What to do When a Parent Wants Their Child to Lose Weight: Creating Body Image Issues in Children

Consider the following scenario: a parent schedules a nutrition appointment for their child stating that the child wants to lose weight. Once I meet the child during the intake appointment, it is apparent that the child is not interested. Rather, it seems that the parent wants the child to lose weight.

As a dietitian, what is my role when this happens? I will explain, but first I will take a step back to tell you about how I conduct a nutrition intake appointment. There is always a reason that brings a patient into an appointment--what they want to get out of it. When I do an intake, I may discover other reasons to work on nutrition. Or I may discover other priorities that are more important than nutrition.

When a parent wants their child to lose weight, I need to clarify the situation and motivations. Sometimes "weight concern" is how the parent phrases their reason for coming, but there are also underlying weight-related health issues, such as diabetes or elevated lipids. With these parents, a conversation can help the parent have better language to use when speaking to their child about nutrition. For some kids, focusing on weight is so distasteful, and they are understandably resistant. A child may be more receptive to a more medical reason to improve nutrition.

Sometimes bringing the focus away from weight does not help the child engage. In these cases, I would be concerned that working with a dietitian will do more harm than good. When that happens, if might be best to hold off from working with a dietitian at that moment.

If there are underlying medical concerns related to a higher weight, and the child is not ready to engage in nutrition change, there are other ways you can help your child. Working with a therapist may be helpful for your child to build more responsibility and initiative. Or, consider asking your child's pediatrician for help, and maybe they can bring up improving nutrition directly with your child. You can even ask your child what they think will be helpful for them to improve their health. Their responses may be really enlightening. Other times, you may have to put nutrition change on hold and readdress it at a later date.

Sometimes "weight concerns" are a term a parent uses to encompass weight-related health concerns, but sometimes "weight concerns," is simply the parent wanting their child to be thinner, with no current medical concern. Although this child might be at higher risk for health concerns over the upcoming years, it is important to put that aside completely for the time being and first address the pressing child-rearing concern.

Parents showing their dissatisfaction with their child's body gives a very unhealthy message to the child. Children may hear and believe that they are ugly, unlikable, not attractive, not worthy of friends or romantic relationships, or even overall not worth anything. If you want your child to be thin for no reason other than outward appearances, I really encourage you as the parent to work with a therapist who specializes in body image issues and disordered eating. Only once you understand your motivations and hone in on the values you want your child to hold, you may be able to address health concerns with your child.

Overall, I think the most important message parents must understand is that their motivation matters. A child can see and recognize a parent's values. Children who hear messages about their body being a problem can end up having poor body image that follows with them the rest of their lives.