FAMILY MATTERS: Handle weight issues with care

Issues of body weight are complex and often stigmatized, especially for children and teens. As students begin to return to school, conversations about body image and health should happen with children of all sizes – thin, medium and heavy.

Bodies come in all shapes and sizes, so try to emphasize health and wellness above dieting and weight loss. When speaking with children, it’s important to talk about weight from a compassionate, strengths-based approach.

To get the conversation started with your child, here are some open-ended questions that parents may ask:

• Tell me how you feel about your health (physical, social, emotional).

• What does being healthy look like for you?

• Are there any ways I can support you for better health (physical activity ideas, eliminating trigger foods from the house, etc)?

• How do you feel about your body?

If you are concerned about your child or teen’s weight, talk to your doctor about your child’s growth history, body development, physical health and eating habits, as your child may benefit from a weight management assessment. The Weight Management Clinic at Mary Bridge Children’s Hospital and Health Center specializes in helping families and children ages 6 to 17 who face weight and eating issues.

The children and teens who come to us are often being teased or bullied about their weight. As a result, they can have moderate to severe body hatred. We aim to provide a safe and compassionate atmosphere that does not stigmatize but rather educates about the complexities of childhood obesity.

With our “health at every size” approach, we respect the diversity of body shapes; promote eating that balances individual nutritional needs, hunger and pleasure; and promote enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss.

We also communicate about the topic of “weightism,” which is “prejudice or discrimination against someone based on weight.” Often this is applied to people who are “too fat” or “too skinny.” When we talk about discrimination, we often think of sexism or racism. However, weight is often seen as a more acceptable form of teasing, such as giggles when a heavier person walks by, comments about what a heavier person is eating, or perhaps comments that a thin person “can eat anything she wants and never gain a pound!” We don’t often think about the stigmatization that these comments or glances cause.

There is also rampant over-simplification of weight issues. Weight is multi-factorial and complex in terms of causes (genetics, lifestyle, physiology, environmental stressors, etc). Focusing on a stigma, or personal-responsibility approach, is ineffective and harmful to one’s sense of well-being. Often heavier people have tried to lose weight, have been on numerous diets, and have not been successful. This contributes even more to a sense of shame and blame.

When a child is struggling, parents often have feelings of guilt and helplessness. Here are some things you can do:

• Call it out: In the office or at home, if you hear people make fun of someone because of their weight, say something: “I know that you are making a joke, but it’s very personal to me, and I don’t think it’s funny.”

• Address bullying: If your child or teen is being bullied due to weight, have them talk it out and make sure that the school providers are aware. This might be a great time for training on “weightism” at school.

• Focus on health versus weight: More you make it about healthy behaviors and not about the number on the scale the higher chance of success.

• Body love! Stop “I’m so fat” language. We all have body parts that we wish we could change: tummy, hips, arms. Rather than ignoring that part of your body or telling yourself, or others, that “you are fat.” Try to give yourself some positive self-talk. Make some peace with that body part. “Tummy, I know I think you’re flabby, but you digest well, and I admire you because you are part of my body.”

• Strengths-based versus stigma approach: Focus on what your family is already doing well. Perhaps a family is great at eating healthful meals together but they have challenges being active. Every family is different, so celebrate your strengths while you work toward improvement.

Stephanie Wichmann is a pediatric medical social worker in the Weight Management Clinic at MultiCare Mary Bridge Children’s Hospital and Health Center in Tacoma. For more information about the Mary Bridge Pediatric Weight Program, call 253-403-1256 or visit

By Stephanie Wichmann

For The Courier-Herald

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