Addressing childhood obesity should be a family affair

Parents can best help their children overcome obesity and develop healthy eating habits by adopting a “family treatment” approach to positive habits, including acting as a “champion” for good choices and being a healthy role model.

That’s the message to families with children who are overweight or struggling with healthy eating from UB faculty member Myles S. Faith, an expert on childhood obesity and eating behavior in children. His research includes the effects that both nature and nurture have on how children eat, and using technology to treat children from their homes.

“Parents should keep a positive tone and attitude for their child,” says Faith, professor and chair of the Department of Counseling, School and Educational Psychology in the Graduate School of Education.

“Children with obesity confront bias and discrimination all the time, and this can take an emotional toll. By cheering on gradual progress and small changes, kids see that parents are on their side and care. The use of positive reinforcement and praise predict better child outcomes in research studies.”

Faith, whose comments on childhood obesity were quoted recently in People magazine, suggests parents of children with weight issues are wise to discuss this issue as a “family matter.”

Sometimes a child will be teased because of his or her weight, Faith says. Other times, a doctor or school nurse alerts parents to the problem. In some cases, a parent is concerned because obesity runs in that family.

“No matter who brings up the topic, parents are wise to think about and discuss this as a family matter,” says Faith. “It is not just a matter for the child in isolation. The question then becomes, how can the entire family work as a team to get healthier together? What changes can they make together to support not only the child, but others in the family?”

For example, Faith says, rather than thinking “I need to get my child to walk more,” a parent might think “How can we as a family walk more together, to support one another?” or “What can I do differently to encourage my child to be more active?”

Faith stresses the “devastating” effect, psychologically and behaviorally, that “weight teasing” can have on some children with obesity.

“It’s associated with greater depression, suicidal thoughts, poorer body image and worse eating regulation,” Faith explains. “Moreover, research shows that weight teasing often comes from family members, not just strangers or kids at school. Parents should therefore remember to keep things positive and to be a role model for change, and recognize that name-calling can be detrimental and should be avoided by others in the family.”

He suggests families think along the lines of “building healthy family habits.”

“‘Habits’ is a powerful word,” he says, “because most children get the term, and it implies that a behavior needs to be practiced over and over. This is the essence of behavior change. It needs to be rehearsed a lot and reinforced.”

Results for treating childhood obesity come when families collectively concentrate on eating healthier foods, reducing screen time and staying active, Faith says.

Physical activity does not necessarily mean going to a gym, he adds. “It often means building more walking time into one’s day and making it a habit.

“Dietary changes involve reducing calorie-dense foods, and this often includes beverages, and increasing healthier foods and water.”

The key to lasting behavioral changes is to start with specific goals, Faith explains.

“Instead of setting a general dietary goal, for example ‘Our family will eat more healthy,’ more specific goals are preferable, such as ‘Each family member will eat five servings of fruits or vegetables every day. As a family team, we will eat 15 servings each day.’

“Ideally, the whole family is on board and supportive, thinking of this as a family team effort,” he says. “If we look to the science, the strongest evidence for effective childhood obesity treatment is for family-based approaches.”

Faith recommends “self-monitoring” as one of the best strategies for behavioral change, including childhood obesity. Self-monitoring is straightforward, he says. It means keeping a log or journal of the behavior we want to change.

“That can be daily servings of water and soda consumed, the number of step counts on an activity monitor, or the number of snacks eaten during the day,” he says. The parent, child or both write every time the behavior occurs, so that it can be monitored over time.

“Not only can families assess personal progress,” he says. “It also helps with behavior change. Research studies show that the more families self-monitor specific behaviors, the more successful children are with weight control.”

Families can watch their progress by looking at the weight scale.

“That’s the ultimate outcome,” Faith says. “However, progress monitoring of daily behaviors and habits is critical.”

Parents can play a role in keeping their children’s confidence up by remembering to keep things positive and to reinforce small successes.

“There is much to be gained by focusing on what’s going successfully and to build from that, rather than by focusing on the negative,” Faith says. “If goals are not achieved, parents can still acknowledge the effort, be positive and problem-solve together. If parents show a lack of confidence, children can absorb this and feel down on themselves.”

Scientific evidence supports family treatments for childhood obesity where parents use positive reinforcement, Faith notes.

“Many parents often think, ‘My child must change,’” he says. “An alternative way to think is to ask, ‘What can I do differently, to help my child change and feel good about progress?

“Child behavior change is not just about a child; it’s also about a relationship with caregivers.”