Talking about obesity

Quick Impact

'My child is a very fussy eater and refuses to eat vegetables'

Ask parents how they would feel about trying these options: 1) mix vegetables or fruit in with other dishes so that the children don't know they are eating them (and ask the parents how long they think this should be continued because, eventually, children will need to know they are eating and enjoying fruit and veg); 2) Try other unusual vegetables that the children have never seen or tried before and don't call them a vegetable at first until they decide they like them.

Ongoing Support

Now that their child is more interested in trying out new foods - even if they don't like all of the ones they try - it is time to let them decide which new foods the family is going to add to the weekly shopping list. Ask the parents how they think they could go about introducing this. The parents may say things such as they could look for new recipes together and challenge their child to find one with a new type of food in it, then make it together. Start 4 Life has lots of interesting, inexpensive and simple recipes on its website.

Quick Impact

'My child is never hungry and hardly eats at meal times but complains she is hungry between meals, so I give her snacks as I am worried about not feeding her enough.'

In this case, I would ask the parent what they are giving as snacks. Depending on the type and size of the snack, snacking may be why the child is no longer hungry for meals and will not eat them. Or they may be filling up on milk. Use open questions to help parents come to this realisation. Ask parents if they feel there should be a pattern to their mealtimes and where the best place is in their house to eat as a family, and why they chose that place as their answer.

Ongoing Support

Next - encourage parents to reflect on whether there are times when their child does need a snack (they may suggest times of rapid growth, or when they has been a lot of exercise during the day), and what they think and appropriate snack could consist of: an apple or peeled carrot (both need to be cut into small pieces if their child has braces), a plain yoghurt with some fresh berries, a piece of wholemeal bread thinly spread with peanut butter or WOWBUTTER, or some plain popcorn.

Quick Impact

'My child hates fruit.'

Investigate what types of fruit the child has eaten to date. It may be that they were offered oranges or other citrus fruits in which case offer them bananas, grapes or melons. Ask parents what mealtime would be best for them to introduce new foods, and ask them how they feel about doing something like making it a game where the children choose which fruit they would like to include in a fruit salad and allow them to the softer fruit up with a butter knife so they can help with preparing the food as well as eating it. Explore the parents' feelings about substituting mashed then frozen soft fruits for a healthy twist on ice lollies; encourage them to suggest types of fruit they fell would be suitable.

Ongoing Support

Next - ask parents which words they think should be avoided and which ones should be used when talking about why new foods should be tried. (Hopefully they will say to avoid using words like 'healthy' and focus more on the fun of eating new things.). Ask the parents if they have considered growing their own veg, which ones may be easiest to grow, and ways they could do this. You're looking for answers that show consideration of growing their own fruit or veg in a window box, a pot or a growbag. And, that they are aware there are many types of healthy food which are simple to grow at home and that they can just ask their local garden centre or DIY store for targeted advice.

Quick Impact

'I nag them about so much, I don't want to start on food, too.'

It can be fun! Involve the whole family in growing, cooking and preparing food. Ask parents if they feel treats should be stopped completely or what a suitable alternative might be (ideally they will say that occasional treats are a better option than part of the regular daily food).

Ongoing Support

Next - ask parents what they could do to get the message across without nagging about healthy eating. Ask them how they could be positive about food and the benefits that eating well has.

Quick Impact

'I don't want to give her an eating disorder.'

Reassure the parents that many children go through at least one stage of being fussy about food. Ask them how the fussy food stage is making them feel and discuss that the way that we deal with the child's reaction to food will impact on their eating habits. Ask them what they think would be the best way to respond to their child behaving fussily about food, and what solutions they may be able to think of to work around this to allow them to still introduce new foods. (They respond with ideas such as staying calm, continuing to offer food over a period of weeks along with other new foods.) Explore how limiting eating a minimal variety of food can be to the family.

Ongoing Support

Next - suggest the parents avoid talking about weight or fat in relation to food. Ask them to think about the different types of emphasis they could put on food instead which will make the point that food is fuel and way of nourishing our bodies so that they can do amazing things.

Quick Impact

'All the family are big boned. It's in his genes.'

You can acknowledge that some families do seem to be naturally bigger, and take the opportunity to ask the parents how they think their lifestyle will impact on their body shape in years to come. Open the discussion up to include time for them to reflect on way they could start a family project to eat well and be active. Ask them how they could make being active more fun.

Ongoing Support

Next - if parents mention barriers to family exercise such as cost implications you could offer to give them links to free family activities such as a Sunday junior parkrun near them. They are 2k in distance, free, times events for 4-14 year-olds (but adults can take part too; the parents just won't get an official time on the stats table). There are also Saturday parkruns, too, which are 5k long but families are welcome to walk, run or a combination of the two. Their local council websites should also have a page or a circular, which will list free family activities in their area.

Quick Impact

'It's not because he eats a lot. He hardly eating anything at mealtimes.'

Ask parents to consider how much/when their child snacks and what effect this may be having on their child's appetite at mealtimes. If he's been having lots of snack (including sugary drinks), he just might not be hungry at mealtimes. Parents could try limiting snack, especially those that are high in sugar or fat, and seeing if he eats better at mealtimes.

Ongoing Support

Next - make mornings count. Ask parents to consider when it's best to offer snacks and what impact mealtimes may have on their child's wish to snack. Using visual aids, explore what they know of healthy breakfasts and what benefits these may offer their family. Don't just have a bowl of cereal. Try porridge with fresh banana and a sprinkle of cinnamon or boiled eggs and toast soldiers. The same goes for other meals too - help parents to consider adding in foods that take time to eat and are filling.

Quick Impact

'I work full-time. I haven't got time to cook.'

Emphasis with the parent - it can seem really hard to get on with cooking after a long day" Encourage them to try to think of foods they know of that can be combined into a meal in less that 5 minutes (e.g. eggs in a variety of ways, microwaved jacket potatoes with healthy fillings both only take 5 minutes.) Support parents with exploring ways in which they could plan their week to get organised with the shopping and whether making food in bulk (and which kids of food) is an option for them.

Ongoing Support

Next - for fast meal menus and recipes, parents can visit Change 4 Life recipe section where they'll get a lot of choice to try out as a family. Discuss whether involving the children in these tasks is an option for the family because allowing children to join in with meal planning, preparing and cooking can be a valuable life lesson for them as well as making food seem fun in a different way.

Quick Impact

'He doesn't like any healthy stuff. He'd eat nothing.'

Children need to try things lots of times before they like them so parents shouldn't worry he's never going to like a food. Ask them what their reactions have been to his refusal to try or to like the new food - do they get upset, or do they praise him for trying? Explore what ways they have tried to introduce the new food so and what new ways they can think of. Group sessions are ideal for this as parents can share ideas with other

Ongoing Support

Next - offer parents reassurance (if others in the group haven't done so already) and encourage them to be patient. It may take some time for him to be willing to try new foods, and he isn't going to like everything (who does?) even after trying them several times, but there will definitely be new tastes that he will come to accept and then even enjoy, especially if they are willing to consider role-modelling behaviours they would like to see from their child.

Quick Impact

'I was like that as a child.'

This is helpful information as it will help the parent reflect on whether their lifestyle was any different to the way their child's is now. For example, what did they do for fun/eat as a child that is different to what their child does now? Do they think that, with the lifestyle/diet/amount of exercise their child has now, their child will have the same body shape as they do now? And, if they do, is this they want for their child?

Ongoing Supports

Next - ask parents to consider what effect it will have on their child's behaviour if they're constantly on a diet or rave erratic eating times, and to reflect on what kind of lifestyle messages they may be sending their child.

Quick Impact

'The rest of the family are skinny, I don't understand it.'

People get their body shapes from both sides of the family and the possible combinations are endless, which is why some siblings/family members can look very different from others. Ask parents to think about how they could adapt their lifestyle and diet in slightly different ways. Encourage them to also consider what positive benefits this may bring them and their children despite their differing shapes.

Ongoing Support

Next - support parents to think about the effects food will have on their child's body shape over time. Do they think it's ok to have the occasional treat? How might they manage the family's lifestyle to make this a positive part of their life? It is perfectly acceptable as long as they balance these with smart food choices and physical activity, in which case their children's lifestyle will be healthy, and hopefully, as they explore this issue with your/their group's support, they will come to this conclusion.

Quick Impact

'The father works long hours and doesn't get home till later. He and his wife want quiet time to enjoy together so they eat after the children are in bed. Why should I recommend that this type of family eat together?'

Research shows that families who have meals together are less likely to have obese children and more likely to have children who eat more fruit and vegetables, less fast food and fewer soft drinks. Ask the parent to reflect on ways in which they can have some much-needed quiet time together whilst still finding time to enjoy meals as a family - could they fir this in any part of their week?

Ongoing Support

A positive experience of family dining improves the chance of developing healthy lifestyles. Conversely, parents complaining about the child not eating all their food will have a negative impact. For this family, it might be better suited for them to aim to eat together a few times a week rather than every day. Exploring their schedules and thinking about the positive benefits of meals together will help them to decide what balance they want to for.

Quick Impact

'The parents are angry because they say they offer their child a healthy diet and, after listening to them describe an average day's food, this does seem to be correct. What can I say now?'

You can acknowledge that you do agree their child;s diet is health - it's good for parents to know you can see the positive aspects of their parenting. Using portion size charts such as the Eatwell Guide, ask parents to compare how much of each type of healthy food their child is eating, and whether this is the right amount or more healthy food than they burn off. ask them what amount of exercise their children do and what influence they think this exercise has on using up the healthy food they have eaten.

Ongoing Support

Asking parents to demonstrate what they think is an appropriate serving size for all food groups can be useful in opening discussions around this subject. Often parents are giving children larger portions or encouraging less exercise than they needs.