This is a hard post to write. I debated doing it at all, but it’s on my mind, and as I’m sitting here trying to think about all the things that I could be writing, this is the one thing that keeps coming up. It feels like lately, everything in our lives revolves pretty much around L., our precious, perfect, flawed, struggling little boy, and figuring out how to stand up for him and do what we believe is best…in so many different ways.
We had another pediatrician’s appointment the other day, which was supposed to be just one of the check-ins we do every couple of months to talk about how his PT and OT are progressing and whether or not he’s getting closer to being on track for his age, developmentally. The answer, luckily, is yes — he’s actually even close to being kindergarten ready across the board, which is a surprise considering that his motor skills were closer to those of a 2-year-old than a 4-year-old just a few months back. Academically, he’s well ahead of the game. Physically, he’s catching up. Socially and emotionally, he’s right in the middle, pretty much — but where he’s behind, it’s noticeable, so we’re still committed to keeping him back for the year and starting kindergarten at age 6. With his late-summer birthday, it’s a fine solution, even if he didn’t have a diagnosed disability.
I was happy to be able to give all this good news to the doctor, and she seemed happy, as well as surprised, to receive it. L.’s dazzled us all with his amazing progress. But as my son sat quietly on the chair next to me, dreamily regarding the safari animal poster on the wall, the doctor arranged her laptop so I could see it and said “This is STILL a problem.”
“This” was L.’s growth chart. I should’ve figured.
Yup. Still heavy. No, not insanely so. But bigger than the other kids. And this time, he hadn’t grown as much taller as he had just gotten heavier. Of course, as his mother, I happen to have that perspective on his habits and cues that allows me to realize he’s likely approaching a growth spurt, which was the first thing I pointed out. (The doctor, by the way, agreed that based on all of his records, that’s a very likely immediate possibility.) But she’s still concerned, and concerned enough to really want to dig into the point with me.
“Look,” I said. “I understand what you’re saying to me, about him being heavy. This is not new. But you’re really going to have to help me out here, because I cannot figure out what we are doing wrong.”
For the first time, she sat down with me and asked me to detail his daily diet — something we haven’t done before. And looking at the page afterward, she said, “I wish it were easier than this.”
Ordinarily, she said, she would ask for this information, and she’d hear about Cheetos for snacktime and sugary cereals for breakfast. Sweetened drinks all day long and desserts every night. She had wanted it to be that, secretly, I think. She had wanted to be able to tell me the simple solution: Stop feeding your kid junk. And faced with the reality of what we’ve been giving L., she couldn’t.
I had a moment of hope, of thinking that we’d talk about activity levels and routines and genetics and whatever else you talk about when you’re feeding your kid fruits and vegetables and real food from scratch, but that kid is still bigger than he ought to be. But she squared her shoulders. “He must just be eating too much of it, somewhere,” she said. “It’s all healthy food, but the only answer is that it’s a simple equation, and the calories in must be too much.”
The recommendations followed: Measure out L.’s plain Cheerios in the morning, and don’t allow him to eat the cup we were giving. (1/2 to 3/4 maximum, she encouraged. And nothing else.) No more occasional small treat after dinner if he’d had a reasonable diet all day long. Not even one homemade cookie. No more few little pieces of dried fruit in his lunchbox. And for the little bit of milk he uses on his cereal, and the one cup or so a day he drinks, switch from the one percent we do give to skim.
I left with my head spinning. Where had we gone wrong? Where have we gotten into such a predicament that we’re essentially talking about putting our 4-year-old child, who eats a healthy, varied, unprocessed array of foods, on a diet? Since when is restricting Cheerios the answer?
The more I thought about it, the more I started to feel scared, and helpless, and angry. For a few pounds of baby fat, we’re going to completely shut down any and all desserts, ever? Take away a couple of slivers of dried mango? Obsessively portion-control his unsweetened cereal? And what kind of message is that going to send to him about his body, and about food in general?
J.’s response was swift and decisive. “That is crap,” my wonderful husband declared. “We can find solutions to this, yes. We can change some things, yes. But we’re not going to make this a food police state, and no way am I going to measure out his food. He. Is. Four.”
Clearly we have some decisions to make, and we’re talking them through carefully. I don’t want L. to be heavy, for many reasons. But what’s really ringing in my ears is the doctor’s pronouncement that with everything he has to deal with in life, “He doesn’t need to be the FAT KID, too.”
If J. had been there, he says, he would have responded with, “Oh yeah? Well, most of the other kids he knows are skinny, and they eat nothing but day-glo mac and cheese and neon yogurt tubes and hot dogs all day long. Would you recommend that we put him on that kind of a meal plan?”
I almost laughed when he said it at first; but I understand his point. This debate, both in our family’s lives and in our nation, continues to be about the wrong things. It should not be about weight. It’s about health.
What we will not do: Restrict portions (beyond a reasonable measure, of course) of healthy foods because of a terror of calories. Buy into the flawed reasoning that skim milk is a “better” or even more slimming choice just because it’s got less fat. Become unreasonable dessert-deniers, petrified that every crumb of every sweet that ever passes his lips will tip the scales from “a little heavy” to “poster child for childhood obesity.”
Because it’s not about weight. It’s about health.
We will not allow ourselves to be brainwashed into the faulty American system of thinking that if something has fat, or carbohydrates, or calories of any kind (God forbid), it is going to cause obesity. The more we as a country have departed from whole, natural foods, whatever their nutritional profiles might be, the fatter we’ve gotten. The more low-fat, low-carb, chemically adulterated versions of “food” we consume, the worse off we are. We will not begin this insane, destructive, Calorie-Counters Anonymous cycle of worrying first about how bad a food might be for you rather than thinking of how GOOD it might be. Not at the age of four. Not ever.
Because it’s not about weight. It’s about health.
What we will do is be sure that L. moves more. He’s finally learning to coordinate his body, and building the strength and endurance he needs to be able to sustain activities at a level closer to what his classmates can achieve. He’s starting to like exercise. He’s even finding things, like swimming, at which he’s actually pretty good. I suspect that before we count fat grams and calories, we ought to try counting minutes of fresh air and physically active fun.
We’ll re-examine treats in general. While we’ve never offered lots of them, to be sure, the occasions where we’d offer something small to L. after dinner definitely have become a bit more frequent; he’s gotten to be such an excellent, well-rounded eater, that after a day’s intake of fresh vegetables and lean protein and a good serving or two of fruit (miraculous for him), we couldn’t find fault with offering a small cookie or a few chocolate chips. He’s gotten something like that, oh, maybe 3-4 times a week lately. For many kids, that kind of moderation may not be an issue; for him, maybe it is. We’re embarking on a new family policy of choosing one night, preferably on a weekend, when we will all enjoy something sweet together: a small scoop of good ice cream at the local shop, which the boys love, or a dish of homemade pudding. That way we can all look forward to it, and we’re not setting a destructive pattern of total deprivation that will lead him to want to binge on sweets whenever he sees them.
Because it’s not about weight. It’s about health.
We’ve already switched over, without incident, to plain water or seltzer for all beverages, except the one glass of milk he drinks at dinnertime. We’ll stay vigilant about that. We’ve already phased in larger portions of more vegetables, and smaller portions of meat and carbs, as he’s gotten older and more receptive to a wider variety of foods. We’ll continue to do that.
We’re also taking this as an opportunity to re-address the weekly breakfasts out with G. and P. While they’ve ceased to offer the dessert platters masquerading as meals, I know there’s still far more sugar, far more refined junk, far more of EVERYTHING than he really needs in those “breakfasts.” And when they’re offered on top of his usual daily meals, it occurred to both J. and I that — right there, in one fell swoop — the whole problem of extra caloric intake might be solved.
What saddens me is that we have to approach all of this, at least outside our home, from the angle of talking about my child’s body size; that when we have to invoke the “f” word for anybody to regard us seriously. It shouldn’t be about that. In none of the decisions we are trying to make for L. are we worried at ALL about whether his BMI is such and such, or he’s 2 pounds heavier than the growth chart recommendation, or if he’s even the chubbiest kid in his class (he’s not, just for the record). We, as his parents, are concerned about his HEALTH. Physically, Emotionally, Spiritually, his well-being.
And that is where I part ways with the public discourse, friends. Because I can tell you with great sincerity that it is possible to do everything “right” and STILL have a kid who contributes to the alarming national statistics; that just having positive lifestyle factors may not be enough to stop your kid from being, as our pediatrician so bluntly put it, “The Fat Kid.”
Or maybe he’s not the Fat Kid. Maybe he’s just a big kid. Maybe he’s going to grow; maybe he’s going to become more active; maybe he’s been putting on muscle along with that baby fat, as he’s learned to do things that were impossible for him before. I don’t know. I don’t care. I don’t want to make excuses, but I’m crying foul.
Dear Doctors and Activists and School Administrators, please, please hear this one thing. I don’t mind if you want to talk about my kid’s diet. I don’t mind if you want to talk about lifestyle factors. I don’t mind if you want to talk about anything we do in our home with our child, if it’s in the interest of looking out for his well-being. But I want you to do that with EVERY family, regardless of what the “numbers” say — with my family as well as the family of the skinny kid, and every family with a kid somewhere in between. Ask us ALL what we eat. Get a picture of what’s going on in ALL our homes and around ALL our tables.
Because. I can’t say this enough. It is not about weight. It is about health. And until we focus on the real issue and stop trying to create target populations based only on ONE factor, we’ll never change what’s really at the root of all of our problems. It’s not fatness that’s killing us all slowly; fatness may be, for some people, the byproduct, but it’s not in and of itself the issue. Divergences in body shape and size have always existed. Aside from wild, extreme swings away from the statistical averages, discrepancies and variations are part of what makes us human; and frankly, a standardized “growth chart” or “BMI measurement system” or anything else that pushes severe panic buttons when anyone falls even slightly outside of its range does nothing but encourage us to seek answers where they may not even be needed.
It is not about weight. It is about health. And until the day when we can all say, with great sincerity and truth, that we’ve done our best to make certain our children are absolutely healthy at any and every size, we will not have done what is necessary and called for. We will not have solved the real problem.