More than 12 million children and adolescents are obese, and the rate is climbing, according to officials with the Centers for Disease Control and Prevention.

Talking to someone about their weight can always be difficult, but what do you say when it comes to a child? Talking to children and their parents about weight is a sensitive topic, but the sooner the conversation starts, the easier it will be to help the child achieve a healthy weight.

No parent wants to hear that their kid is fat. In fact, doctors and health professionals are even reluctant to warn parents that their child is overweight.

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According to a study published in the journal Archives of Pediatrics and Adolescent Medicine, less than a quarter of parents of overweight children can remember ever being told that their child had a weight problem.

Associate professor and lead of the study, Eliana Perrin, said there may be a number of reasons why parents aren’t getting the message. Some doctors might be unfamiliar with BMI (body mass index) charting and the related definitions associated with being overweight, or perhaps it could be because of the stigma associated with obesity. Some doctors just might not be making the message clear, particularly to parents who might not want to hear.

However, it’s important for every doctor to have a conversation with parents about their child’s weight, whether the child is overweight or not, as maintaining a healthy weight is easier if it starts as a child rather than doing so later in life.

When starting the conversation, one fact holds true: Parents don’t want doctors calling their kids “fat.” Research published in the journal Pediatrics found that parents would prefer more sensitive language be used when talking about the issue.

“Many people find the term ‘fat’ to be pejorative and judgmental,” says Rebecca Puhl, the study’s lead author and the director of research at Rudd Center for Food Policy and Obesity at Yale University. “A lot of the time, providers have positive intentions, but the language they use can be seen as blaming, accusatory and not helpful.”

Researchers asked 445 parents to give their opinion on 10 commonly used-terms to describe weight. The parents winced at the words “chubby,” “fat,” and “obese.” They instead preferred to hear that their child is hovering at an “unhealthy weight.” The surveyed parents also approved of the term “high BMI.” As recommended by Rudd, doctors should start the conversation by saying, “I’d like to have a conversation about weight. Are there specific terms you’d like me to use?”

When talking directly to a child, however, saying “We need to talk about your weight,” can put a lot of pressure on a child. He or she may not even know what that means. Instead, talk about healthy eating and exercise.

Ask the parents to work together with their child by taking action and exploring different options. For example, suggest taking a cooking class together to learn healthier ways to prepare meals or schedule time every week to do an activity that gets you both active. There’s nothing worse than feeling alone for a child, but by working together parents help them take charge of their health and build self-confidence.

Doctors may also want to ask the parents to be a positive role model for their children as well.

“Parents are kids’ number-one role model,” said Dr. Robert Pretlow, author of Overweight: What Kids Say. According to Pretlow, when asked how the childhood obesity epidemic can be stopped, 70% of kids who responded to a survey said that the most important factor is their parents setting a good example.

“Kids develop their attitudes about food and eating from their parents,” Pretlow said. “If parents go to fast-food restaurants and expose their child to junk food around the house, that child will develop the same habits—and those habits are extremely hard to break.”

With those things in mind, talking to parents and their children about obesity doesn’t have to be as hard as it seems. Just remember that it’s crucial to talk about obesity and to be conscientious of the language used.

“Instead of instilling shame,” said Puhl, “we want to provide support to patients to become healthier.”


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