Granny says

The issue: “His grandmother says…”

Why it matters: Parents are more likely to turn to family members than to doctors for advice about feeding. Grandparents, particularly those who have emigrated from countries where food is sometimes scarce, often have views about how children should be fed and how much they should weigh. This often runs counter to standard pediatric advice.

Starting the conversation: “Most parents find family members’ advice about feeding really helpful. What advice have you been given that you agree with? What do you disagree with, or question? Sometimes doctors give advice that’s different from what grandparents say: What does your mother think about the advice doctors give today? Why do you think she feels that way? Why does your mother think your child should weigh more and be bigger? How did your mother feed you when you were a child? Would you do it the same way, or differently? Do you think the way your mother fed you has influenced the way you eat today?”

Getting parents to care

As many healthcare professionals know to their frustration, parents often seem unconcerned about their children’s overweight. Why they are not concerned is a complex question, not well understood. However, we do have some clues. Studies show that parents are more likely to be concerned about a child’s overweight and ready to make some changes when:

•   They perceive the child as less active and slower than other children
•   They recall a doctor raising concerns about the child’s weight in the past, although this, in fact, seems to occur in only about 22% of families
•   The child is 8 years old or older
•   The parent is overweight
•   The child’s weight is perceived as a health problem

Overweight parents

The issue: They way parents perceive their child’s weight has a lot to do with their own weight status.

Why it matters: Parents are more likely to shape their feeding behavior in response to their child’s weight status when they themselves are overweight. These parents are also more likely to address a child’s overweight as a problem that needs intervention.

Starting the conversation: “Is being overweight a common problem in your family? How do your family members feel about their weight? Was being overweight something that concerned you as a child? How did you deal with it? What tactics do you find helpful in managing your own weight? What do you find hardest? Do you think the challenges are the same for your child, or different?”

Family history re: weight and health

The issue: Overweight is linked to many health problems.

Why it matters: Parents are more likely to address a child’s weight problem if they believe overweight is having an adverse effect on the child’s health.

Starting the conversation: “Some families have many members with diabetes or heart disease, and that’s particularly likely if they are overweight. Is this true of your family? Is there anyone in the family you think has had health problems related to weight? Why do you think they’ve had such a difficult time with their weight? Are you worried that your child could have these health problems? What do you think you could do to prevent that?”