When Dara-Lynn Weiss's seven-year-old daughter tipped the scales at 42 kilograms, she put her on a stringent diet. Here, Weiss recounts how she saved Bea from the threat of obesity.
One night the whole family went to our friends' house for dinner, joining a number of other couples and a large contingent of kids. The kids ate ﬁrst: pasta and vegetables. With my daughter, Bea, safely out of earshot, I told the assembled friends about our new food strategy and how Bea was understandably grouchy about it. I pointed out how she had complained about how much smaller her pasta serving was than anyone else's, and how it was hard for her and tough for us to see her go through that frustration, but that it seemed necessary. Our friends were uniformly sympathetic and supportive.
A few minutes later Bea came into the room. "I'm hungry," she said.
Bea's request for food seemed to take on a searing significance in the wake of what I'd just shared with the grown-ups. I suddenly felt like there was a spotlight shining on us. I imagined that while everyone was continuing to eat, they were also listening to see how I would react to this tricky situation.
"You had dinner already," I reminded her.
"But I'm hungry," Bea said.
"Do you want some salad?" the hostess asked readily.
"No, thanks," I interrupted quickly. "She already ate dinner."
"I'm still hungry," Bea pointed out.
"Maybe you could have, like, a piece of fruit," I said, scanning the kitchen.
"If she's hungry, she can have some salad," my friend offered again.
"Okay," said Bea.
I stared at the Niçoise salad, full of tuna, eggs, potatoes - and olive oil.
"I'm sorry. Bea," I interjected. "It's got a lot of dressing on it, and ..."
"Just olive oil!" my friend interrupted. "It's super healthy!"
I forced a grim smile. "I know, but ..."
"Just a little!" my friend insisted, and pushed the bowl into Bea's hands.
I didn't know what to do. My friend was being a hospitable dinner hostess, responding caringly to a child complaining of being hungry. I was trying to be a good mother, an advocate for my child's health. But I also wanted to be a polite dinner guest. Bea happily devoured the salad as I sat silently.
I was mad at myself for not being more protective. I felt bad that I'd let her eat food we hadn't planned on, just to avoid some social discomfort. It wasn't the one bowl of salad that worried me. It was the very real fear that not sticking to our strategy 100 per cent, all the time, left the door open for more such moments to creep in. I'd been on enough diets myself and had tried enough half-hearted measures with Bea to realise what was required.
So next time, I spoke up. We were at Bea's cousin's birthday party. I saw her heading for the M&M bowl on the buffet table, even before lunch was served. "Hey!" I shouted. And, though grinning, I widened my eyes and opened up my hands as if to say, "What the hell?" Bea caught my gaze, slipped a few of the M&Ms into her mouth, and ran off.
When the kids sat down to lunch, each place setting featured a juice box. I replaced Bea's with a water bottle. "Aww, I want the juice!" she whined.
"I know, but it's just juice," I said with an exaggerated sneer, sending up its inconsequence, trying to forge an intimate camaraderie over the idea of wasting calories on a drink - like all the other kids were ignorant for mindlessly drinking what they were given, whereas she was the clever strategist. "We're going to have cake soon! So let's just drink water." She didn't argue.
When the cake was served, Bea literally licked her plate clean.
Amid the frantic goodbyes, goody-bag distribution, jacket-locating, happy birthday wishes, and general post-sugar-consumption mayhem, I saw Bea approach the buffet table again. She was staring at the cookie plate. I pushed my way through the crowd, calling out to her. "Bea! What are you doing?" I said, raising my voice above the din.
"I want a cookie," she said simply.
"You can't have a cookie," I said.
"Why not?" she asked. She knew why not.
"You just had cake! We had a whole discussion about what you were going to eat here. You could have had cookies, cake or M&Ms, but you cannot have all of them. You picked cake. You're done."
I'm not sure anyone paid attention to us. But I knew that if they had, they might've found the exchange embarrassing. The high-strung mum nagging her overweight daughter about cookies and candy. I imagined their thoughts: "Jesus, lady, what is your problem? Just let her have the stupid cookies. She's seven years old. This is her childhood. Childhood is cookies and birthday cake. Eating cookies is not a disease; it's a small, simple pleasure. You are ruining her innocent years by making every treat a sin. Did you ever weigh the damage of your nagging eye against her buoyancy and joy?"
To me, intervening when I saw Bea about to make a bad choice needed to become a reﬂexive reaction, like seeing her about to wander into a busy street. I didn't know if this anti-obesity undertaking could really work, but I did know that it was sure to fail if I gave in "just this once". In order to keep her resolve strong, my will could not bend.
While these minor public scufﬂes over food weren't fun, I didn't think they were so different from the mum-versus-kid limit-setting disagreements many other families engage in over sweets. What did get significantly more stressful were the times when I turned Bea over to the care of another adult and returned to ﬁnd that bad choices had been made while she wasn't on my watch. At those times I felt frustrated and helpless that I couldn't control everything.
Part of the problem was that communicating Bea's nutritional needs to others was a delicate matter. "If you had a peanut allergy, I would be telling your friends' parents that you couldn't have anything with nuts," I insisted. "Your problem is that you are overweight, so you can't have things with lots of calories. It's not that different."
Ironclad logic, right? Bea didn't see it my way. She thought I was being annoying, unfair and a drag. I understood her feelings, but I see how obesity is annoying, unfair and a drag. Life isn't fair. Imparting that wisdom to our children is an inevitable part of parenting. Obesity is a medical condition, not just an aesthetic one. It can be a life-threatening disease, so it makes sense that we would treat it as such. No one should be any more embarrassed by it than they are to have epilepsy or attention deficit-hyperactivity disorder. Was admitting to being overweight any more humiliating (or obvious) than just being overweight? Wasn't it less embarrassing to acknowledge it and let people know you were aware of the problem and doing something about it?
My MO has always been two-pronged: cover up my ﬂaws as best I can, then lay them out on the table for discussion to expose my insecurity pre-emptively. Throughout all the years that I've battled with my weight, even as I sought to hide my body under layers of obfuscating clothing, I fessed up about my feelings to others. I was the girl you could overhear groaning, "Ugh, I am so fat," as I patted my distended belly. If I had an obvious pimple on my face, I would attack it with concealer, then ﬁnd a way to work it into conversation, just so everyone knew that I knew that they noticed it, and they shouldn't feel awkward about it.
In Bea's case, to allay the potential awkwardness involved in discussing an obese child's dietary restrictions, I wanted to be very plain-spoken about our predicament. But Bea wasn't a fan of that approach, so I usually conﬁned my dictates about what Bea could eat to phone calls, text messages or emails with her friends' parents or care-givers before the play date started. The problem, however, was that even when the information was communicated, parents of kids who were not overweight often failed to grasp the strictness of Bea's eating limitations.
For Bea, who was there to play and who would no doubt much rather join in fully, all this could be confusing. What was she supposed to do when presented with a snack she coveted, which her friend was eating, and which a grown-up entrusted with her care had chosen for her? Of course she accepted the snack every time. Then I'd show up, and a little hell would break loose.
So Bea wouldn't feel singled out, my husband Jeff strongly believed the whole family should be in it together. We received a breakdown of how many "green lights" (which loosely translated into units of 100 calories) we got at each meal and snack. We were given a reference book listing how many "green lights" are in common foods and how to calculate the trafﬁc-light value of any other foods. Two green lights were exchangeable for a yellow light, four were exchangeable for a red light.
We would be required to eat a certain amount of fruit and vegetables every day and not to overdo it on unhealthy foods. But within our allocation of trafﬁc lights, we could pretty much put together our own daily menus. I was pleased that our nutritionist wasn't one who just told you junk food was bad and whole grains were good, or who encouraged you to squeeze more fruit into your diet without taking anything else away. This was someone who understood that overweight kids need to eat less.
She explained that there are two kinds of diets: the calorie-restriction method, in which you eat any kind of food but limit your quantities, and the approach where you don't count calories but limit your food options (such as low-carb diets). She didn't think either system was particularly successful. Her program was a combination: limiting overall calories but also encouraging better food choices.
Bea and I got two green lights for breakfast, three for lunch, and one for each of two snacks. While Bea got three green lights at dinner, I got four. Bea's brother, David, got several more green lights, since he wasn't trying to lose weight. And because of his size relative to the rest of us, Jeff got the most green lights of all, including a whopping seven at dinner.
Approximately once an hour, every hour we were together, Bea could be expected to complain, "I'm hungry!" But what did that mean? It was, of course, possible that her stomach was really too empty. But given what I saw her eat and how quickly she claimed to want more, that seemed unlikely. I'd also read that sometimes hunger was actually thirst in disguise. Was she maybe just thirsty? I suggested water, but that recommendation never went over too well. I wondered whether she was confusing a generalised desire for food with physical hunger. It's an error most people fall victim to, myself included. There's hunger and there's appetite. It can be hard to tell the difference. Then there are the times when emotion drives appetite. Maybe she was bored, tired or stressed, or maybe she needed some special attention from Mum. Maybe complaining of being hungry was a way to seek comfort. I started challenging the veracity of Bea's statements that she was hungry.
I think I have a pretty good ability to detect when one of my children is actually sick or hurting and when he or she might be inventing an ailment in the hope of getting out of going on a boring school field trip. But one can never be sure. So it was with Bea's hunger. It strained credibility for her to claim to be as hungry as she was as often as she was. But I couldn't really say with complete certainty that she wasn't.
My ﬁrst step was to ask her to really think about whether she was hungry.
"Lunch was an hour ago, and you just had a bowl of soup and a banana as a snack. Are you sure you're hungry right now?"
"I'm sure," she replied.
Instead of sighing and giving in, as I had done previously, I introduced a new and controversial concept: hunger appropriateness. I told her she might well be hungry, but she shouldn't be. She'd had enough to eat. She was going to eat again soon. Now was not an acceptable time to be hungry. If she was, indeed, truly physically hungry, perhaps it was best that we teach her body not to be hungry when she's had enough to eat. Thus I'd refuse her the requested snack - even the heretofore permissible-at-any-time fresh fruit or vegetables - and tell her to have some water instead. She'd just have to wait until the next meal or snack which, I reminded her, was never that far away.
I went over and over it again in my head: was I right to try to teach her new, more healthful habits, including the idea that one shouldn't just eat constantly throughout the day? She had demonstrated an inability to regulate her own food intake. Weren't limits in order? Or should a young, growing child have the right to need to be fed constantly, and should I adapt to that demand instead of ﬁghting against it?
On the one hand, I wanted to give Bea a pass about her weight, let her be a kid. I didn't want to overwhelm her with concern about her health, her body, or food at such a young age. I worried that doing so would have adverse long-term effects, making her insecure or obsessive or saddling her with lasting eating issues. But on the other hand, childhood obesity is a clear and present danger. I wasn't trying to slim Bea down a few centimetres - I was treating a disease, potentially saving her from diabetes, hypertension, heart disease, even early death. When I told myself that, I'd feel better momentarily.
Bea stepped on the scale, and i had a moment of reﬂection. I recalled the previous year's weigh-in at 42 kilograms. I remembered the worry over whether I could help her, of my determination to help her, of the effort of helping her, of the frustrations and triumphs and surprises and disappointments. All, it seemed, leading up to this moment.
The digital scale displayed her weight as ... 35 kilograms.
There it was. The magic number we'd been working towards, ﬁnally appearing on the scale.
"She lost weight, that's great," the paediatrician said as breezily as she'd declared Bea's weight problematic the year before. "She doesn't need to lose any more."
There it was: the ﬁnal word. We'd done it. Mission accomplished.
Or was it?
When our appointment ended, Bea got dressed and we stepped outside of the ofﬁce. I looked at her, beaming expectantly as we walked down the street. But she said nothing.
"How do you feel about all the weight you lost?" I asked her when we got home.
"Good," she said, blandly.
"Do you like the way you look now?" I asked.
"Yes," she said, definitively.
"Do you feel different?"
"No. That's still me," she said. "I'm not a different person just because I lost seven kilograms."
The tone had become unexpectedly heavy. I felt a small pit in my stomach. I pulled her onto my lap and pressed my cheek against hers.
She went on. "I'm not comfortable with saying, 'Oh, yeah, I've changed everything and everything's going to be perfect for the rest of humanity,' " she said. "I've changed half of the way, but not ﬁxed my entire life. Because that isn't true. Who can ﬁx their entire life when they're eight?"
"Well, no, of course you haven't changed your whole life. But you're not overweight anymore. You did ﬁx that. That part of you is in the past."
Her body tensed in my arms. She began to tear up. "Just because it's in the past doesn't mean it didn't happen," she said.
The outcome of Bea's diet was, to her, not a victory, or even really an ending. She understood, even though I hadn't, that it was glib and reductive to act like her experience was one worthy of glee. Her maturity in realising this, and her intelligence in articulating it, ﬁlled me with pride and sadness in equal measure.
If I wondered why Bea couldn't revel in her success, I needed only to look at myself. No matter how well I controlled my eating, I still had feelings of fear and guilt around food. No matter how many kilograms I lost, another diet was just around the corner. Regardless of how far I had come since my younger years of obsessive dieting and negative self-image, I still had a complicated relationship with my body. And even if my eating and weight issues had evened out as I got older, I'd spent many years being victimised by them, and I knew that was a tragic waste of energy, time and self-esteem.
I am not an alcoholic, but I feel like I understand the mindset of a sober alcoholic. You are managing your disease and have it under control at that moment. But it's still there in you. You think differently to non-alcoholics. You must manage your behaviour more stringently than someone who does not share your addiction. It will always be a part of who you are. There are similarities with being overweight. You can manage your weight, control your eating, even become thin, but that tendency is still inside you.
I had believed that I could set Bea on a different track, that I could "cure" her of being overweight by changing her eating habits before her self-image dimmed so much that she came to think of herself as a fat person. But I was too late. Or maybe it was never possible. She had indeed changed her body and her lifestyle, but the metamorphosis was bittersweet, because it had cost her some of the innocence of her childhood.
I live with the worry that this experience will somehow hurt her later in life. I fear the possibility that she may develop an eating disorder, though it's impossible to predict.
Parental pressure is frequently faulted by people suffering from eating disorders, but so is parental failure to intervene with weight and food issues. It's a lose-lose proposition for parents. But maybe a parent's attitude toward food and weight is not as central to the issue as we think. In 2002, a genetic link was found to eating disorders. One of the researchers stated that as far as the onset of eating disorders goes, "sociocultural factors are only important in that they might elicit an expression of someone's pre-existing genetic predisposition".
Food was not a fraught issue in my household growing up, yet I developed problems with it. There are some issues that kids are just born with. I didn't make Bea obese. I don't blame sugary drinks, processed foods, trans fats or gargantuan portion sizes. She didn't become overweight because she gorged on junk food or played video games all day. She was simply and indisputably born with the unfortunate tendency to overeat and a congenital preference for foods that are conducive to weight gain.
And the risk of an eating disorder? There, too, I think that's either in Bea's DNA or not. I hope like crazy that it's not, but only time will tell.
Frankly, I'm far more concerned about the greater likelihood that Bea will suffer the kinds of nagging concerns about her weight that most girls and women do in our society. I am hopeful that the practical and emotional tools we have helped her develop - not the least of which is a comfort level in discussing weight and food, and knowing what is healthy and appropriate - will be useful to her in that area.
Even though I stand by the path I took, I believe Bea deserves most of the credit for what she accomplished. At age seven, she accepted an eating regimen that most other kids would have roundly rejected. She had the maturity and foresight to understand that the sacriﬁces she has to make now have a long-term payoff, and that's not something a parent can take for granted in a child so young.
One thing is clear to me: had I been any less strident, any more ﬂexible, we would have failed to get Bea healthy. Had I not opened my mouth - loudly, at times - to intervene when she was eating the wrong thing, or when someone was giving her something they shouldn't, or when she wanted to skip karate, or take a cab when we should walk, I can assure you, Bea would still be overweight. Because, as I've said, those little challenges happen every single day, sometimes every hour! If committing to enforcing healthy habits makes me appear humourless and harsh, then so be it. That is what it takes.
It's not like anyone expects leniency in other areas of children's health and safety. Most parents I know won't start their car until their kids' seat belts are fastened, period. But somehow, when it comes to eating, our anxiety about our children's feelings overrides our concern for their health. Once I understood that her weight problem was a disease, I had no choice but to treat it as such.
Edited extract from The Heavy: A Mother's Battle Against Her Seven-Year-Old Daughter's Obesity, by Dara-Lynn Weiss, published by William Heinemann on Friday.
The big picture
About 6 per cent of Australian children are obese. But, unlike adults, they aren't getting any more so. The proportion of obese children in Australia is about the same as in 1995, according to University of Sydney nutrition education professor Jennifer O'Dea.
In the decade before that, childhood obesity tripled, rising from 1.5 per cent to 5 per cent as fast-food consumption and sedentary behaviour rose and the scale of studies increased.
Obesity is measured by the Body Mass Index, or BMI (based on an individual's weight and height), though calculating a child's BMI is more complicated than it is for adults, where those with a score over 30 are classified as obese.
O'Dea recently completed Australia's largest longitudinal study into Australian children's weight and found a strong correlation between obesity and ethnicity. Just 4.9 per cent of Caucasian children were classified as obese, compared to 5.8 per cent of Asian, 9.8 per cent of African, 12.2 per cent of Aboriginal and 22.7 per cent of Pacific Islander children. This suggests obesity is grounded in ethnicity. But it could also reflect the limits of the BMI, which measures a child's height and weight but cannot account for greater muscularity.
Boys (7 per cent) were more likely than girls (5.5 per cent) to be obese. Estimates of the number of obese children who become obese adults range between 25 and 50 per cent. About 8 per cent of teenage girls were vomiting to try to control their weight, while 30 per cent of adolescents were on a conventional diet.
O'Dea's research suggests the strongest predictors of a child being classified obese include coming from a family with low socio-economic status, skipping breakfast and not sleeping enough.
– James Robertson
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