Health

Thu Nov 14

6 things to do if your child’s weight is beyond the ideal range – and 1 thing to avoid

Written by: Nick Fuller, Clinical Trials Director, Department of Endocrinology, RPA Hospital, University of Sydney

One of the more significant challenges we face as parents is making sure our kids are growing at a healthy rate.

To manage this, we take them for regular check-ups with our GP or nurse, where vital measurements, including their weight and height, are captured and compared to an “ideal” range.

But how accurate are these measurements? And what should you do if your child’s weight falls beyond the ideal range?

How children’s weight is measured

It’s important to help our kids maintain a healthy weight. Around 80% of children ^[1] who are obese when they reach adolescence will struggle with their weight for life.

GPs and nurses regularly measure a child’s height and weight and use growth charts to visualise their growth over time. They typically use two charts, covering:

birth to two years, which adopts World Health Organization ^[2] standards. These were developed using studies in six countries measuring the growth of healthy, breastfed infants
two to 18 years, which adopts charts from the US Center for Disease Control ^[3] for children and adolescents’ weight, height and body mass index (BMI).

These charts use percentile lines to plot a child’s measurements as a growth curve, which is then compared to the expected – or ideal – range of weights and heights taken from children of the same age and gender.

A child’s growth is considered healthy when their measurements track consistently along percentile lines. Poor growth is characterised by a child’s weight or height measurements trending downward across percentiles.

In children under two years of age, a weight-for-age above the 85th percentile is considered in the overweight range ^[4], and a weight-for-age above the 97th percentile is considered in the obesity range.

In children aged over two, a BMI above the 85th percentile is considered overweight ^[5] and a BMI above the 95th percentile is classified as obesity ^[6].

But growth charts and BMI aren’t perfect

Growth charts provide a simple but effective indication of our child’s growth and development. They can help health-care professionals detect potential medical issues early for investigation by a specialist.

But growth charts can cause parents a great deal of anxiety and stress because they fail to recognise that every child will grow and develop at a different rate.

So it’s vital to assess trends and changes in weight over time and not to react to measurements that might be an outlier.

1 thing to avoid if your child is above the ideal range

Don’t restrict your child’s food intake ^[7] or limit their diet if they’re outside the ideal range. While this may succeed in helping them lose weight initially, it will be detrimental later.

Imposing a diet on a young child affects their ability to metabolise food and their innate ability to regulate their food intake as they grow and develop. This can affect their relationship with food ^[8] and accelerate their weight issue over time.

Fixating on a child’s weight can also lead to anxiety, low self-esteem, eating disorders and body image issues ^[9].

6 things you can do

If your child’s weight is measuring outside the ideal range, continue to monitor their growth over time and focus on enabling them to “grow into” a healthy weight. You can do this by:

1. Focusing on health, not weight

We each have a predetermined weight: a set point ^[10], which our body protects. It’s programmed in the early years of life – particularly during the first 2,000 days of life – from conception to five years of age.

Our genes ^[11] play a role in programming our weight set point. Just as DNA prescribes whether we’re shorter or taller than others, we’re born ^[12] with a tendency to be slimmer or bigger. But our genetic make-up is just a predisposition, not an inevitable fate.

Modelling healthy habits and positive attitudes towards food, exercise and body image in the family home will support your child having an optimum body weight ^[13] throughout their life.

This includes:

teaching your child about nutrition, covering the importance of the foods we eat and why certain foods are only eaten sometimes
making time for daily activity that focuses on the enjoyment of movement and not exercising to lose weight or change how we look
being mindful of how we talk about our bodies and avoiding making negative comments about weight or appearance.

2. Reaching for nature first

Expose your child to plenty of “nature’s treats” – for example, fresh fruits and veggies, honey, nuts and seeds. In their natural state, these foods release the same pleasure response in the brain as highly processed junk and fast food, and provide the nutrition their body needs.

3. Eating the full rainbow

Offer your child a wide variety of foods of different colours and textures. Cook family favourites in different ways, such as lentil spaghetti bolognese as an alternative to beef spaghetti bolognese.

Being a more adventurous eater helps develop children’s palates ^[14] and ensures they get the nutrients their bodies need for healthy growth and development.

4. Making mealtime relaxed and fun

Get the whole family involved in mealtimes. Improve your child’s innate appetite regulation ^[15] by slowing down and eating together at the dining table. Slowing down your eating means there is enough time for appetite hormones to be sent to the brain to tell you you’ve had enough.

Mealtimes that are relaxed and fun also help create positive associations with healthy eating, and help overcome food fussiness ^[16].

5. Playing every day

Consider the national activity guidelines ^[17] to understand your child’s exercise needs at each stage of their development. This is around 60 minutes of physical activity or energetic play for most age groups, and can be broken up into several smaller bursts.

Schedule regular time for activities that incorporate movement and a sense of play, such as active games together, exploring sports, and going on family walks and bike rides.

6. Revisiting screen time rules

Ensure your child has a healthy relationship with screens and has good sleep health by modelling healthy tech habits ^[18] and implementing simple rules such as making mealtimes and the bedroom at bedtime screen-free zones.

Create positive entertainment alternatives that bring the family together.