Is another child's weight problem your concern?

Victoria Clayton • E-mail

Should you intervene when your child's friend is overweight and has bad eating habits? What should you do when a youngster has an imaginary friend? Growing Up Healthy answers your queries. Have a question about children's health and well-being? E-mail the author. We’ll post select answers in future columns.

Q: A very close friend of our family is a single father of a 5-year-old girl who is average height and weighs 90 pounds. Whenever she is at our home I try to encourage healthy snacks such as fruit and whole grains (because she always seems to want to eat). Yet, as often as not when they visit she brings a doughnut and some sugary drink. I am extremely concerned for her current and future welfare. Is it appropriate for me to broach this subject with my friend and, if so, how?

A: It’s certainly appropriate but how you do it could range from being direct and frank to simply setting a good example, says Amy Jamieson-Petonic, a registered dietitian at Cleveland’s Fairview Hospital and a spokesperson for the American Dietetic Association.

“What we do know is that we can’t really ignore children’s weight issues any longer,” she says. Jamieson-Petonic notes that because of obesity and the related health problems this is the first generation of children who might not outlive their parents.

“I’m seeing so many kids with so many problems related to weight — type 2 diabetes, high blood pressure, bone and joint disorders, reproductive disorders, high cholesterol, you name it," she says. "In children as young as 6 years old these days we’re seeing conditions indicative of coronary artery disease.”

She urges being direct with your friend, but only if you truly feel comfortable. If so, sit down and have a discussion without the child in the room. “Have a nice, calm environment and share your concerns with your friend about his daughter’s health,” recommends Jamieson-Petonic. Stick to discussing health issues, not weight and vanity. Almost all parents are concerned for their children’s health.

If your friend agrees there’s a problem, urge him to see his daughter’s pediatrician for an assessment and help with diet and exercise.

Also consider what you might do to offer support. If you’re a great cook, invite them over for a healthy dinner once a week (perhaps involve the father and daughter in the preparation even — it can be a learning experience for them). Or talk with him about good alternatives to some of the junk food items his daughter likes. Maybe your friend even needs help shopping or help with childcare so he can have time to grocery shop.

Don’t be surprised, however, if he’s not entirely receptive, warns Thomas M. Badger, director of the Arkansas Children’s Nutrition Center and a professor of physiology at the University of Arkansas for Medical Sciences in Little Rock. Last year Arkansas became the first state to measure the body mass index of school children and send the information home in the form of a “Child Health Report” letter to parents and guardians. (BMIs are assessments of body fat based on height and weight for a specific age; critics have charged, however, that they often don’t accurately assess whether a child is healthy or not.)

The Arkansas Child Health Report told parents their child’s BMI and whether, according to their standards, it meant the child was underweight, normal, at-risk for being overweight, or overweight. It also told them where their child ranked in terms of BMIs of other children across the state.

Even when parents were simply given statistical information, Badger says, not all parents took it well. Some of the parents were appreciative because they’d simply never recognized or admitted that their child had a weight problem. “But some parents were also outraged. People react quite differently to being told their children’s weight situation,” says Badger.

Jamieson-Petonic, who has developed a program in her community called Shape Up, which involves getting the entire family to exercise and learn about nutrition, agrees. “In our program, we find the overweight kids basically model their parents’ exercise and eating habits.” She points out the obvious: if the 5-year-old is bringing doughnuts and soda to your house, her father is probably the one buying them. So what you’re really bringing up is that the family may need a health overhaul.

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