Denial = Bad, Awareness = Good


Childhood obesity
is a tough problem, and when parents look for answers, the answers might depend on the attitudinal states of various family members. Maybe you realize that your child has a problem, but he or she refuses to acknowledge this. Or maybe your child is asking for help, and you are the one who is in denial. In a two-parent family, one might be aware of a serious problem while the other dismisses the notion.

The first thing to do is cultivate awareness. Lay in a groundwork of information before you take a stand. “How can you tell whether your child is obese?” is the titular query posed by a Los Angeles Times article that points out that a great many American children are overweight or obese, and recommends that parents learn more about the BMI, or Body Mass Index. This is a widely used way of quantifying the degree of obesity a person is experiencing. Here is reporter Mary Forgione’s succinct description:

One of the tools a doctor will use is a BMI growth chart that compares your child’s body mass index, or BMI, calculated from his or her weight and height, with others of the same sex and age. Children who fall in the 85th to 95th BMI percentiles (meaning 85% to 95% of children have a lower BMI) are considered overweight; 95th percentile and above indicates obesity.

Forgione recommends that parents check out a page called “About BMI for Children and Teens,” which goes into much greater detail about every aspect of BMI and even addresses such uncommon questions as, “My two children have the same BMI values, but one is considered obese and the other is not. Why is that?” (link is ours). The answer to that query may be a bit confusing at first, but a perusal of the entire page will clear things up, especially with helpful charts and graphics:

The interpretation of BMI-for-age varies by age and sex so if the children are not exactly the same age and of the same sex, the BMI numbers have different meanings. Calculating BMI-for-age for children of different ages and sexes may yield the same numeric result, but that number will fall at a different percentile for each child…

An interesting essay by Kinjal S. Shah fills in more blanks for the knowledge-seeking parent, beginning with an assurance that many health professionals are now realizing that compulsive overeating may be seen through what Dr. Pretlow calls the psychological food dependency-addiction lens. One thing to know is that compulsive overeaters are not the same as bulimics. They don’t try to take counter-measures to cancel out the huge consumption of food during binges. How they look is of very minor importance, compared to how they feel, and food makes them feel good.

Shah says that compulsive overeaters tend to fantasize about food and spend a lot of time thinking about and planning meals when they aren’t actually eating, which is most of the time, because in between binges, the compulsive overeater will also graze, consuming small amounts of food throughout the day. Even feeling stuffed and sick will not induce them to stop. Just like any other addict, the compulsive overeater will shy away from ordinary activities that used to be enjoyed, and will probably have a history of failed attempts to quit the overeating behavior. The writer says,

Signs of compulsive overeating that parents can watch for include depression or mood swings, eating alone due to shame, eating very fast, or even withdrawing from eating with others but still experiencing a high weight.

Visit the Weigh2Rock website, where, among other things, Dr. Pretlow explains the difference between a child being medically overweight and socially overweight. He also offers a checklist of “Ten Ways to Tell if Your Child Has a Weight Problem,” compiled by pediatric nutritionist Michelle Daum.

Is the child being teased, or outgrowing clothes at an accelerated rate, or experiencing shortness of breath from minimal exertion? Are the child’s activities and friendships changing? Has the child told you that he thinks he is overweight, or she thinks she is overweight? Has a doctor said so?

When a child has a tantrum (or a teen has a hissy fit) because a certain food isn’t available, it might be an indication of food addiction. As a good parent, you might want to observe signs in yourself, too, in order to assess what kind of example you are setting. Look for patterns, like saying “the usual.” An unvarying diet is not a healthy diet. When a habit is so ingrained that your friends and the workers at all the fast-food joints know what you mean by “the usual,” this could be a bad sign.

Rationalizing is another bad sign. If you catch yourself standing in the supermarket aisle thinking, “I wasn’t going to buy chips, but since they’re on sale, it makes sense to get some today…,” count that as a red flag.

Your responses and feedback are welcome!

Source: “How can you tell whether your child is obese?,” LA Times, 10/07/10
Source: “About BMI for Children and Teens,”
Source: “What Parents Need to Know About Compulsive Overeating,” Ezine Articles
Source: “Solving the Over-Weight Puzzle,”
Photo credit: City of Marietta, GA via / CC BY

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources