And Prevention of Obesity

In many American families, parents and children struggle over meals. Often, the children do not want to eat what is on the table. The parents, fearing for the children’s health, will try to make the child’s eating an issue. If the battle escalates, meal time becomes no fun for anyone at the table.

Much of the struggle is based on the idea that children who do not eat “properly” are more likely to become ill. However, this concept turns out to be generally incorrect. We rarely see children in our office who are ill because they “don’t eat right.” Poor weight gain is rarely a result of a child choosing not to eat enough food.

In fact, when a parent says to a child, “I know you are not hungry, but you need to eat,” then the child may actually hear the parent say, “My parent says I cannot trust my appetite.” If the child disagrees, there is a battle; if the child agrees with you then the child has learned not to trust his or her own appetite, and it is possible that eating disorders and/or obesity may result later in life.

We have several suggestions that can help children develop healthy eating habits:

1. Fighting – Never fight over meals. A child may eat whatever is on the plate. If he does not want to eat, then that is also acceptable. The child may go play, or stay at the table and participate in the conversation, depending on the parents’ rules. Never discuss the topic of “how much did you eat.”

2. Meals – Everyone at the table should eat the same meal. Do not find something that the child “wants” to eat; or make separate meals for each person. This habit is based on the erroneous idea that if the child does not eat, he will become sick.

3. Planning – Allow the children to participate in weekly meal planning. If the children have had a chance to help decide what is on the table, then you will know that at each meal there will be at least one food on the table that the child is willing to eat. Then, if the child decides not to eat at mealtime, you know it’s not because the child dislikes what’s on the table.

4. Snacking – There should be no snacks for 1½ to 2 hours after the meal depending on the age of the child. The child should not be permitted to refuse what’s on the table, but then complain 20 minutes later that he is hungry for cookies or ice cream. It is also a good idea not to permit a snack for 30 to 60 minutes before the meal.

5. Juice – It is a good rule to limit juice to 4 ounces per day diluted half and half with water. Put it in a sipper cup only, so that the child does not become “hooked” on juice bottles. Milk or water is a better choice. Limit milk to 24 ounces per day.

6. Television – No one in the family should eat when the television is on. The TV is such a strong stimulus that for many people it overwhelms the appetite drive. People can automatically place food in their mouths and overeat. Or they may stare at the television, not eating enough to satisfy their appetite; when the TV goes off, they may still be hungry and continue to snack for the rest of the evening. Either way, obesity is a likely result. This is a good rule for all the adults and children in the house.

7. Watching Television – Limit TV watching to 7-10 hours per week. The inactivity promoted by TV clearly leads to obesity. Even reading a book burns more calories than watching TV. And, advertising for junk food clearly alters appetites.

8. Exercise – If the parents exercise regularly, the children will see them as role models, and will be more likely to engage in regular exercise themselves over time.

You will notice that in the above suggestions, there is no discussion about quantities consumed, or the variety of foods consumed. It has been shown in numerous studies that if children are permitted to choose and if a variety are offered at each meal, over time the diet will be fairly well balanced. This eliminates the need for struggle, and makes meal time a pleasurable opportunity for socializing and enjoying the family life.