My Five-Point Plan for Pediatricians

Childhood obesity is a a result of adult behavior. 

And the adults most responsible are: Parents.

And the adults who come into contact with parents on a regular basis who are in the best position to advocate on behalf of their children? Pediatricians.

Based on my experiences over 20 years working in the weight loss industry, pediatricians, wait way too long to have “the conversation” with parents and when (if) they do, often tell a parent nothing more than their over-fat kid should “eat less and move more.”

So, if I was able to talk to a group of pediatricians, I would ask them to consider implementing my five-point plan to best help their obese patients.

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. Parents often tell me, “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. When you do, you are not helping your patient in the long-term.
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 advice about their child’s weight, and that the longer they put it off, the more at risk their child is for poor health.
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. With the advantage of personal experience, you’ll be more inclined to initiate these conversations earlier on.  

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We all know how precious children are, and the profound responsibility we have as parents to raise them. Pediatricians, however, are gifted with an opportunity to have a lifelong and positive effect on children’s lives as they guide them from infancy through adolescence and teens to become healthy and happy young adults. I believe they have a responsibility to do all they 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.

Pediatricians should be straightforward and honest, 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.