Weight Gain Isn't the Problem

When your child's weight goes up at their yearly physical, your pediatrician might comment that you should make some changes. 

Or maybe you see a post on social media telling you what changes to make if your child has gained weight. 

It can be really confusing. And it might leave you questioning what changes to make, or feeling like you should be cutting back on portions, or getting rid of "junk".

In this episode, we talk about:

• Why weight is one piece of data, not a diagnosis or a directive
• The questions worth asking before changing anything, including what might actually be driving weight changes that have nothing to do with food
• Why significant weight gain around ages 9 to 11 is often the body doing exactly what it's supposed to do
• How restriction, even subtle, can create the very eating patterns we're most worried about
• What to do when a provider tells you to make changes, and how to advocate for your child

If you've ever left a pediatrician's appointment feeling like something was wrong with your child's body, and nobody thought to ask how things were actually going, this episode is for you.

CONNECT with Nicole:

- Instagram: @nicolecruzRD
- Book a FREE Eating Alignment Call with Nicole to learn more about our approach and how we can work together: Eating Alignment Call

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Thank you for tuning in and see you next week!

Transcript

SPEAKER_00 0:01

Welcome to the Intentional Table Podcast. This is where we go beyond nutrition to not only talk about how to help your child eat well and get the nutrients they need, but how to also support them in having a healthy relationship with food. If you want your child to eat a variety, listen to their body cues, eat the amount they need, and not be obsessed with sweets, or you just don't want to fight about food, you're in the right place. Here you'll find practical tips and compassionate guidance to support your family in navigating food with more joy and less stress. I'm Nicole Cruz, registered dietitian and mom of three, and I can't wait to dive into today's episode with you. Welcome back to the intentional table. So I was on Instagram and I came across this post from an influential, well-known dietitian, and it definitely made me pause, and then it made me really angry. And so then I thought, we really need to talk about this because if I'm coming across it, you are likely seeing things like this too. And honestly, it's harmful and it's information that can create a lot of fear for parents and send them in the wrong direction. So this is the way that our culture often thinks about food, weight, bodies. And we hear stuff like this on social media from our pediatrician, from our other friends or family members. And so I want to share some ways that we might have another perspective around it. So the post basically was a carousel post, and it said, like, if your child is gaining weight, the cause usually isn't too much food. It's too much starch and low nutrient dense foods. And what we need to do is to actually think about including more colorful foods and more protein and all of these things. And that's great and all. I am all about looking for more ways to increase protein and fruits and vegetables and increase variety overall and help our kids get the nutrition that they need to feel good in their body and to fuel them well. But tying that to weight gain is where the problem is. Weight is just one piece of data. It is not a diagnosis. It's not a directive for how we should be feeding our kids. And when a child gains weight, our first move should not be to jump in and change what we're doing. I'm not saying that that can't be a piece of it that we might not want to check in around how we're feeding and what we're feeding. But we shouldn't just make this jump based on our child's weight or weight gain. The first thing that we actually want to do is get curious and ask questions. And I actually had something like this come up when I took my son to the pediatrician for just a yearly visit. And we went in and the doctor came in, you know, after the nurse had done like height and weight and all of that. And our pediatrician walked in the room and he took a look at everything. And then he told me that his weight had jumped up and we might want to make some changes. Now, mind you, the year before when we went in, his height had jumped up. And the pediatrician looked at his numbers and he joked with me and he said, Oh, maybe you are gonna have a basketball player after all, right? It was like funny, he was good with his height jumping up, and now his weight goes up a little bit, and he is telling me automatically out of his mouth, you might want to make some changes. I feel confident in the approach that I have with food. And so I looked right at him and said, we won't be making any changes. And the problem with this is he never once even asked me a single thing about what my kid already eats, if I have any concerns about his nutrition or his diet. He didn't ask me how he's doing socially. He didn't ask me about the sports that he's playing. He didn't ask me a single thing. He just looked at his weight and said, you might want to make some changes. Now, sadly, this is normal. And it happens to younger children, it happens to teenagers, and it happens to adults. And this is one example of weight stigma. Assuming something about a person based on their body size, or assuming that something needs to change based on somebody's weight without any other information. No other information about health, like there's no labs drawn, there's nothing here saying that something is out of balance, and without any other information about our lifestyle or mental or emotional health. Now, if there is a jump in weight, I am not suggesting that we should be negligent and never pay attention to it. There is a reason that we get the height and weight of children, and we do want to notice are they growing in a relatively predictable way? Or is there something that seems off? And that is okay. That is okay to look at. But if we're noticing that the weight has jumped, has jumped percentiles, and mind you, kids are supposed to gain weight and they do gain weight at different rates than other kids. So jumping a percentile is not inherently bad, but it could be information. So if this happens, here are some things to consider before going to we need to change their diet and we need to control their weight. We need to make some arbitrary changes. We want to consider is there something going on emotionally or socially? Has our child been going through a hard transition? Could there be bullying happening at school? Is there a lot of stress? Might they be using food to cope, eating more emotionally or compulsively? And that might be happening, but the weight then is just a symptom of the emotional or mental stress that your child is going through. And that's what we actually want to be paying attention to. Now, there could also be a medical reason, such as thyroid issue or other conditions that drive weight changes. Now, this warrants some investigation. You might need to get blood work done or see a specialist, like an endocrinologist, right? We might want to take a deeper look at their labs if something seems off, or maybe they're having other symptoms, like they seem more tired or sluggish. Again, we don't want to be negligent. It's just a piece of information, but we don't want to jump in and try to fix the weight based on this. And I use fix very loosely. Another thing to consider is is your child about to hit a growth spurt? Kids do develop at different rates. I know I said that before, but I think it is so important because we will see our children often grow out before they grow up. Like their body is preparing them to get taller, to have the stores to do that, or to start creating hormones for puberty. Their body might be doing exactly what it needs to do, and it might be doing it before the rest of their peer group, or maybe it's doing it later than the rest of their peer group. We don't know, but gaining weight before height is developmentally normal. Now, some kids don't do that in the same way, and that's okay too, but it's also very common, and this also just goes back to how we all grow at different rates and into different body sizes. And if your child is about to grow up in height, then they need the stores to do that, which also means that their appetite is going to increase. So if it does seem like, oh my gosh, they're eating so much more than they used to, is something going on, that might be normal. They might need to be eating more to gain the weight to then be able to grow taller. And again, this can happen at different phases. A lot of times people get nervous or uncomfortable because they think that their toddler is supposed to grow out of the like baby fat or the baby weight. But toddlers don't always slim out just because they get more active or because they aren't the, you know, cute, pudgy little baby anymore. There are toddlers that are going to be bigger than other ones, or maybe they're going to thin out as they get older, or maybe that is just going to be their body size. But it's not always predictable that they're just going to lose the baby fat at two or four years old. And then again, we want to think about, like I mentioned, puberty around 9 to 11, especially for girls, significant weight gain is the body preparing for puberty. We have to create more fat stores. We have to be prepared to be able to make more hormones. This is not a problem that needs to be fixed. And a lot of times girls are uncomfortable with it. Or because we live in such a fat phobic society, doctors are uncomfortable with it. They're like, oh my gosh, waking, we need to do something about this, even though it's completely developmentally normal. Now, another thing to consider is how your child feels about food based on the feeding dynamics. If there is a sense of restriction or scarcity, even if it's subtle, that might be propelling your child to eat more. If they feel like they're not allowed to eat the amount they want and need, then they are going to seek out more food in reaction. And a lot of times parents think that looks like my kid doesn't have an off switch, or they're eating emotionally or compulsively. But actually, it's in response to the restriction. It's just like an adult who goes on a diet, and then when they go off, they feel like they're eating everything in sight and it feels uncontrollable. So then they feel like, I need more willpower, I need more control, I need to go back on that diet to, you know, stop me because I'm out of control with food. But actually, these responses are happening because of the initial feeling of scarcity or deprivation. And trying to restrict even more makes it worse. And so a lot of times we end up in these cycles because we feel concerned. Oh, it looks like my kid doesn't know when to stop eating, that they can't sense their fullness. They would just keep eating and eating. So we put some limits on, and then they feel that even more. And now they're trying to eat even more, and it just perpetuates itself because we get more uncomfortable, then they seek out more food, and it just keeps going and going. And a lot of times this happens in response to a normal growth. Like your child is about to grow up in height, like we just said, right? They're going to have a growth spurt or something. And so maybe it does seem like they're eating more and gaining some weight and we get uncomfortable. So then we're like, oh, we should really eat healthier. We should watch our portions. And then they feel restricted. And then it just perpetuates the cycle and actually increases the normal weight gain that was already happening. Now, trying to restrict our kids' intake or control their body size is potentially harmful in and of itself. It might impact them getting the nutrition that they actually need. It also can plant the seeds for guilt and shame and disordered eating. It can make them feel that sense of scarcity and not listen to their body or not trust that they're allowed to eat the amount that they need. It can show them that their body is a problem and that it shouldn't be growing that way. And it also can miss if there are underlying issues, like if our child is struggling with something and maybe they actually need more support at school, maybe they need to get into therapy, maybe they're being bullied, whatever the thing might be. We risk missing that because we are just focused on the weight and feel like we need to control it. Now, in my case with the pediatrician, I said we won't be making any changes. And I absolutely did not make any changes. I didn't change my approach at all. And I do want to say this in the context that I feel very confident with how I feed my kids. Now, does that mean that that wasn't a bit of a gut punch or I didn't question myself at all? No, of course it makes you like pause a bit and say, like, what? Am I doing something wrong? But at the same time, I do feel confident with how I approach feeding my kids. And so I wasn't thinking, oh my gosh, I do need to make some changes based on their weight. And so if you are questioning, am I doing something wrong? Should I be feeding them different? Could I be perpetuating this? Or am I not really giving them the options to grow into the body that's right for them? Or am I being too loose with food or, you know, whatever might be coming up for you, then I want to encourage you to get that support so that you too feel more confident and can trust that your child is growing into the body that's right for them. Because that really was a key component for me in this situation was feeling like I know what I'm doing and I am trusting my child to grow into the body that's right for them, regardless of its size. If he would have stayed on that growth curve, great, because I trust the way that I'm feeding. If his body changes and he does get a lot taller and then his weight goes down on the percentiles and he's more quote unquote like slim, great, right? Because I am trusting my approach. And to be honest, in my scenario, that is what happened. He is still growing and getting taller, but has hit a significant growth spurt. And when we went back for another visit, I want to say like two years later, he's like, Oh, look at this. Look at where he's at. And I actually reminded him and I said, Yeah, you said that to me two years ago. And I didn't change anything because this is how his body was meant to grow. And he's like, Oh, okay. You know, he didn't, we didn't get into a big conversation, but I reminded him of that because I think it's so important that we can actually trust our kids to grow and develop in the way that their body is supposed to, without interfering. And often the interference is what makes the quote unquote problem worse. So, with that said, my child did get taller, his body did shift. And that is one example of how it might play out. Another example is maybe he went up in percentiles in weight, and then he just stayed on that growth curve, and that became his new normal. And that's where his body was supposed to grow and develop to be. And that is absolutely okay too. Bodies will land where they land. So whether your child goes back to the percentile that they were at, or they just continue growing at that new percentile, either one is totally fine. What might actually be worth watching though is if their percentiles continue to jump and jump and jump, and it looks like a very steep line up on a growth chart. It also would likely be paired with eating that looks compulsive, or you actually see your child in discomfort or expressing that they don't feel well after they eat. It might be eating that seems really emotional or disconnected. You might want to check in with yourself. Is there a sense of scarcity here? Have I been restricting a bit? These are things that you do want to pay attention to. And if you are seeing this pattern, I would absolutely reach out and get some additional support. That could be with someone like myself who can guide you around that. That could be with your pediatrician, or if you don't feel trusted in that, getting another opinion with somebody that specializes in disordered eating, like an eating disorder specialist, dietitian, or therapist. We really want to find somebody who takes a non-diet, weight-inclusive approach and understands kids through the pediatric lens. Now, if you are in this boat and you are worried about your child's weight gain, I want you to start with the questions that we talked about, like looking at their behaviors with food, looking at if there could be anything else going on for them at school or with family. Could this be a developmental timing thing? So first start there. Look at whether restriction could be showing up anywhere and whether or not you feel like you have a confident approach with food. After you do that, then we can look at the food quality, right? We can have that conversation around what are you actually feeding? What does their movement look like? Should we be making some changes here? Not to control their weight, but just like we would look at any child in any body size. How does our diet look? What are we offering? Are there ways that we could increase variety, get more fiber in, get more protein in? Those are all real and okay to have, but they're not necessarily the place that we want to start. Now, if you don't necessarily have concerns, but a provider has told you that you should make changes, one, you are allowed to say, I won't be making any changes. You're also allowed to ask more questions, understand where they're coming from, what recommendations they would make. And you're allowed to get a second opinion, especially from someone who specializes in this space. A provider jumping to fix that weight without asking any questions is not giving complete care. And I recognize that they are not necessarily trained to do this and that they often have a very short time frame with us. And I also think that we need to be really careful of that because it still can create harm. So sometimes we as parents have to advocate for ourselves in those situations. Now, if you have been doing the work, if you feel confident in the way that you are feeding your child, if you actually aren't really that concerned, you're not seeing behaviors around food, then trust it. Because the number on a scale is not indicative of anything being wrong or anything that you need to change. It is just one piece of information. And often we give far too much pun intended weight to it. Okay, and with that, I am going to wrap up here. I hope that that was helpful. I trust that it is. I just want you to remember that you deserve more than just looking at a simple number on a scale, whether that's about your child or whether that's about you. And you deserve to have more information and more support with that. If you could use that, please don't hesitate to reach out. I am happy to be the one that provides that or that gives you more resources or points you in the right direction. All right, thank you so much for joining me today. And let's take just a moment and remind ourselves, as we always do, that nourishing a healthy relationship with food is just as important as the food itself. Thank you for joining me at the intentional table, and I'll see you next time.