Dear Pediatricians

(c) carbouval fotosearch_k17576573

Dear Dr. ________:

The season is about to change.

The leaves are about to change colors of red, orange and yellow.

The sunrise and sunset times are about to change.

The temperatures are about to change.

The lazy days of summer will change to the hustle and bustle of the holiday season.

Amidst all these wonderful changes, however, is the one thing that will NOT change: Last school year’s over-fat kids will be this school year’s even-more-over-fat kids.

According to the CDC, 1 in 3 American kids are overweight; 1 in 6 are obese. In New Jersey, however, according to the Data Resource Center for Child & Adolescent Health, 1 in 4 school-age children (6 to 19) are overweight or obese. 1 . . . in . . . 4!

September is not only the start of the school season, it’s also Childhood Obesity Awareness Month. So let me take a minute to address this issue of childhood obesity—I write and podcast about it often, and talk about it until I’m blue in the face with my adult clients who are parents of school-age kids. I’m a mom, so I come at this subject from two perspectives—as a parent and as a weight loss professional. This issue is a passion of mine, and I speak with much hands-on and visual knowledge.

My daughter, now a 19 year old college junior, attended the Ranney School in Tinton Falls for 15 years, graduating high school in 2015 at the age of 17. Not only was she a “lifer” at that school, but by association so were my husband and I on and about that campus for 15 years. Starting at the age of 2-1/2, I watched as my daughter traveled from one grade to the next with many of the same kids. I saw first hand the metamorphous of so many overweight lower school boys and girls turn into more overweight and obese middle school kids, and finally, for many of them, even more over-fat high schoolers. As for the obese high school seniors? Well, the college “freshman 15” we hear so much about mostly applies to kids of a healthy weight who, away from home for the first time, put on 10-15 pounds. For overweight and obese college freshman, however, it’s more like a “freshman 25,” 30 or more, and I have the clients to prove it. Then, many of these freshmen continue to gain weight over the summer break and go back to college as juniors 60 pounds overweight or more. The heavier a kid is when he/she goes off to college, the more weight they gain . . . faster. 

Every September, as I would return to school with my daughter, I’d see these ever-expanding kids and I’d think to myself, What the hell is wrong with those parents? Don’t they give a damn? They’re not mentally impaired; they see it, surely. Instead, they choose to normalize it because it’s easier to do that. After all, all their friends are fat, so no big deal, right? Instead, they choose to accept it because, almost always, they themselves are fat, so no big deal, right?

Childhood obesity is a result of adult behavior. 

And the adults most responsible are: Parents. Pediatricians.

Parents, who do nothing—and that includes doing nothing about their own obesity so as to instill good habits into their households and set an example for their children.

Pediatricians, who, based on my experiences (a) wait way too long to have ‘the conversation’ with parents and then (b) do nothing more (if anything) than tell a parent their over-fat kid should “eat less and move more.”

In order to best help your obese patients, as well as to prevent it in other patients, please consider the following:

1. Confront a parent as soon as you see a child’s weight exceeding their height on the percentile charts. It doesn’t matter if the kid is “just a little” overweight. Overweight is overweight. Don’t wait.
2. I often hear from parents, “The pediatrician said he’d be happy if my son lost 20 pounds.” And my reaction is, “Of course he would . . . because 20 pounds less is better than where he is now, but your son needs to lose 50 pounds.” Be 100% totally candid as to the ideal healthy weight that a child should be. Don’t sugar coat it. Don’t give parents a false sense of just how overweight or obese their kid is. 
3. You can’t monitor what you can’t measure. Therefore, document every weight-related conversation you have with a parent: what the child’s weight/height was on that day, and what the parent’s reaction was. If there’s an improvement in the child’s weight at his/her next visit, you’ll have been the catalyst. If your patient shows weight gain at every yearly physical, you’ll be able to show the parent the number of times you’ve spoken to them on the issue and for how long they’ve disregarded your advisement about their child’s weight.
4. When it comes to obese kids (and especially those with obese parents) approaching puberty or just after, speak with them privately: Does their weight bother them? Do they have any questions about it? Does anyone at school bother them about it, etc. These are the things they often do NOT bring to the attention of their obese parents because they do not feel they will get the guidance or support they need to make changes; I hear this all the time directly from these kids.
5. It’s a fact that overweight and obese doctors of all disciplines are more reluctant to have a conversation with an overweight or obese patient. It’s also a fact that overweight parents are often defensive and combative about their children’s weight. So, while it’s never easy to bring up this sensitive issue, it’s even more so when a pediatrician expects a parent to take seriously any guidance about weight and health that he or she doesn’t follow themselves. If you’re overweight or obese, lose weight. You’ll be better able to meet the potential challenge of a parent conversation head-on with the advantage of personal experience, and you’ll be more inclined to initiate these conversations earlier on.  

As parents, we are blessed with the enormous gift of responsibility for the environment in which we raise our children—emotionally, physically, psychologically, socially and spiritually. Nothing is as important for a child’s emotional and physical well-being as is good health . . . and the eating (and exercise) habits that contribute to it.

Pediatricians have the responsibility to uphold the Hippocratic Oath, “I will prevent disease whenever I can, for prevention is preferable to cure.” You are gifted with the opportunity to have a profound and positive effect on a person’s life, as you guide them from infancy through adolescence and teen years to become healthy and happy young adults. You have the responsibility to do all you can to prevent them from becoming obese, to prevent the long list of medical conditions, emotional scars and socialization issues that are in their future otherwise.

Parents need to stop being ignorant, arrogant and complicit about their child’s weight. If they don’t, they need to at least start acknowledging what they ARE doing: killing their kids . . . s l o w l y.

Pediatricians need to start being more forthright—earlier—with candor and honesty and with less regard for a parent’s feelings and how they may react and only with regard to the health and wellness of their patients.

With discipline, guidance, structure and accountability—and without any gimmicks—Weight★No★More℠ Diet Center has been teaching clients of all ages, and with all medical issues (including pregnant and nursing women), how to lose weight in a manner that resembles the way they can eat for the rest of their lives: eating proteins, vegetables, fruits, dairy, grains and fats every day. We’ve been doing this for almost 30 years, so we must be doing something right!

No one is better equipped to work with overweight and obese kids or to deal with and assist their parents in this regard than we are. Please visit my web site to read about our programs, fees, answers to frequently asked questions, and so much more. There are many physicians who refer their patients to us, and I hope you will do the same. I have enclosed some business cards for that purpose.

Slimcerely yours℠,

Lori Boxer

The above is the letter that will be sent throughout the month of September to dozens of pediatricians in the local areas in which my offices are located as well as to the surrounding communities.