Answering Anna's questions

Anna is a friend of mine from graduate school and the author of the blog "French Kids Don't Get Fat." (http://frenchkidsdontgetfat.typepad.com/) Anna has been interested in kids' nutrition for a long time. In fact, I remember sitting with her in her kitchen with 2-month old Matthew in my arms as she talked about some of her ideas. Anna is a writer, and even back then she knew that childhood nutrition was going to be her subject. Little did I know that this infant son of mine was going to propel me toward that subject as well. I am so happy to have Anna in on this conversation because I think that the two different angles from which we approach the subject is invigorating. I look forward to reading Anna's book someday, but for now I'll follow her blog.

Anna asks several questions in her comment on my blog post titled "Matthew's winning camp essay" and I'll try to answer them here. She mainly wants to know why I think Matthew got fat. In short, I think it's because we followed a typically American diet, pretty high in carbs and fat, and that he was genetically predisposed to being fat. As Anna pointed out, our daughter, who was eating the same, did not get fat, which I think is evidence of the genetic predisposition. I've struggled with my weight, and she will too, but becoming obese would take some doing. Bob, on the other hand, has struggled with obesity to some extent and his family definitely does. I think Matthew got an extra dose of that ingredient in the genetic soup.

I think Matthew also has always wanted to eat more. What causes that? Is that genetic too? If I had steered him toward better foods, which is basically what Anna's theory and blog is about, the outcome would not have been the same. I was too lazy and too unaware. Anna says, "I think you probably knew what he should be eating." Yes, that's true to an extent. I knew a lot about nutrition, but the information is so inconsistent. I remember I went through a phase where I put flax seed in things, for isntance. That was good. But it was peripheral. There's a lot of specialized information out there. I wish I had had an unwavering foundational guideline: Lowfat. Emphasis on whole grains and vegetables. Period.

I blew it. I failed him. We all fail our kids in some way, and I accept that.

He still has quite a focus on food, but he veers toward lean protein and naturally lowfat foods because of what he learned in camp and I help him with that. He blows it often, but I help him get back on track. As of the last couple months, he has launched full force into the puberty process. I tried to wipe off what I thought was a smear of dirt on his upper lip and it was actually the uneven beginnings of soft moustache hair. We sure laughed about that. His voice is changing and he's getting taller. I am crossing my fingers that this will help a lot with the weight issue. I hope that a little vanity kicks in too. I can see him becoming one of those teenage boys that works out and lifts weight once he sees the results. He really likes girls.

Anyway, thanks so much for your questions Anna. Did I answer them thoroughly enough? Please continue to join us here.

Well, not much progress

I've been silent for a while. Sadie has been dealing with many things this fall, all of which are intertwined, I'm sure. I've been very overwhelmed at how to help her.

She is in a tough 4th grade class at school. She has had trouble focusing in class, not getting classwork done, and bringing a fair amount of work to finish at home along with her homework. That has taken a lot of energy on our part -- my part -- to get help her get the work done. Which, especially in Sept & Oct, also created a lot of conflict! She has been getting to bed late (I've heard the research finds about children who don't get enough sleep have a higher tendency to be overweight). She has been swimming regularly, but those nights we are up very late finishing homework. Over the past six weeks, we've felt that she is increasingly angry, which has displayed itself in yelling at her sisters, losing control & her temper, and other sort of passive-aggressive behaviors of taking things from her sisters, negative put-downs, and sneaking food. We had her reading level evaluated in September and the test came back showing her two levels below her grade level! (She had finished last year just at grade level.) We saw her pediatrician for an ADD screening. In the physical, she had gained 8 pounds since July!! That's with the swimming and the walking home from school every day. She also has become more and more self-conscious of her body. She's dressing in ways to cover-up, conceal her body. I am curious about how much of her distraction in class could be connected to self-consciousness about her body.

So where do I focus? The calorie consumption? The exercise? The reading? The sleep patterns? The homework skills? The anger management? The clothing options? And what happens if we are headed to medication for ADD?? Her doctor did give a referral for a counselor who, the pediatrician says, is very good at targeting environmental/structural changes vs. medication vs. therapy. So after the holidays, we'll pursue that.

But I also ask myself, how did we get here? And how do we help ground her when Patrick and I are both so stretched with trying to cover the bases of work, finances, the other girls, etc.

It's not all bad. She continues to have very good friendships, friends that are encouraging her in her class, friends who count on her. She is very funny; she was particularly engaged in the presidential election, and made some very astute and funny comments that seem as if she'll have a future writing for Saturday Night Live. A couple of weeks ago, she won a poetry contest in her class. She was selected by her classmates to present the poem in a school-wide assembly which, I've heard from other parents, she did with aplomb. She has taken to the swimming environment, become very independent in how she manages it (except for keeping track of goggles, etc.)

Today was the last day of school for the winter break. Fortunately, we have two weeks off. Our Christmas plans are rather low key due to economy. I'm hoping to focus on the girls, get some time alone with each of them, take some walks. I'm not sure how to proceed with Sadie in the year ahead. It breaks my heart to see her struggle, to see her angry. Where do I go from here?

Matthew's winning camp essay

Why I Want to go to Wellspring Camp

Last summer I went to a YMCA camp in Tennessee. Everyone, including me, loved it there. This camp was at a lake, so a lot of activities were in the water. A favorite activity was called "The Blob," which was basically a huge inflated balloon on the water that was connected to a ladder, which was connected to a bigger part which had a slide on one side. At the front was about an eight-foot jump to the Blob. If you wanted to be launched into the air by someone else jumping on the Blob, you would crawl to the front. This was the part that was hard for me, almost devastating. I saw my friend be launched about twenty feet in the air by someone, and it looked like so much fun. On that first day I tried about five times to go to the edge, but I never made it. Every single time I couldn't pull myself up. I kept trying throughout the week at camp, persevering as long as I could, but I finally had to give up. I think this problem was caused by my weight.

Sometimes I feel like I myself am a Blob. Many people at school call me names that make me think this. I know that I am not a Blob but it is sometimes hard to remember that. When I look at myself in the mirror, I feel like someone I am not. When I was younger, I was able to do things that everyone else could, but that was when I lived in the country in Oregon. When I moved to the city, I didn't get as much exercise, and things slowly got bad. I go to a magnet school with a lot of homework, which means I'm sitting a lot. The movie Supersize Me inspired me to avoid fast food restaurants, and I'm exercising more at a gym that my family joined. But I'm still not losing weight, and I need help.

Almost everyone at school thinks I have a nice personality, but still they make fun of me as if they think it won't bother me. I want to go to a camp where I can do all the activities and where the other kids know what it is like to be overweight. If you've ever read the book Holes, you would know that Stanley, the main character, dreams about going to Camp Fun and Games, and he too was overweight, and he was made fun of by everyone at school. I think if I go to Wellspring Camp, it would be like going to Camp Fun and Games, then because of camp, I would have a chance to think better of myself. And I'm sure when I lose weight from this camp, I would be able to go back to the lake at that other camp, and climb right up on the Blob like everyone else. Also, people will stop making fun of me. By going to camp, I'll be able to conquer the Blob in more ways than one.

Boys and Girls

Do you think the experiences around obesity are different for boys than girls? Do you think girls are more compassionate toward boys??

Swimming is going well for Sadie. Food journals, not so well. This weekend we resume our Saturday morning walking training together. One step at a time!

Happy AND Sad

Last year, when Matthew was gaining so much weight, I began to be very concerned about what was in store for him socially. Middle school can be brutal anyway, but for an overweight child...it can be unbearable.

He only recently let on that he is being teased these days: on the bus, in the halls at school, at swim practice. Good god. When I let myself feel it, it hurts so bad. But I have to let myself feel it, cry even, if I'm going to get the emotional energy and clarity I need to do something about it.

I believe that you have to feel all the emotional impact of something that has impacted you. Your energy gets extremely restrained if, for instance, you've been hit by a train and you go around pretending that you haven't been hit by a train. And if you're upset about something that's happening to your child, and you don't acknowledge how it makes you feel, it can make you very tense and anxious around your child, which adds to his own stress. I have to have the courage to feel, and teach my children to do the same.

And the teasing - it makes him want to eat more. Now that I'm extremely sad, let me back up to explain the one bit of happy news.

When Matthew was 7, the week before his first swim team practice, we went swimming and I showed him what "freestyle" swimming was, and had him try a few strokes. Two weeks later, he got his first blue ribbon in a swim meet. The kid can swim fast. He's had success during all these summer swim seasons, even as he's gained weight.

So this fall, we decided to enroll him in year-round competitive swimming. He goes to practice three times a week, and each practice is nearly three hours long and involves dryland cardio and weight lifting as well. He's liked it, but not as much as I thought. Then he finally admitted the other kids on the team tease him. Swim meets are optional in the age group he's in, but Bob and I decided to push him and have him swim in the meet Saturday. He didn't want to. But he did it and he came in first place in his heat in the 100-yard butterfly and second in the 100-yard freestyle. We were thrilled. He was thrilled.

His coach shook his hand and said, "It's good to see you smile for once."

Talk about happy and sad. I was so happy to see how happy he was. And so sad to realize that Matthew, the kid most known (until he hit 12) for his huge smile, was not smiling lately.

I pray that we can build on the swimming.

It sounds like two really fortunate things happened in your family, Jan: Sadie choosing to join swim team and Callie being asked to keep a food journal. If naturally-thin Callie is the one who's been assigned to do that, and the whole family participates in some fashion, then Sadie doesn't have to feel singled out at all if she's asked to participate.

I've been thinking about a scene from a movie we saw (part of) last week. The parents are recently divorced, there are two girls - 8 and 6 I think, and the mom is seeing someone new. The new boyfriend is a fitness nut, and he's trying to help the 8 year-old, a little chubby, with her diet and exercise. The dad comes over and has a righteous fit about it. To paraphrase his reaction, it's something like this: How dare you make her self conscious about this!? She's only 8!

Emotionally I was totally on his side. His anger came from genuine love and concern for her feelings. So it's complicated, because on this blog I'm advocating for taking conscious steps if a child is heading for obesity. And I'm advocating for that because in our household the problem got away from us, and by 11/12 years old our son was very overweight and the effects on his life were making him really unhappy.

I guess the middle ground is for the parent, who like the father in the movie is motivated by unconditional love and a desire to protect the child's sense of self, to help the child out. And what I've learned is that to be conscious about it and actually talk about it doesn't damage the child like I thought it would. Like it would have for me as a child because any parental "help" that came my way was more...rejecting.

Which leads me to how we're doing around here. I've noticed in the last week, as the weather's getting a little cooler, that I've wanted to pig out in a way I haven't since I started this new way of eating in July. But I haven't gained any weight because I've been eating, for instance, nearly a whole bag of fat-free pretzels at a time. While watching Project Runway or something.

So I'm going to address what's going on for me that's making me do that, but it's not a huge problem because of the food I've been pigging out with. I've noticed that Matthew, too, loves to eat and eat. He's always been a cereal afficionado. But now he eats Special K with fat free milk. My dilemma has been whether I need to say something if I see him eating bowl after bowl. It's so hard for me to stop the policing, but I have to. He put on a few pounds over the last few weeks, but now he's taking control again. I'll tell more about how he's done that and how I've tried to stop myself from policing and replaced those kinds of messages with supportive cues that help him with his own goals in my next post.

How is Sadie liking swimming? Matthew's swim practice is two hours long, includes "dry land" training (usually running) as well as swimming, and he comes home totally wiped out but with a sense of achievement. It's been very good.

How is it going with Sadie?...

What really struck me in your recent post was, how did you say it, "we are committed to the journey without being very focused on a specific goal". Wow! So, how's it going here?....

Well, we were delighted when Sadie chose for herself to join swim team this year. She is really enjoying it, comes home tired and aware of her body in new ways after workouts. She said to me, "maybe if I do this, I'll get thinner". I responded with your advice in mind, but was also aware that she is trying to make changes. We've been working with the "how hungry/full am I" measurement of 1 - 10, which has given us a new language. We even bought pedometers for her and me!

But we started back to school which brings a realm of distractions, frustrations, things that get in the way. She is struggling with her classwork and homework. (Talk about feeling that I've failed her!) But what has been hanging over me, or nagging at me, is the realization that we can't just take this weight issue on, reach the goal and be done with it. That it is hourly lifestyle choices, a way of life. And let's face it, I've spent decades trying to ignore that fact in my life.

Now, I hate to make her issues all about me, but my reluctance to deal with her issues, to lead her to new choices and validate her current feelings is all about the very same things that I've been running from my entire life. It sickens me that she will have to deal with this her entire life. Okay, I've got to get over that.

So your words about the family committing to this, embracing this, really helps me see this differently. What Sadie weighs as an adult is probably not my responsibility. Giving her the skills to make choices, understand how her body works, find her strength, find ways to express her feelings...well that is my responsibility, our responsibility.

Callie has been assigned by her ballet mistress to keep a journal of what she eats. (I inquired: "did she talk about weight or being thin?" to which Callie replied "no, she just wants us to be eating healthy food"....let's hope!) But what a perfect time for us all to start keeping journals of what we eat for a few weeks, to create new awareness, to get me focused on the things that I've been avoiding for the past decade, to commit to the journey of healthy living.

We'll see how we do today.

Comments Welcome!

If anyone is reading this blog, we would love to have your comments.

I need to not think so hard about my replies

Because then I hesitate to post, because I want to be sure I'm being as honest with myself as possible, so I put it off to think about it, then life intervenes--business trips, family trips, taking a kid to college, and a little back spasm.

But this is not so hard to answer.

There was a long, intermediate period between "he'll grow into it" and "we must take this more seriously." I would notice how heavy he was getting, fret about it, look for an answer, then put it aside. I mean really, I would feel, especially in the middle of the night, like I'd really failed my child. It was awful. It's a lot of why I want to write this blog.

Giving straight answers, but not wanting to create failure. That's the tightrope. If I could go back to the first "Mom, am I fat?" question I would give him some height/weight numbers, introduce him to the BMI, but make very clear that we're all going to work on being healthier. We're going to watch what we eat and we're going to get more exercise. I think it would be a bit like walking a tightrope - not overemphasizing the goal, but really commiting to the project - but I think the possibility of "failure" could be avoided. We are walking that tightrope here at this very moment and will continue to. As parents we're totally committed to this program and are finding it easy. Bob has lost 15 pounds and I've lost nearly 20. It's not as easy for Matthew, but he's committed.

My neighbor's pediatrician informed her at a well-child checkup this summer that her six-year-old daughter was obese. The girl is as cute as can be, and seems minimally chubby. My neighbor didn't even consider giving the news to her daughter, because the girl has no awareness or being overweight whatsoever. What the mom did, though, was gently and gradually say no to the requests for juice, the desserts, and she increased exercise in her whole family. She has one beanpole daughter and two who love to eat. I think she took the right approach, and I wonder if I would have done the same if my pediatrician had brought out the "O" word when Matthew was that young.

How's it going with Sadie?

What changed things for you?

What changed in your son that took you from "he'll grow into it" (I've said that, I've even told that to Sadie) to "we must take this more seriously"? Was it just that the weight gain didn't stop? or was it more social? And, how is he learning to talk about it?

I want to help us learn to talk about this in ways that acknowledge and give straight answers, but don't create failure. Is this my failure we're talking about now??

The BMI calculator, or, Mom, am I Fat?

To make Sadie conscious of her weight or not. That is the question. For you and I, to have been made "conscious" of being overweight as children or teens meant nothing but pain and misery and a sense of failure. But I do think there's a way to help a child become aware of a weight problem that is constructive and not destructive. It's absolutely one thing I would do differently if I could do it all over again and go back to when "Matthew" was about nine years old.

That's around the age when he first asked me if he was fat. Poor kid was looking for a straight answer and my answer was two tenths Yes and eight tenths Don't Let Anyone ever tell you You're Anything Less than Perfect, my Precious Child! How confusing. For one thing, he already felt great about himself. We had done a good job with that. He just wanted to know if he was fat, because he was starting to get feedback.

If I could go back, I think I would do exactly what you're thinking of doing and show Matthew a chart or enter the information on the CDC BMI calculator and look at the results with him so that he could see that, yes, objectively, he is overweight. I seriously doubt he would have spent the rest of the evening crying into his pillow. He just isn't that kind of kid. Plus, he likes science, and this is science.

It's also sociology. Kids are way heavier now than they used to be. According to the book they gave us at the family workshop at the Wellspring camp, the reasons for obesity are biological, environmental, and behavioral. Both the diet and activity environment for kids has changed tremendously since we were kids. I remember going to McDonalds in California, yes, but the portions were way smaller then. I had to walk to school. All the kids were outside playing in the neighborhood, all the time. We rode our bikes. Matthew would understand that and perhaps even be fascinated by the differences and the reasons for them. As for biology, it's just not fair that Matthew tends to gain weight while his sister does not (or not as much) and that his friends can eat whatever they want and they're little beanpoles. But them's the brakes - he inherited the chubby. I would also explain to him that it's behavior, it's the choices we make on a day-to- day basis, and that's the area we are going to change. And then I would make a plan with him.

When he was that age (and maybe younger) the pediatrician suggested that we let him grow into his weight, that we try to keep him from gaining weight for a year or two. I think that was good advice, but I think I would have taken it much, much more seriously. For Matthew to grow into his weight now, even after the weight loss, he'd have to gain nothing for about 6 more inches of growth!

So I would have: allowed him to see that yes, like many children these days, he is overweight. I would have committed to working on it with him, and would have made a very specific plan with him. It would have involved weekly weigh-ins, to make sure he wasn't gaining weight. (This would have seemed extreme to me back then, as I saw the scale as a cruel self esteem buster) And I would have started an all-out family lifestyle makeover involving regular exercise and lowfat diets.

I believe that if I had known to do that, we wouldn't be where we are. It's going to be a challenge for Matthew to maintain the weight loss at this point, much less lose more. If you decide to talk to Sadie, let me know how it goes.

BMI - What is it??

I followed your childhood obesity link to the Center for Disease Control and looked up more about BMI. This is something that I've heard a lot about over the past few years, but have never actually done the measurement.

The BMI Calculator tool on the CDC site is very easy to use and, since the girls had just had a check up, I did it for Callie & Sadie (I did it for me as well). As you guessed, Sadie is right on the cusp of obesity. Wow, now is the moment!

The recommendation is (no surprise) eat a healthy low fat diet, daily exercise, limit screen time. Okay, that seems doable.

My question is: How to best share this information with her? For the past year, I've not wanted to make her "self conscious" but I suddenly realize it is important to make her "conscious". Let's face it, she's already self conscious! I can see that in some of her comments and choices this summer about clothing and group activities.

Maybe showing her this simple graph/tool will actually give her, give us the tools to talk about this more openly together. What do you think?

Mom's on Weight Watchers, everyone else still eating unconsciously

A couple years ago I signed up for Weight Watchers, went to meetings once or twice a week, and lost eight pounds. I gained it back pretty quickly, but the program was effective at the time. You count your points for everything you eat, you exercise and subtract some of those points, and you lose weight.

Instead of doing that separate thing for myself, isolated both in time (there really wasn't much chance I was going to count points the rest of my life as it's somewhat complicated) and within the family, I wish I had started to make other lifelong changes and involved my whole family.

I think that instead of mom going on a diet to lose weight, she would do better to make one significant, permanent change at a time and get the whole family on board with it.

Changes such as: we're all going to learn to read food labels and we're all going to aim for eating less than 12 grams of fat a day. Such as: we're all going to get pedometers and we're going to aim for walking at least 10,000 steps a day.

Or, if nobody else in the family is manifesting a weight problem, just bring only lowfat food into the house, cook lowfat food, and involve the whole family in exercise on a regular basis. And tell them why. She can be more intentional about it and lose weight herself, but her family will be learning healthier habits along the way and will have less risk of ever being part of the obesity epidemic.

But if one or more of her children are starting to have weight problems, it's best to get on it right away and make it a conscious effort on everyone's part. Not in an anxiety-producing way, but in a slow, steady, one change-at-a-time way. And make it fun, make it a challenge. If only I could go back and do it this way, my son never would have gained the weight that propelled him from "a little chubby" to obese.

Since he did become obese, we needed outside help, and that outside help was this camp. Everything I've learned from the Wellspring program is making me look back and know exactly what I would have done differently.

List of Solutions I had along the way - an ongoing list of things I tried, either consciously or unconsciously, to solve the problem

1. Not bringing any attention to the problem because that would make him feel bad about himself and make it worse.

List of Theories I had Along the Way - an ongoing list of the theories I had in the middle of the night when I should have been sleeping

The italicized ones I still believe are accurate.

1. He has a naturally large body type
2. He's addicted to carbs
3. His school is too demanding and stressful
4. He doesn't get enough activity during the school day
5. He has my husband's family's genes
6. He has my and my husband's love for eating
7. My husband's too dismissive of a father