Study backs up Dr. Walt’s recommendations: No harm seen in telling parent child is overweight

Reuters Health is reporting that most parents find it acceptable to be told about their child’s weight status, and the feedback has “minimal” adverse effects for most families, according to researchers from the UK.

My Take?

Carpe duh! I’ve been preaching for years that it is dangerous to NOT tell parents when their child is obese. As a result, most parents of obese children in the U.S. do not know nor recognize that their overweight or obese child is so.

I discuss this phenomena in my book SuperSized Kids: How to protect your child from the obesity threat. In fact, a news report in a newspaper for family phsicians about Dr. Walt and SuperSized Kids says this:

Today’s children are headed for the record books, but for all the wrong reasons.

“Pediatric obesity is a real threat to your children’s health and to their families’ health,” said Walter Larimore, MD, FAAP, a family physician in Monument, CO. 

“Unless we intervene, the growing incidence of pediatric obesity means this generation of children may be the first in American history to have a shorter life expectancy than their parents.” He points to research showing that a high adolescent BMI is associated with a 30-40% higher adult mortality compared with medium BMI and it lowers life expectancy from eight to twenty years! 

It’s not too late to act. Starting with a research project at Florida Hospital in Orlando, Dr. Larimore (and Sheri Flynt, MPH, RN, LD, the Manager of the Center of Nutritional Excellence at Florida Hospital) created an intervention that reduces body mass index and blood pressure for both overweight children and their overweight parents as it improves overall family health scores. 

Dr. Larimore has already written a best-selling book for parents, Supersized Kids: How to protect your child from the obesity threat (with Sheri Flynt and Steve Halliday). Now he is taking the message to family physicians, including a simple, clinically proven, eight-week intervention.

The most important step the family physician can take is to confront childhood obesity directly. If a child is obese or overweight, say it to the parents and say it to the child, he advised. 

Confronting overweight/obesity and telling both child and parent that it’s time to deal with the issue may make a significant difference.

Hard to believe? Taking a moment to encourage a patient to stop smoking is all it takes to spur 20% of patients to quit. Advising parents to buckle up their children every time they get into a vehicle is enough to change behavior in 50% of families. Dr. Larimore believes childhood obesity intervention can be just as quick and just as effective.

The key is an eight-week, family-based action plan with a menu of small, easy steps, Dr. Larimore said. The plan can be easily recommended by the family physician and explained by a medical assistant. Options start as simply as turning off television during meals, cutting out a single fast food restaurant visit each week, or getting fifteen more minutes of sleep at night.

“It is highly healthy behaviors that we are after, not weight loss,” he explained. 

“Once kids realize they have options, they tend to make healthier choices. They are already concerned about self- and body-image, they just don’t know they can do anything about it. That’s where the family physician can walk through an open door.”

So, what does this new study say, that backs up what I have been preaching? Here’s the background.

In 2005, the UK launched its National Child Measurement Program (NCMP), which gives parents information on a child’s weight only if they ask for it, Dr. Jane Wardle and colleagues explain in the journal Pediatrics. The National Health Service is currently considering changing policy so that all parents are informed of their child’s weight unless they opt out.

Concerns have been raised that telling parents a child is overweight may have adverse consequences, the researchers from University College London add.

To investigate, they surveyed children and parents six weeks before and four weeks after they were measured at school. The children were in year 3 (6- to 7-year-olds) and year 6 (10- to 11-year-olds). About half of the parents invited to participate in the study agreed to do so.

Among the 358 children included in the study, 83 percent were at a healthy weight, 13 percent were overweight, and 4 percent were “very overweight.”

Before the measurements, only 39 percent of parents with overweight kids recognized that their child was overweight, while 61 percent said the child’s weight was “about right.”

After the measurements, 49 percent of parents of overweight children said they had made dietary changes and 48 percent reported changes in physical activity, compared to 12 percent and 10 percent of parents of healthy weight children, respectively.

After measurement, normal-weight kids showed increased body esteem, while body esteem for the overweight children did not change.

Ninety-six percent of all children said the process of being weighed and measured was enjoyable or “OK,” while 3 percent of healthy weight kids and 7 percent of overweight children said they didn’t like or even hated the experience. 

Ninety-four percent said they would agree to being measured again the following year, but 5 percent of normal weight kids and 10 percent of overweight kids said they would not. Most of the children who objected to being measured were in the older age group.

The researchers found that food restriction by parents increased slightly for overweight girls, but “there was little evidence of parents becoming overly vigilant about their child’s eating after weight feedback.” Being identified as overweight also didn’t appear to lead to more teasing by a child’s peers.

Seven of the parents said either they or their children were upset by receiving feedback on the child’s weight.

“Crucial steps for the future will be to identify the best format for providing feedback, examine the training needs of staff carrying out measurements, and ensure that services are in place to meet the needs of families who would like advice and support in making lifestyle changes,” the researchers conclude.

SOURCE: Pediatrics, September 2008.