“One of the challenges in even collecting that data is that a lot of health care visits are now virtual, so weights aren’t taken,” said Dr Richard Besser, president and CEO of the Robert Wood Johnson Foundation, which releases an annual “State of Childhood Obesity” report. “But there’s a lot of concern about children’s weight going up in the pandemic. And it makes a lot of sense that this is something that’s going to happen.”
The lack of overall data hasn’t stopped many parents from worrying or wondering whether they should intervene if their child gains weight during the pandemic. But if you think that your child’s body is bigger than it might otherwise be right now, it’s important to view that change as something to be curious about, rather than as a problem to solve, the physicians and nutritionists I spoke with said.
“I think it would be a big mistake to think about putting kids on diets or counting calories during the major stress of a pandemic,” Besser said. And research shows that childhood dieting can increase the risk of eating disorders later on. So parents should keep their child’s overall health, including mental health and growth history, in perspective.
“People don’t realise that it’s very normal for bodies to change, pandemic or not,” said Dr Katja Rowell, a family physician and childhood feeding specialist. Many children, of all ages, tend to follow a particular growth pattern that involves “rounding out” before they shoot up in height, she said. This is especially common just before and during puberty, a time when kids can gain up to half of their body weight. “We may be seeing normal variation in weight and height that we’re now blaming on the pandemic,” Rowell said.
Elinor, a mother of two in Ann Arbor, Michigan, said her 7-year-old daughter had always been small for her age, until 2020. “All of a sudden, she’s in the 95th percentile for height and 99th for weight,” said Elinor, who is using only her middle name to protect her daughter’s privacy. At a recent checkup, Elinor said the family doctor looked at her daughter’s growth chart and responded with a dispiriting, “Ah. ... Wow.”
Elinor was relieved when she heard her daughter later cheerfully report to her dad, “The doctor was so surprised! I’m going through a really great growth spurt!” But Elinor acknowledged that there may be more going on with her daughter’s body. “She used to have a great gym class and swim class built into her school day, plus recess,” she said. “Virtual school is not the same.” The family also spent much of the past 10 months relying on less-nutrient-rich shelf-stable foods so they could grocery shop less often, and they’ve all been stressed. “My husband is a health care worker, treating COVID patients and working mad crazy hours,” Elinor said. “So our lifestyle has changed quite a bit, and we have the added anxiety of, are we safe in our house?”
A.C., a father of two teenage boys in Washington, DC, who preferred to use his initials to maintain his family’s privacy, has been trying to strike a delicate balance with his 10th grader, whom he said has gained 50 pounds since April and has shown signs of depression as he copes with remote schooling and less time with friends. “We’ll find the evidence the next morning: a package of microwave potatoes or Cheetos that he finished at 2 or 3 am,” AC said. “The way I would handle this in normal times is a lot more ‘take-charge’ than I feel is appropriate right now.”
Avoiding that “take charge” approach may be the best thing you can do as a parent of a child who has gained weight, pandemic or not. “We get the message that being a good parent means having a child in a certain-sized body, but I like to remind parents that they are not in charge of their child’s weight,” said Anna Lutz, a dietitian in private practice in Raleigh, North Carolina, who specializes in eating disorders and family feeding. “Instead of worrying about weight, focus on supporting kids in taking care of themselves emotionally and physically.”
Restricting food is often the first strategy parents try when they’re worried about a child’s weight, but Rowell counsels caution with that approach. “When we try to get kids to eat less in order to weigh less, we often see the very outcomes that we’re trying to prevent,” she said, referring to the work of the late Leann Birch, a developmental psychologist who showed in several famous experiments that overly controlling what children eat can cause them to fixate more on the foods parents don’t want them to have. That may manifest as a toddler demanding extra cookies or a teenager binge eating in the middle of the night. A study published in 2007 in the journal Obesity found that parents with anti-fat attitudes were the most likely to restrict their children around food. “If we are seeing a rise in weight dysregulation during the pandemic, part of that has to be laid at the feet of all of the fearmongering we see about kids and weight,” Rowell said.
Instead of shaming or worrying about what (or how much) your kids are eating, work toward getting the whole family eating on a more predictable schedule, and then make sure that everyone can eat their fill at each meal and snack time. Amee Severson, a registered dietitian nutritionist in Bellingham, Washington, encouraged parents to avoid cutting kids off or pushing them to finish a plate, because both tactics disrupt a child’s ability to listen to their own hunger and fullness cues. She also emphasised that parents need to listen when kids say that they’re hungry, even if that happens an hour after lunch. “If eating has been chaotic, it may take a while for kids to fully trust that they will be fed reliably, and fed enough food,” Severson said.
It’s also possible that staying home has affected your child’s eating in a positive way. “I think about my son, who didn’t eat much of his lunch at school because the short lunch time, loud cafeteria and cold brown-bag lunch weren’t conducive to that,” said Lutz, the dietitian. “Now, he eats a full, hot lunch almost every day.”
On the physical activity front, you might brainstorm with your kids about how to get the family moving more without invoking weight loss as the goal. Standard advice like “get one hour of vigorous physical activity per day” may not be realistic right now, or ever, for some kids. “There have always been kids who enjoy sports and outdoor play most, and there have always been kids who prefer reading, writing and playing video games,” Severson said. “We can help them find forms of movement they love on their own terms.” That might look like TikTok dance routines or yoga videos for older kids, or building forts out of couch cushions for little ones.
If you think that your kid’s weight gain may be a symptom of depression, anxiety or another mental health issue, check in with them about those concerns and leave body size out of it. “This does not mean seeing how your kids are eating and asking judgmental questions,” Severson said. “This means saying, ‘How are you? What do you need right now?’” If your child’s mental distress is affecting their ability to function or if they have been struggling with anxiety or depressive symptoms, consider bringing in professional help.
For Elinor, it has been helpful to view her daughter’s body changes in the same light as she would a change in her kids’ academic performance this school year. “I am not worried about reading levels or body size,” she said. “I’m focused on mental health and overall safety.” And that’s the real goal, Lutz said: “Children need to know they are safe and cared for, and that they can trust their body’s changes, no matter what that is.”
© 2020 New York Times News Service