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A Heavy Truth
Is your pediatrician addressing your child’s weight? Why you should make sure she is.
By Sanjay Gupta, M.D., Time
According to a 2005 study in the journal Pediatrics, doctors diagnosed obesity less than 1% of the time among those between the ages of two and 18 — a figure far below the one-third of young Americans struggling with their weight.
Mark Jacobson, an adolescent-medicine specialist with the American Academy of Pediatrics, explains that parents may feel guilty about having an overweight kid because they know it’s partly hereditary and because they feel it’s their responsibility to control their youngster’s exercise levels and diet. Parents also worry about a child’s developing eating disorders if weight becomes an issue, so they say nothing at all.
“I’ve had a patient whose mother whispered the letters w-e-i-g-h-t to me, with her hand over her mouth so the child couldn’t see. I could tell it was something they had thought about and didn’t want to bring up with the child,” says Jacobson. Still, he insists that doctors must discuss the topic. One way to do so gently, he says, is to avoid the word obese and instead say the child has a weight problem. Doctors may also tell kids that their weight is a couple of years ahead of their age. Then, Jacobson says, he focuses the discussion more on the behaviors that could help improve the situation — such as watching less TV and playing outside more — instead of concentrating principally on shape.
“You don’t want to make people feel embarrassed and not want to come back to you,” he says. “You want them to get treated.” Jacobson stresses that every pediatrician should determine a child’s body-mass index (BMI), a figure arrived at by factoring weight and height to produce a two-digit number that roughly diagnoses obesity. BMI is an imperfect metric, in part because it does a poor job of taking body type and muscle mass into consideration, meaning that a stocky person with low body fat can be labeled obese. But as a starting point, BMI helps.
None of this absolves parents from stepping forward and bringing up weight on their own. But whoever raises the topic, it’s important for patients and doctors alike to remember that modest amounts of weight loss can disproportionately benefit overall health, even if the loss doesn’t feel or look like much. That fact may be the best reason for everyone to show a little courage and say what needs to be said — even if it hurts a bit.
Adapted from the Sept. 3, 2007 issue of Time. ® 2008 Time Inc. All rights reserved.
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