I hadn't thought much about my daughter's weight. Yes, she was a little bigger than the other girls in her friendship circle, but she was healthy and active too.
My GP on the other hand, was concerned. Ava's BMI was on the high side – in fact, according to the chart on the doctors wall, she was most definitely "overweight". Pointing out the sharp line on Ava's growth chart she frowned, "we need to get this under control" she said.
We talked in whispers while Ava drew a picture in the corner. I answered questions about Ava's diet and lifestyle – yes, she does have a big appetite, no, she doesn't watch a lot of TV.
The advice was standard; I should take Ava to see a dietician. I took the referral and agreed with the doctor that it would be better to get Ava on the right track. But as I stuffed the white envelope into my bag I felt a pang of apprehension.
Ava has always been a happy child. She has lots of friends and a cheeky streak that no one can resist. But this issue with her weight is threatening to jeopardise that. She's been saying things like "I wish I could be skinny" and "If I wasn't so fat I'd be able to run faster."
I asked myself some big questions that week. I took a step back and looked at our family lifestyle through fresh eyes. With both of us working full time we have been cutting some corners – too many dinners out, too many café treats on the go. We've given in to 'pester power' more than we should have.
On the other hand, Ava is a very active girl. She swims, plays footy and takes dance classes. In addition to organised activities we are an active family – we go for walks and bike rides. My partner and I are both fit too – hopefully setting a good example.
I weighed things up. If I took Ava to a dietician then I would have the support of a professional. The dietician would be able to explain things to Ava without emotion. Perhaps, Ava would listen more objectively.
But despite this, there was also a very real risk that taking Ava to see a dietician would exacerbate the negative feelings she had already started to express about her body. I didn't want Ava to think that her body was wrong and needed to be fixed.
I decided that Ava's self esteem wasn't worth the risk. But I was mindful that our GP also had Ava's best interests at heart. I did my homework – I scoured the Internet for the best dietary advice for youngsters (especially the official guidelines available from the Dieticians Association of Australia) and spoke to my partner about the small changes we could make as a family.
It was important to me that the changes we made were positive and subtle. There was no point in giving Ava a negative message about her body or her appetite.
The last thing I wanted was for my gorgeous girl to think we'd put her on a diet – I didn't even want her to hear the word diet. It is such a loaded word for so many of us, but it doesn't have to be for our kids.
Three months later I went back to my GP to put my mind at ease. We spoke discretely while Ava played and I explained why I had been reluctant to use the refurl. She nodded along and listened to the new strategies I had put into place – better portion control, fewer snacks and more vegetables.
After weighing and measuring her, the GP plotted the new information on Ava's growth chart. There was only a small shift in the right direction, but it was a shift that reassured our doctor we were tackling the issue head on. Keep it up, she said as we left her office.
Now, with my GP's support, the challenge is to maintain the strategies we put into place while holding Ava's self esteem in the highest possible regard. Maximising my daughter's health is one of my highest priorities, but maintaining her happiness is paramount.
* Names have been changed