Editor's note: Michelle Icard, author of 'Fourteen Talks By Age Fourteen' and other books about raising adolescents.
Since 1990, I have worked with parents, middle schoolers and their schools to help them navigate the often awkward, painful, but sometimes funny in retrospect, early adolescent years.
Over time, most of the stretch marks that we acquire during our adolescence will fade away. We forgive the child who teased us for tripping in class, and we also forgive ourselves when it comes to bad haircuts, messed up friendships, and embarrassing attempts to be popular.
Ironically, the growing pain that is most associated with physical growth can be very difficult to overcome.
It is normal for children to continue growing during adolescence. Therefore, the changing body of a child at this time should not cause concern. Adults are thrown into a spiral of anxiety about their weight, health, and self-esteem.
Kids are always concerned about their changing bodies. Early puberty is a time of rapid change. Children constantly compare themselves to each other in order to determine if they are developing normally. All these boys grew over summer, but I am still shorter than the girls. Is there something wrong with me' No one else wears a bra but me. Why am I such a weirdo?
The worry has increased over the last two decades. I've noticed parents getting more and more worried about their children's body changes during early puberty. When I speak about parenting, many parents express their concern about their children gaining 'too much weight' during early adolescence.
Even kids who are bright, happy, and physically active may need to lose some weight, even if they are more chubby than their peers.
Why do parents seem to be so obsessed with weight? Partly, I believe it's due to the fact that our national conversation about body image has reached a frenzy. In the last year, there have been two new perspectives that have complicated this issue for children.
Jimmy Kimmel’s Oscars monologue made Ozempic, and its weight loss properties, a household word. Small bodies and weight-loss are highly valued, whether it is in the mainstream media or social media. Young teens that I know are aware of celebrities who have adopted a new method to shrink their body.
The constant messages of being thin and fit can lead to a distorted view of health and wellbeing in children, which is difficult to separate from the actual state.
Many parents are worried that ignoring their child's obesity or saying nothing is dangerous.
It is the opposite that is true. When parents don't mention their child's changing shape, they keep them healthier. Here's why.
Children are supposed to gain more weight
Adolescence is the period of growth that we experience most, other than in the first year. Most adolescents will double their weight between the ages 13-18. Weight gain is a sensitive and sometimes frightening subject for parents, who are afraid of too much weight gain too quickly.
Understanding what's normal is important. Boys grow the most between the ages of 12 and 16 on average. In just four years they could gain up to 60 pounds and grow an entire foot. The girls' biggest growth spurt occurs between the ages of 10 and 14. According to the growth charts of the US Centers for Disease Control and Prevention, girls can gain an average of 10 inches and up to 50 pounds in that period.
Emailing Dr. Trish HUTCHISON, a board certified pediatrician and spokesperson for the American Academy of Pediatrics who has 30 years of experience, she said, "It is totally normal for children to gain weight when they reach puberty." About 25 percent of height growth occurs at this time, so youth will gain weight as they grow taller. Children gain an average of five pounds and two inches in height every year since the age of three. When puberty comes, this usually doubles.
New guidelines for children's weight
In January, the American Academy of Pediatrics published a revised set of pediatrician guidelines that included medication and surgical recommendations for certain children who measured in the obesity range.
Its 2016 guidelines, on the other hand, talked about eating disorders prevention and encouraged pediatricians and parents to 'focus on health-promoting behavior' and not on dieting or weight.
She said that the new guidelines put weight at the forefront of health. "And we all know that there are other ways to measure health."
Can messages from doctors about weight loss be harmful to adolescents
Davenport is concerned that children could misunderstand the weight-related discussions with their pediatricians, internalize inaccurate information and develop disordered eating.
She said that a child could interpret the message to mean that they don't need to eat so much, or that there is something wrong with their body. This can lead them down a dangerous path. "What someone might take away from this is, 'I have to go on a dieting'. We know that diets increase the risk of developing eating disorders."
Many parents and tweens are on diets.
Hutchison wrote in an email that'some current statistics show 51% of 10 year-old girls tried a dieting and 37% of their parents admitted to placing their child on one'. She added that the new American Academy of Pediatrics Guidelines could make dieting a problem.
Hutchison stated that there is evidence to suggest that conversations about obesity are beneficial for treatment. However, the wishes of the family should be taken into consideration when deciding on a time frame. The psychological effects of obesity may be greater than the physical risks.
Weight is an important number
Weight is important. Davenport stated that it is important to know the weight of children and teenagers. Dietitians are not against weighing children because it's a way to measure their growth. We want to know if there is anything unusual about an adolescent’s growth curve. We don't have to talk about weight in front them.
Weight is data. Weight may or may indicate that something is wrong. Davenport says that the biggest concern is when a kid doesn't gain weight. This is a sign that something is wrong.
Hutchison stated that obesity is not a disease caused solely by energy intake and expenditure. Hutchison said that the problem is more complex, with other factors such as genetics, physiological, social, economic, and environmental factors playing a part.
She said that it's important to let parents and caregivers know that obesity or being overweight does not indicate poor parenting. "And it is not the child's or adolescent’s fault."
Hutchison also stressed that the American Academy of Pediatrics' new guidelines are only suggestions and not intended for parents. The guidelines are part of an 100-page document which provides clinical practice guidelines to health care professionals for the evaluation of and treatment of overweight and obese children and adolescents. Only four pages in the document discuss medications and surgery.
What can parents to do protect their children?
Parents must work to overcome their weight bias and protect their children against providers who do not know how to talk to their patients about their weight.
Davenport stated that he has been treating eating disorders for more than 20 years and sadly, he cannot tell you how many clients have come to him after hearing from their medical providers about a weight issue.
Hutchison stated that doctors and other healthcare providers must do better.
Hutchison stated that 'we all have work to do' when it comes down to having conversations about weight. We need to treat each child with respect, without judgement. We don't ever want children to think that there's something wrong with their bodies.
According to American Academy of Pediatrics, the right approach is to ask parents questions without using the word "weight." Hutchison gave the following example: 'What, if any concerns do you have regarding your child's health and growth?'
Hutchison believes that by working with children who are in need of guidance or desire it, doctors can make a positive difference.
Davenport, her business partner Sunny Side Up Nutrition and the Carolina Resource Center for Eating Disorders have become more specific, with their input. Navigating Pediatric Care is a tool that outlines the steps parents can take to ensure their health care provider only discusses weight with them and not with children.
Davenport stated that pediatricians should ask for permission before discussing weight with children. It's the parent's responsibility to advocate for their children and ask.
Davenport suggests that parents call in advance to schedule an appointment and discuss the child's weight before they bring them to a doctor. She suggests contacting the doctor or nurse in advance by phone or email, although she admits that this may not be as effective in busy settings. She suggested printing out a card that you can hand to both the doctor and nurse at your appointment. You can say to the child: "We would prefer not discuss weight with my child."