How To Talk to Your Kids About Weight in Light of the New American Academy of Pediatrics Obesity Guideline

In January, the American Academy of Pediatrics issued its first comprehensive guideline on evaluating and treating children and adolescents who have obesity. Recommendations include offering more guidance to families of “obese” children, considering weight loss medications for kids age 12 and up, and perhaps the one that raised the most alarm, that 13-year-olds may be eligible for bariatric surgery.

The guideline has received significant backlash among clinicians, eating disorder experts, and other health professionals, who have stated that invasive surgery on young children is dangerous, weight loss drugs do not work long-term, using BMI in growing bodies (or perhaps at all) is inappropriate, and, among the many harrowing statistics gathered by the National Eating Disorders Association, one that stands out is that second to opioid addiction, eating disorders have the highest mortality rate of any mental health disorder in young people.

In light of this guideline, parents want to know how to talk to their kids about weight in a way that is helpful, or—at the very least—isn’t harmful.

Why even talk to your kids about weight in the first place?

While it may feel like the best thing to do is avoid talking about weight at all in your house, it’s actually important to bring up the topic with your child. “If parents sit back and feel comfortable that they are building resilience in their kids simply because they don’t talk badly about bodies at home, or don’t diet at home, they are being misled,” says Sumner Brooks, RD, a registered dietician, eating disorder specialist, and co-author of How to Raise an Intuitive Eater: Raising the Next Generation with Food and Body Confidence. Instead, she says, “We need to intentionally be positive about bodies of all sizes due to the fact that there is so much cultural fatphobia.”

Virginia Sole-Smith, a journalist, thought leader on weight bias, and author of The Eating Instinct and the upcoming release, Fat Talk: Parenting in the Age of Diet Culture, says that, while these conversations were always important, “I do think these guidelines mean that it’s going to be more important than ever for parents to talk to their kids about anti-fat bias and how it shows up in so many contexts of family life, but especially in healthcare [ due to the likelihood] that anti-fat bias will be present in the exam room at your child’s next doctor’s appointment.”

With that in mind, here are some practical tips on how to talk to your kids about weight

When your child says something hurtful about someone else

As a parent, I’d already been trying to understand how to talk to my daughter about weight. And not one day after I finished reading Fat Talk, my daughter said of another child, “She needs to exercise more. She’s fat.” Very fortunately, I was freshly prepared with some expert tips.

Here’s what the experts interviewed for this article said to do:

“Be careful not to shame a child for saying something fatphobic—it is not a reflection of their own thoughts; it is them repeating something they’ve been taught or something they saw or heard,” says Brooks. So, when speaking with my daughter, I decided to get curious and followed up with a question like what Brooks suggests to ask: “Well that’s interesting to say because I don’t think there’s anything wrong with being that size or looking that way. Tell me more about what you mean?”

Indeed, my daughter told me she’d just repeated something she’d heard. So then, I said what Sole-Smith suggests in her book and what is becoming my mantra: “All bodies are good bodies.” We went on to discuss, as Sole-Smith suggests, how people can be healthy at every size and fat is just another way for a body to be, such as tall or strong.

When your child says something negative about themselves

There will come a day when your child says something disparaging about themselves, and this is where building on body-positive conversations will come into play. You’ll be able to call upon past conversations about how it’s unkind to judge other people’s bodies and ask your child to apply this compassion to themselves.

For example, Brooks suggests saying something like, “Talking bad about our own bodies doesn’t feel good. Our bodies are so amazing, and it’s interesting how different we all are. I love how awesome bodies are, big bodies, small bodies, and medium bodies!”

Another tip is to shift value from your child’s physical body into their other wonderful characteristics and skills, like drawing and playing sports, or personality attributes like kindness and empathy.

When someone says something fatphobic about your child

Your child might be the target of bullying about something regarding their body. Puberty might elicit comments. Validate their feelings of sadness or hurt without validating the reason for the bullying, says Brooks.

If your child is having trouble reckoning the positive messages at home with those from the outside world, Brooks says you can say, “Growing kids need to gain weight. I know it might be confusing to hear some adults say that weight gain or being fat is unhealthy and then to hear me say that it isn’t. What I think is important, is that you know your body is always good as it is, no matter what anyone says or thinks.”

When you want to protect your child from anti-fat bias at the doctor

This scenario can feel intimidating since parents have been trained to trust that their pediatrician has their child’s best interest and health at heart. However, it’s clear that anti-fat bias exists in these spaces, so it’s important for you, the parent, to step in, if necessary.

“If your child is very young…let the provider know ahead of time (via email, phone call, patient portal message, or bring a [note] you can hand to the nurse at check-in) that you don’t want weight discussed in front of your child,” says Sole-Smith. That way, the doctor won’t say anything about your child’s weight to them without their consent.

“If your child is older,” she says, “talk more directly about how lots of doctors have been told that body size equals health and this means they focus on it in appointments in ways that might feel bad. Tell your child that you know their body is never a problem to solve; that it is their right to decline to be weighed or to discuss weight loss, and that you will support them if they need or want to do that. Then you can brainstorm together how to handle the appointment.”

Your child might elect to have you in the room or set a “no weight talk” boundary ahead of time. After the appointment, debrief. If your child did not feel safe and supported by their provider, you may want to find a new one, if possible.

When your child says something about your body

It’s pretty likely that the good old mom or dad bod will come up in fat talks with your child. If, like my kids, your child makes a comment about your “squishy tummy,” Brooks says, “They are not saying that comment as an insult, they are making an observation,” devoid of judgment.

Rather than become self-conscious or upset, Brooks says, “A comment like that is an opportunity to demonstrate body acceptance and set an example of a neutral response.”

For example, when my kids mention my body, I try, as hard as it is, to say something like, “It is squishy!” and leave it at that. This is an important skill because it’s not just what we say about ourselves, but what we do that matters most to our kids’ perceptions of bodies. Try not to disparage your own reflection, even non-verbally. That can look like wearing a swimsuit and going swimming with them, wearing shorts in the summer, and generally just being as comfortable in your skin as you can, says Brooks.

Your intention also matters. In Fat Talk, Sole-Smith discusses how your intention might even matter more than your behavior. Are you eating salad for lunch because you want to lose weight or because you want to eat colorful, flavorful foods that make you feel good? Speaking up about your reasons matter.

How to talk to your kids about weight when you encounter anti-fat bias out in the world

The truth is, you and your kids are going to continue to see and notice anti-fat bias in the world, especially in the media. As I watch shows and read books with my kids, I try to find opportunities to point out and discuss places where the author or the characters are being unkind. We don’t “cancel” the entire book or show, we simply discuss.

It’s also a good idea to treat real-world comments as learning moments, and a way to practice your own assertiveness in a respectful way. If a friend or family member says something that doesn’t align with your own values, Brooks says you can say, “In our house, we don’t believe…” and then insert the phrase that fits like “there are bad foods,” “fat people are lazy,” etc.

Of course, these conversations will be a lifetime of work—along with anti-racist talks, sex talks, and all the other hard but important conversations you’ll have with your kids. Even if doctors fail to do no harm when it comes to talking about weight, we can strive to. Hopefully, we can give our kids a chance to live in bodies they love and accept, and let them love and accept others, too.