Your Child’s Weight: Helping Without Harming (Book Review)

Every parent and dietitian should read Ellyn Satter’s Your Child’s Weight: Helping Without Harming.  Ellyn Satter is a registered dietitian and family therapist, and is considered to be the leading expert on feeding and raising healthy kids.

In the book, Satter refutes the idea that parents must force their children to eat less and exercise more to lose weight.  In the long run, this technique backfires, as children become preoccupied with food and turned off to physical activity.  Rather, Ellyn coaches parents to feed well, parent well, and allow children to grow up to get the bodies that are right for them.

For a summary of the books main points, read on, or click here for a PDF summary from Satter herself.

Feed well.

Feeding embodies your entire relationship with your child.  Feeding your child is nurturing your child, and it should be about providing, not restricting.  Restricting hurts both emotionally and physically, and in the long run it will make your child fatter, not thinner.

To feed well, start by having regular family meals.  Family meals are more important than most people realize.  Not only do family meals teach kids how to eat well, they also provide kids with reliable social and emotional support.  Children who have regular family meals do better in school, have better mental health, and display better social skills.  Make family meals rewarding for everyone by following these tips:

• Prepare and serve food that you enjoy.  It doesn’t all have to be healthy.  Find a balance.
• Put 4-5 foods on the table and let everyone pick and choose what they want.
• Teach and expect your children to behave nicely.
• Understand enough about children’s normal eating behavior to feel successful with feeding.
• Follow Ellyn Satter’s Division of Responsibility (below).

Follow Ellyn Satter’s Division of Responsibility.

Ellyn Satter’s Division of Responsibility states that:

• Parents are responsible for the what, when and where of feeding.
• Children are responsible for the how much and whether of eating.

In other words, if parents do a good job with feeding, they can relax and trust their child to do a good job with eating.

Parent’s feeding jobs:

• Choose and prepare the food.
• Provide regular meals and snacks.
• Make eating times pleasant.
• Show children what they have to learn about food and mealtime behavior.
• Do not let children graze for food or beverages between meal and snack times.
• Let children grow up to get the bodies that are right for them.

Children’s Eating Jobs:

• Children will eat (although sometimes erratically, this is normal).
• They will eat the amount they need.
• They will eat an increasing variety of food.
• They will grow predictabily.
• They will learn to behave well at the table.
• Gradually, during school age and teen years, your child will learn to manage the what, when and where of feeding for himself.  Slowly dole out responsibilities as they demonstrate responsibility to handle them.

Parent well: physical activity.

Ellyn Satter also promotes a division of responsibility with physical activity:

• The parent is responsible for providing structure, safety and opportunities to move.
• The child is responsible for deciding how much and whether to move.

In other words, if parents will provide fun and safe opportunities for physical activity, the child will take care of the rest.  Children are naturally inclined to move and find joy in active play.

Parents jobs:

• Provide safe places for activity that the child enjoys.
• Find fun and rewarding family activities.
• Provide opportunities to experiment with group activities such as sports.
• Set limits on TV but not on reading, writing, artwork or other sedentary activities.
• Remove the TV and computer from the child’s bedroom.
• Make children responsible for dealing with their own boredom.

Children’s jobs:

• Children will be active.  Each child is more or less active depending on natural inclinations.
• Each child is more or less skilled, graceful, energetic or aggressive, depending on natural inclinations.
• Children’s physical capabilities will grow and develop.
• Children will experiment with activities that are in concert with their growth and development.
• Children with find activities that are right for them.

Know how to read your child’s growth chart.

Children grow predictably, usually along a similar path on a growth chart.  According to Satter, it doesn’t matter if the child is at the 5th percentile or the 95th percentile, as long as he/she is tracking along the growth chart.  There is only an issue if a child’s weight is accelerating or decelerating, and rapidly crossing growth chart lines.  (Slow and gradual change across the percentiles is typically normal.)

If a child’s weight is rapidly accelerating or decelerating, Ellyn asks, “What is undermining this child’s natural ability to grow in a way that is right for him/her?”

Usually, Ellyn finds that the cause is restrained feeding, poor feeding practices or stress.  Forcing food, restricting food, or allowing children to graze all day can all cause weight issues.  The solution?  Follow the division of responsibility, and the growth pattern will begin to track appropriately.

Allow children to grow up to get the bodies that are right for them.

Satter recommends that you let go of any agenda that you (or your child’s doctor) may have regarding your child’s size or shape.  Feed well, parent well and help your children to feel good about themselves at any size.

Questions?  Comments?  Let me know what you think.