Parenting in the Early Years, Part 3

Baby feeds himself

Stanford University is backing a concept called the DOR program, which stands for “division of responsibility.” A research team, led by Dr. W. Stewart Agras, started with a total of 62 families in which at least one parent was obese or overweight, and there was a child between two and four years of age who was deemed to be at high risk of obesity. The families were divided into two groups, with one set of parents being taught the “We Can” program promoted by the National Institutes of Health.

The other group received instruction in the DOR program, which employs a child-development approach and attempts to persuade parents to abandon pressure tactics when trying to get kids to eat what’s good for them. In short, it’s the responsibility of parents to provide the food and serve it, and the responsibility of children to decide what, or how much, they eat. One of the precepts here is that children need to learn to listen to their own bodies and trust the messages they hear from internal regulating systems.

Dr. Agras believes that parental control can mess with a kid’s ability to recognize her or his own true hunger or level of satiety. The conclusion:

At follow-up, parents educated in the DOR approach were putting less pressure on their child to eat, compared to those taught about the ‘We Can’ program, regardless of the parents tendency to over-eat (personal lack of self control).

The “We Can” group were discovered to pressure their children harder which, even when the food being offered is more healthful, actually leads to a “decrease in positive feeding practices,” which can in turn lead to an increased risk of obesity. Basically, children will resist control, and there are situations where an authoritarian approach is counter-productive.

Kids on diets?

There seems to be some confusion over the word “diet.” Actually, a person’s diet consists of whatever they eat. Then there is “diet” as in a special weight reduction regime. When a parent forces a child into one of those, there is likely to be criticism, as in the case of Dara-Lynn Weiss and the Vogue child diet scandal.

There are solid reasons why it is a bad idea for a parent to unilaterally decide to subject a child to a crash diet or a fad diet, and compiled them in a piece titled “7 Reasons Never to Put a Child on a Diet Without Doctor’s Orders.” Of course, it’s a good idea to go to their page, because each item on the list is explained in more detail.

For instance, the uncredited writer makes the point that even using the word “diet” is a red flag to the child, a notification that you consider her/him excessively fat and probably don’t love him or her any more. Here is the list:

1. Growing Bodies Have Very Real Nutritional Needs
2. Hunger Leads to Desperation
3. Emotional Eating Isn’t Curbed by a Rigid Diet
4. Diets Encourage Deprivation, Rather Than Promoting Physical Activity
5. Diets Condition Kids to Look for the Quick Fix
6. Putting Kids on a Diet Can Damage Fragile Self Esteem
7. Dieting Creates a Complex Relationship With Food

Number 2 is important because it taps into one of the major ways in which children differ from adults. A grownup is okay with delayed reinforcement — the reward that comes in the future. Hungry now, thin later. But kids don’t get it. They haven’t been around long enough to form such sophisticated concepts. What a hungry child is more likely to do is binge when the opportunity presents itself.

Number 5 makes the point that a crash diet, while it may be a quick fix, is antithetical to the preferred lifestyle of making a sustained effort, a commitment that continues day after day after day. It could use a little elaboration that wasn’t mentioned by the author. Learning to love the quick fix is also an invitation for your kids to get into pills later on. Pharmaceuticals or street drugs, all kinds of pills have their dangers, and dependency on that kind of instant gratification is a mindset you don’t want your children to fall into.

But #3 is the shining star of this list, and reiterates what Dr. Pretlow has said time and time again. Diets, exercise programs, even bariatric surgery, appear to work in the short term. But if the underlying problem is emotional, and if an actual addiction is in place, those methods only treat symptoms, and this can come to nothing but a bad end.

Your responses and feedback are welcome!

Source: “Forcing Kids to Eat Contributing to Childhood Obesity?,”, 09/05/12
Source: “7 Reasons Never to Put a Child on a Diet Without Doctor’s Orders,”, 07/07/13
Image by Bridget Coila.

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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.

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