My doctor just told me my 4-year-old son is overweight

Question: I've just taken my 4-year-old son to the GP as he had a bad cold and I wanted to make sure it wasn't the flu. While I was there, out of the blue the GP told me that my son was very overweight. To be honest, I was a bit shocked. I always thought he was a bit pudgy but didn't think it was a big problem. I was also a bit annoyed that the GP told me, but now that I think about it, I realise he was only doing his job. Now I have been reading up about childhood obesity and all the health problems it brings  and I realise I need to do something about it. I should tell you I am quite overweight myself, and I never really got rid of the baby weight. I also think that my worry that my daughter, who is six, might be overweight as well, and their Dad is even beginning to put on the pounds! Do you have tips as to how I can help my children? I don't want to make a big deal of it or make them feel bad.

Answer: As parents, getting concerning news about the health of your child is always upsetting and a big shock when it is unexpected. Hearing that your child is overweight can have a particular upsetting impact as it is easy to feel blamed as a parent and guilty that you have not noticed before.  However, it is important to realise that childhood obesity is as much a collective societal problem as an individual personal problem.

Collectively, we have got into habits of inactivity and eating unhealthy foods, and we are all living in a society that makes it much harder to raise healthy children: parents are working longer hours and have less time to prepare food at home; shops and supermarkets bombard children with images of sugary treats, making it hard to go out and not to be tempted; and many supposedly healthy foods marketed to children, such as breakfast cereals and yogurts, contain large amounts of sugar.

This means that parenting and raising healthy children is tougher than ever before.

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It is good that you understand the good intentions of your GP in raising the issue with you. At the risk of upsetting their patients, many health professionals avoid giving parents direct feedback about their own or their children’s weight. This is despite the fact that being overweight and obese is a serious problem that poses many risks for a person’s health. Childhood obesity is a particular concern as once the pattern of putting on weight in childhood is established, it is much harder to change.

However, the good news is that there is a lot you can do to change things for your children and your family. It is a good thing that your GP raised the issue with you now, which gives you an opportunity to take action while your children are young – even small changes made now will make a big difference in the future

Create a healthy family plan

In helping children make positive changes around food it is best not to focus on “being on a diet” or “losing weigh” but instead to focus on positive goals of such as eating  healthy nutritious foods and becoming active, fit and full of energy. To be successful it is usually best to include everyone and to make this a family plan. Don’t single out any child or person and instead see this as a project you are all working on together. Sit down with your partner and agree what you will do together – the more you are both on board and committed to making positive changes, the easier this will all be.

Build on your good habits

The easiest way to make positive changes is to build on the good habits you already have. For example, your children may already occasionally eat a healthy vegetable like peas, so you can make the decision to have them more regularly for dinner. Or you may already walk a couple of days to school so you can try to commit to do this everyday (and buy brollies for everyone so you don’t have the excuse of a wet day). Or if the children already eat a healthy breakfast when you are not rushed, perhaps you can you create a good routine that gives you extra time in the morning.

Make small changes

Making a small change that becomes a habit is much better than starting on a large change that is given up after a few weeks. Below are some ideas to get you started – make sure to pick the easiest change first!

– Have dinner at the table, so there is more time to eat and chat

– Get children to help out with cooking food once a week. Read some healthy menus together

– Give children small portions to start and let them ask for more if they are hungry

– Have only milk and water for children to drink regularly (fizzy drinks only for celebrations)

– Remove biscuits and treats from the house during the week – if they are there you will eat them

– Send children to school with a healthy lunch box every day

– Only have healthy snacks available to kids at home such as (apples, carrot sticks, mange tout, etc)

– Give children a choice only of healthy morning cereal such as porridge (let them choose what fruit to add)

Get help and support

Reach and get support to make the changes you want for your family. Your GP may be able to refer you to a dietician or other helpful services. There is excellent information on safefood.eu including video tips, healthy family recipe advice as well as activity planners and reward charts for children. Safefood have also started a new media campaign to help families get started on on the road to healthy lifestyles, recognising the challenges that parents face, but with the positive message that though “parenting is tough – you are tougher”. See makeastart.ie for more information.

Dr John Sharry is a social worker and psychotherapist.