Can we talk about a sensitive subject? I’d like to share my perspective and experience from where I have landed after 24 years as a pediatric dietitian.


I see children and families for being overweight, underweight, and everything in between. Families often reach out for nutrition appointments seeking guidance on how to improve their child’s diet with the goal of achieving a better weight or BMI. Sometimes a parent will ask if I can meet with the child and talk to them about healthy eating. Other times, parents want to meet with me alone first and not bring attention to a weight issue in front of a child. And then there are times parents and children want to come in together and meet with me as a group.

What everyone wants to do is help their child. There are SO many reasons behind this. The obvious reasons we talk about–health, prevention of future diseases such as diabetes, high blood pressure.

The reasons that are hard to talk about include body image, appearance, how the clothes fit, and how the child feels about themselves. Sometimes there is bullying involved. Sometimes the child is unaware that their BMI is elevated and/or is perfectly fine with how it is. 

I want to be straightforward with you so here we go.

Guidelines Matter.

Just like homework, bedtime, or taking medicine, kids struggle with consistency, remembering, and self-discipline. Heck, even some adults do! Part of parenting is providing those boundaries and helping our children learn to stay within the lanes so they can succeed. Food is part of this. There have to be some boundaries and guidelines when it comes to food. That means setting up a routine, providing healthy foods to eat, promoting family meal times and positivity around food, and promoting health and well-being as the reason. Family eating helps with overweight

People have all kinds of reasons why this is hard. For example, if you were not personally raised in this type of food environment, it may feel uncomfortable. If you had issues with your own body image or disordered eating patterns, you may have a strained relationship with food or nutrition. 

Parenting is hard. Setting boundaries is tough. Kids complain, have tantrums, and often try to break out of the boundaries to test us. And it’s no wonder when it comes to food. Food tastes good. We live in a culture where junk food is associated with happy events, unhealthy food is cheaper than healthy food, and food is so readily available everywhere we go. As human beings, our bodies are wired to seek food. It is part of survival. And we use it for comfort, for social gatherings, self-care, and more.

What the Research Says:

Research indicates that the kids with the healthiest eating habits grew up in environments where these things occurred regularly:

  • Families ate meals together
  • The parents were in charge of planning the meal and both served AND ate healthy foods
  • There was a familiar daily eating routine for meals and a snack or two, without grazing
  • There were no good or bad foods – but there was moderation with sweets and processed things
  • Health was promoted first
  • There was no food or body shaming

Weight was not discussed – either the child’s or the parent’s weight

What we know from research on kids and brain development is that most kids do not develop the skills to have consistent self-discipline in regard to healthy food choices until they are in their mid to late teens. This means that parents must be in control of what food is available in the home. And guess what? That is about all you can do as the parent if you want a healthy outcome. I know. Everyone wants their kid to be the magical kid who chooses to eat healthy foods and leave the Twinkies. But let’s be honest, even adults struggle with this.

Advice as a Pediatric Dietitian

So here is my advice if your child is struggling with being overweight: come see me for the first time without your child and we will discuss and assess the situation. I am happy to provide your child with education about healthy foods and how they benefit our bodies if needed, but I do not want to put your child on a “diet”.  Your job is to follow through with making these foods available in the home, and limiting the amount of junk food at home. There will be plenty of opportunities for that elsewhere. Don’t talk about the food changes. Don’t talk about the weight. Just do it.

That’s it.

Written by Betsy Hjelmgren, MS, RDN, CSP, LDN and Founder of Feed to Succeed LLC.

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Schedule an appointment with one of our Pediatric Registered Dietitians.