Authors: Dara-Lynn Weiss
Thanksgiving was coming, along with both kids’ birthdays (which required in-school cupcakes, family dinners on their actual birthdays, and of course the birthday parties themselves), winter break, Christmas parties, Chanukah observances, and New Year’s. I wanted to start our new program after the holidays but arranged with the nutrition doctor’s office for Jeff and me to meet with her first. He wanted to make sure we liked her and approved of her approach before bringing in the kids.
We arrived for our appointment at the doctor’s office on a busy block in midtown Manhattan on an overcast Friday afternoon in December. We sat down with the nutrition doctor, who began by describing the program. It was flexible enough to let kids eat like kids, tailoring food choices to each child’s preferences, and allowing for inevitable splurges. Her philosophy was that no child on the program should ever have to decline a piece of birthday cake, or feel left out of a pizza party. The key was to empower the child to make her own decisions within the program’s framework.
She explained that at our initial family consultation, each family member would have his or her BMI and other factors evaluated. At the next appointment, we’d receive a breakdown of how many
“green lights” (which loosely translated into units of 100 calories) we get at each meal and snack. We’d be given a reference book listing how many “green lights” are in common foods and how to calculate the traffic-light value of any other foods. We would be required to eat a certain amount of fruits and vegetables every day and not to overdo it on unhealthful foods. But within our allocation of traffic lights, we could pretty much put together our own daily menus.
Immediately I thought,
She gets it
. This wasn’t a nutritionist who tells you junk food is bad and whole grains are good, or who encourages you to squeeze more fruit into your diet without taking anything else away. This was someone who understands that overweight kids need to eat less.
She explained that there are two kinds of diets: the calorie restriction method, in which you eat any kind of food but limit your quantities (such as the Weight Watchers Points system), and the approach where you don’t count calories but limit your food options (such as low-carb diets). She didn’t think either system was particularly successful. Her program was a combination: limiting overall calories but also encouraging better food choices. It struck me as the right way for a kid to go about it: nothing was off-limits, but good habits could be instilled in the process of taking weight off.
I loved that she wasn’t snobbish about organic food or sanctimonious about processed foods. I found it amusing that she had a designer cell phone case and that when the phone rang during the appointment she answered it apologetically and had a slightly cranky conversation with one of her children. She was normal, relatable, and smart.
Jeff explained that, as people with our own food and body issues, we had avoided talking about those topics as a way of keeping
them out of Bea’s life. But her weight problem required management. By staying silent, we were leaving her to find her own path in the dark, which wasn’t helping her at all. The doctor assured us that a child left without tools for dealing with weight gain is more likely to have disordered eating than a child to whom issues of nutrition and weight management are presented in a positive, constructive way. It’s also best to help a child lose weight before puberty, when kids tend to bulk up and their body weight “set point” is established. She said the program is about giving children a foundation with which to make smart eating decisions, not making them feel bad. I was ready to sign up.
“Bea’s going to be resistant to coming,” I warned.
“Don’t worry. I’ll win her over,” the nutrition doctor assured me. And I had no doubt that she would.
We made an appointment for our first consultation with the kids, and left. I was excited, and I needed Jeff to like her as much as I instantly had, and to be game to sign the family up. He did, and he was.
While I’d imagined that Jeff and I would introduce the concept of our new healthful-eating initiative to the kids together, in some sort of Norman Rockwell family moment, that’s not how it panned out. With the family’s inaugural appointment in January looming ever closer and my husband’s evenings taken up with work, I decided to just break the news to Bea and David on my own.
I don’t have any particular finesse in talking to children. I tend to speak to Bea and David like they’re adults, and while I try to be loving and compassionate, my default tone is matter-of-fact and
direct. Another parent might have given more thought and preparation to debuting this sensitive topic. I decided to just wing it.
It was about nine o’clock at night. The kids and I were cuddling in my bed. I went for it.
“Oh, guess what?” I said lightly. “We’re going to go see someone who is going to help us eat more healthfully.”
I didn’t say “doctor.” I didn’t even say “nutritionist.” But you would have thought I just announced that they both had to get kidney transplants.
“What?” Bea cried as tears sprang to her eyes. “I don’t want to.”
“Me neither,” David chimed in, in a rare moment of agreement with his sister.
“What’s the big deal?” I asked.
“We’re just going because I’m fat,” Bea answered.
Wow, already this was going phenomenally poorly. Should I be frank, or should I protect her feelings and maintain my flimsy ruse? What was the right thing to do? What would a good parent do?
“No, that’s not it!” I insisted. “We are all going, because we all need help. Daddy eats too much at night, I want to stop drinking those stupid juices, Dave has to eat stuff other than pasta. This lady is going to teach us all how to be healthier. She’s like a nutritionist.”
David was bereft. “Two kids in my class went to nutritionists, and they hated it!” he complained. “They said it was like the most boring thing!” To David, something being “boring” is only slightly more acceptable than it being “extremely painful” or “potentially fatal.”
“See?” I said, directing my attention to Bea and stubbornly latching on to only half of David’s comment. “Lots of kids go to
nutritionists! Two kids in Dave’s class have gone. Daddy and I went to one once before you were even born.” And, just to bolster the argument, I added: “Maddie went to one.” Maddie was a skinny girl in our neighborhood whose mom had sent her to a nutritionist when she was in preschool because she only ate cheese sticks. My hope was that the more skinny kids I could come up with who went to nutritionists, the less likely it was that Bea would feel this was some sort of sentence for her being overweight.
By now they were both crying, and I felt like I had lost control of the conversation. “Guys!” I said. “It’s going to be fine! We’re all going to go together. It’s like a New Year’s resolution.”
My central concern was for Bea’s feelings. Until we reached the safety of the doctor’s office, it was up to me to approach this topic in a positive way. Already, the kids were acting like going to this appointment was a punishment.
“Why are you crying, sweetie?” I asked Bea, caressing her cheek, ignoring David’s flopping around the bed in frustration.
“I want to be able to do it myself,” she whimpered.
“Do what yourself?”
“I know I need to lose weight, but I wish I could just do it myself,” she said.
“I know,” I said softly. “It’s not your fault.”
In that moment, I made the decision that I wasn’t going to withhold words such as
overweight
from our discussion. I knew that word could upset her or embarrass her. But the fact that she was overweight wasn’t news to her. I wanted to make sure she could see I was comfortable taking on the topic; euphemistic nomenclature smacked of unease.
I continued. “You have a health problem. You’re overweight. I wish we could fix it on our own, too, but we’ve tried, and it didn’t work. I don’t know how to do it. So we’re going to get someone
to help us. And it’s not just for you. It’s for Daddy and David and me, too.”
“I know it’s just for me,” she said.
“It’s not,” I insisted.
“I’m embarrassed,” she whimpered.
“Look, the only reason anyone should feel embarrassed when they have an issue like this is if they don’t acknowledge it,” I replied. “It’s brave to admit you have a problem, and smart to realize that you need someone else’s help.”
Silence.
“Bea, this is a problem we can fix,” I told her firmly. “Lots of kids have much worse problems—diabetes or depression or cancer. Everyone has something they have to deal with, whether you realize it or not. This is your thing, and so we’re going to deal with it together.”
“I still don’t want to go,” Bea said sadly.
“Me neither!” David complained.
“Whatever, guys,” I said, drained, pulling them close to me. “It’s not a choice. We’re going.”
I have to say that for a good minute there during the kids’ outburst in response to the idea of a family nutrition reboot, I almost gave up. I thought I would just tell Jeff we needed to figure out another approach.
The kids are miserable
, I’d say.
Bea already feels singled out. This is bringing negative attention to the problem. It’s becoming too big a deal
. Maybe, I thought, we should just go see the nutrition doctor in secret, and run the program on Bea surreptitiously. Maybe Jeff and I should just do the research and work we should have been doing all along about what she should eat and how much, and try feeding her that way before making a whole big dramatic issue out of it.
But I knew we had already tried our best on our own and had failed fairly spectacularly. I knew that in order to fight this disease, we needed the structure and expertise of an authority leading the way. It was the same reason I’d been successful at losing weight only when I did Weight Watchers—having guidelines to follow,
going to the meetings, knowing someone else was going to be putting me on a scale and recording my weight, listening to a lecture, paying that weekly fee—those factors made all the difference for me. Even if Bea didn’t need that kind of supervision, I did. And I wanted Bea to have an active role in her own treatment.
The kids’ spirits lifted somewhat when they learned that for the first two appointments they’d get to leave school early. When the first meeting finally rolled around, I picked them up from school around lunchtime, and we met Jeff at the nutrition doctor’s office.
The mood was grim as we sat in the waiting room. Early dismissal notwithstanding, neither Bea nor David was happy to be there. I couldn’t wait for them to meet the nutrition doctor, so they could see she was cool.
She came out and greeted us, and I waited for the kids to be into her, but they were about as excited to see her as they were any other doctor, which is to say not at all. The first thing she did was weigh each of us. After I peeled off Bea’s jacket and sweater, she stepped on a digital scale. I pretended to be looking at something else so as to appear nonchalant about the number, but furtively caught sight of the display, which read 93. David was under 50, and it says much about my relative concern for his weight that I can’t remember the exact number, if I even bothered to look. I didn’t pay any attention to what Jeff’s weight was, consumed as I was with attending to the kids.
Next came the measurement of our height. Again trying to avoid the appearance of being obsessed with Bea’s stats, I stole a fleeting glance at the chart, and saw the doctor write a 6 as the last number for her height.
Okay, so she’s ninety-three pounds and four foot six
. I didn’t remember the exact numbers from her recent pediatrician appointment, but that seemed right.
We all sat down in the consultation room. David twirled around
in a leather club chair until his head was pointing downward and his feet were in the air as we answered some basic questions about what we ate and how active we were. Then it was time to see whether any of us had a metabolism issue. This part was sort of interesting to me. Bea’s pediatrician had ruled out that explanation for her weight gain much earlier, but I’d always wondered whether I had a slow metabolism or a normal one, and exactly how many calories I burned in a day. A machine that resembled a laser printer with a plastic tube sticking out of it was going to tell me.
Each of us breathed into that tube for an interminable-seeming twenty minutes, then awaited the machine’s output.
To the extent that we may have been hoping for a medical explanation for our family’s weight struggles, we were disappointed. None of us had a metabolism problem. David’s resting metabolic rate was a little faster than average. The rest of us were just normal. Later, Jeff touchingly confessed to me that he felt let down by the experiment. He’d hoped that the machine would diagnose him as having a sluggish metabolism, which would explain why he had so much trouble managing his weight.
At that point, the doctor asked Bea and David, who was by now engrossed in a game on my phone, to go into the waiting room so she could talk to Jeff and me alone.
With the kids safely out of earshot, she opened Bea’s chart. “In case you were wondering,” she reassured us, “you’re doing the right thing by bringing her here.” She divulged that Bea’s BMI for age, or her body mass index plotted against that of other seven-year-olds, was in the 98th percentile. Children with a BMI for age in the 95th percentile or above are considered obese.
Obese
. I found the label shocking. I almost couldn’t accept it. Overweight, I could see. I was prepared for that. But this word put our family in a whole different, more alarming category. To me,
obesity conjured images of 200-pound kids, limping from orthopedic complications. Was that how the medical community saw Bea?
Bea’s percentile ranking was formidable, but she could hardly be considered an outlier.
The statistics quantifying the extent of the childhood obesity epidemic are parroted constantly but merit repeating: at the time of this writing, one in three American children is overweight or obese.
When I was a kid, 4 percent of kids ages six to eleven were obese. In 2008, 20 percent were. Chances are some of the kids you know—maybe even your own—fall into that category, whether you realize it or not.