Dr. Pont said.
And that fourth dimension in the exam room has to include talking virtually nutrition and exercise, but "the focus should be on health or health behavior rather than looking sparse, plumbing fixtures into certain pants," Dr. Puhl said. And then it's admittedly reasonable to talk about eating patterns, about family repast times, nigh what foods kids choose at dwelling and at school, about screen fourth dimension and exercise. Of form, excess screen time or besides much junk food are issues even if you're thin.
The most effective way for parents to assist a child is to make good for you changes for the whole family, regardless of shape or size, Dr. Pont said. Try making small changes slowly, similar adding one new green vegetable into the family unit diet, not keeping sugary drinks in the home or walking to school instead of driving.
And yes, to bring upwardly the big turkey in the room, Thanksgiving is upon the states; hither come up the relatives. If you have a kid for whom this is a sensitive subject, attempt to brand certain that no ane spoils that kid's day. When it comes to a kid's weight or eating habits, "the Thanksgiving tabular array is not an appropriate place to be commenting," Dr. Puhl said.
"Public discussions at the table that are teasing or negative are not helpful," Dr. Messito said, and some people will overeat in response to feeling stressed.
And all the experts recognize that ane essential message to children is that however of import healthy changes in their diet may be, they can however savour special days and special treats and special meals. "Bask the holiday; brand the changes non on a holiday," Dr. Pont said.
"Food is our way of connecting with people, especially effectually Thanksgiving, our way of bringing people together and showing thankfulness," said Dr. Bauer. "Allow's have a shaming-gratis Thanksgiving where we just relish ourselves."
Source: https://www.nytimes.com/2017/11/20/well/family/fat-shaming-weight-stigma-bullying-childhood-obesity.html