When Kids Gain Weight:
A Health at Every Size® Dietitian's Approach
By Billie Karel, MPH, RD, LDN, CDCES
As a dietitian, I use the Health at Every Size® approach to help people with chronic health conditions. This approach takes the focus off weight to pursue changes in your relationship with eating and movement that support your health and authentic well being. This doesn’t mean I’m “weight blind.” It means I’m very deliberately learning to identify the harmful false assumptions our culture makes about weight – collectively known as “diet culture” – so that I can avoid unintended harm to my clients!
According to the Association for Size Diversity and Health (ASDAH): “The Health At Every Size® (HAES®) approach is a continuously evolving alternative to the weight-centered approach to treating clients and patients of all sizes. It is also a movement working to promote size-acceptance, to end weight discrimination, and to lessen the cultural obsession with weight loss and thinness. The HAES approach promotes balanced eating, life-enhancing physical activity, and respect for the diversity of body shapes and sizes.” (More from ASDAH and from the HAES Community.)
We can normalize gaining weight as we grow, appreciate how kids' bodies know just what to do to grow up into adults, and help our child figure out how to keep their body comfortable.
Diet culture incorrectly assumes that gaining weight is always bad, losing weight is always good, and controlling weight is something we could and should do. Through diet culture-tinted glasses, it looks as though being thin is a reward for being good and smart and diligent, and that being fat is the price some pay for being lazy, weak-willed, or unintelligent.
When we take off those glasses, we can see how that black and white framing of weight is so unfair and causes so much harm! Each person’s weight is, in truth, an outcome of many complex factors: genetic blueprint, socioeconomic and environmental factors, stress (chronic and acute), eating and activity patterns, health conditions and medication side effects, for starters. Most of these are simply not within our control as individuals and, what’s more, we are not morally obligated to control them to be good humans. By freeing ourselves of that notion, we can each tend to our health and well-being from a foundation of self-compassion and respect.
We may not be able to totally shelter our kids from diet culture, but we can ground them in a strong counter narrative: that gaining weight is a normal part of growing up and being a human, that kids’ bodies and grown ups’ bodies come in all different shapes and sizes – none inherently more valuable than the other – and that our value as people does not depend on beauty, size, or health.
How can we have HAES®-informed conversations with our children about weight gain?
During some phases of childhood, it is normal for kids to gain weight relatively quickly. If our kids express distress about those changes, we can empathize with how strange it can feel when our bodies change *without implying that smaller would be better.* Instead, we can normalize gaining weight as we grow, appreciate how kids’ bodies know just what to do to grow up into adults, and help our child figure out how to keep their body comfortable. Just as we might help them find new deodorant or facewash to help with other body changes in puberty, we can help them find new clothes or anti-chafe cream or whatever might help when their bodies get bigger.
How can we handle our own worries if our child gains what seems like a lot of weight?
Hold tight to these two truths:
One, it isn’t your job to control your child’s body size.
Two, weight gain happens for good, neutral, bad, or mixed reasons.
In many cases, rapid weight gain is simply part of a child’s normal growth and development and absolutely nothing is wrong. Your child may be growing right along the same growth trajectory they’ve been on since early childhood, or they may be gaining more rapidly before or after a period of rapid height growth. Or, they simply may be growing into a more adult-like body. If you’re not sure, it’s worth consulting with your pediatrician or a HAES® pediatric RD, but please be sure to do so out of your child’s earshot. The American Academy of Pediatrics actually recommends against discussing weight directly with children because of evidence for more harm than good.
Some other good or neutral reasons a child may gain a lot of weight might be improved appetite after a period of illness or stress, improved access to food or ability to eat after a time when things were restricted, side-effects of medications (good/neutral if the medications are working for their stated purpose!), and more.
There are some bad things that can contribute to weight gain such as sleep dysregulation, heightened stress, illness, injuries, or food insecurity. If that’s the case, the weight gain may be the thing you notice, but your effort and concern are best directed at the root issues. If eating more is part of how your child is coping with something hard, that is valuable. They don’t need to feel badly about it and neither do you! However, it may show you that your child needs more support. In times of struggle, you can help your child learn to listen in to what their amazing body needs to keep them safe and well, to practice coping skills and problem solving, to get support, and to cultivate self-compassion and self-worth no matter what.
Your child’s weight isn’t your job to control or “fix.” If they are coping well and recovering from hardship, building resiliency, and growing a compassionate heart, you will have done your job!
A few more resources for HAES® parenting:
Sunny Side Up Nutrition (blog & podcast)
Raising Body Positive Kids in a Body Negative World (article)
Virginia Sole Smith‘s writing, and the Comfort Food Podcast
Billie is a Certified Diabetes Educator, and uses a weight-neutral approach to diabetes and prediabetes nutrition and self-management that emphasizes self-compassion, skill building, and joy in eating. She also specializes in nutrition for children and families and enjoys supporting parents at all stages of feeding their kids, from pregnancy all the way through adolescence. In addition to her work at Lutz & Alexander, she works as a primary care nutritionist and diabetes educator at Advance Community Health. When she’s not working these days she can usually be found chasing her toddler around any of downtown Raleigh’s lovely playgrounds and museums. Billie holds a Bachelor of Arts in Human Biology from Stanford University, and earned her Masters in Public Health in Nutrition from the University of North Carolina at Chapel Hill. She meets with clients at Lutz, Alexander & Associates’ Raleigh office.
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