How to talk to your child about their weight

What do we mean by overweight?

Children are not little adults because they are still growing and developing. This means that their weight, shape and size can change drastically by the time they leave school. Because of this, we measure 'weight for height' as an age-dependent percentile (a way of comparing individual children to a healthy national average). You can check out your child's percentile in the growth chart book you received when your child was born. Otherwise, you can find charts on the internet.

Children are at risk of being overweight if their body mass index (a ratio of weight for height) is on or above the 85th percentile for their age. Being on the 85th percentile means they're bigger than 85% of the children they're being compared to. They are at risk of becoming obese (one stage on from overweight) if their body mass index is on or above the 95th percentile.

Why should we be concerned about weight?

While some children will simply grow out of chubbiness or 'puppy fat', many don't and this can lead to problems later on.

Overweight and obese children may feel breathless, have difficulty taking part in sport and games, and experience bullying or teasing due to their size. Obese girls can reach puberty earlier and have to deal with periods at as young as 8 or 9 years of age.

Overweight and obese children are more likely to stay overweight into young adulthood. This can increase their risk of type 2 diabetes and limit their ability to stay fit and healthy. No one wants this for their child, so what can parents do?

The big question

It can be very difficult to start a conversation at home about body weight but if you are concerned about your child, it's worth the effort.

"If your children's weight is not an issue, either to them or you, the less parents talk about weight the better," says Tam Fry from the National Obesity Forum.

However, if your child's weight does start to impact on their life and well-being, he suggests that parents start by expressing their own fears about how excess weight might affect their child's health and happiness, rather than calling out their size or eating habits. Fry adds: "There are no guidelines which every family can follow except that the conversation should always be loving and honest. Tough love it may be but parents would be failing if they didn't deliver it."

Starting a conversation can be more challenging when parents are conscious that their own weight, eating habits and fitness are not an ideal example for their children to follow.

Parenting coach, Lorraine Thomas, says: "As a parent, look at the food you have in the house. Your child may be old enough to open the fridge ... but you buy what goes in there! Talk to your children about family health so that they are not singled out and show them that you are working on yours too. Set some goals, have some fun, do exercise together and spend quality time cooking together."

Patient picks for Healthcare

General health and lifestyle

The digestive system

The digestive system (gastrointestinal tract) is the long tube that starts at the mouth and ends at the back passage (anus).

by Dr Roger Henderson, MBBS

General health and lifestyle

Exercise and physical activity

Doing regular physical activity can make people feel good about themselves and it can have a number of benefits for health. For example, it reduces the risk of developing heart disease, stroke, high blood pressure, many cancers, type 2 diabetes and 'thinning' of the bones (osteoporosis). Regular physical activity also helps to control weight and ease stress. Ideally, the aim should be at least 30 minutes of moderate-intensity physical activity on at least five days of the week but even 10 minutes is better than nothing. You should aim to do at least a couple of sessions of muscle-strengthening activities per week as well.

by Dr Pippa Vincent, MRCGP

Tips for supporting your overweight child

Avoiding negativity is vital, says psychologist, Emma Kenny. She continues: "Being body positive is essential. If your children hear you being negative about your own body, then expect them to follow with opinions of their own. I remind my kids constantly of how unbelievably blessed they are to have arms and legs and fingers and toes and taste and sight, etc. I think family activities such as nature trails, or even a brisk walk around the block every day can help increase activity levels and fitness and also doing some exercise at home together can make fitness fun."

Elaine Wyllie, a former headteacher of St Ninian's Primary school in Stirling, knows that even a short burst of regular exercise can be a great way for children to take charge of their own physical and emotional health. She was instrumental in introducing a campaign called the Daily Mile. This is a daily 15-minute run or walk which includes all children in the school, even those who are disabled or unfit.

She explains: "We are trying to promote self-care in children so a Daily Mile was a great way of getting the children to take charge of their own health. It was aimed at improving fitness but it actually ended up helping to prevent obesity as well as getting children in the right frame of mind to learn. It is definitely a positive health promotion tool."

The MEND foundation is another excellent place to find information about appropriate interventions for overweight and obese children. Parents can refer their child directly or ask a health professional to do this.

Try these tips if you have concerns about your child's weight:

Check the charts

Check out your child's weight for height on the percentile chart or ask your health professional to help you do this.

Are there issues?

Explore with your child whether their weight is causing any issues. Can they take part in all the activities they want to, do they have happy and stable friendships, and is there any evidence of teasing or bullying?

Be sensitive

If your child's weight for height is above the 95th percentile or if you think their weight is causing issues for them, consider having a sensitive conversation about their health and fitness. Children should never be put on a diet unless your health professional has suggested it.

Suggest positive changes

Focus your discussion on your own fears and hopes and suggest positive steps for making changes, such as taking more exercise as a family and eating healthier foods and drinks.

Don't be cruel

Avoid making negative comments about your child's weight or size, even in jest, as this can be counterproductive. Emma Kenny says: "Siblings often use 'fat' as a loaded insult as so many children know how hurtful such a term can be. As a parent it is important to communicate how unacceptable these types of comments are within sibling relationships."

Make it a family activity

Children are more successful at managing their weight when the whole family makes healthy changes to their diet and exercise habits.