Avoid ‘disrespectful communication’ when discussing overweight, obesity with children
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A conversation about overweight or obesity with a child or adolescent should be initiated in a developmentally appropriate way, using language and tone that is encouraging and supportive, according to a speaker.
“When speaking about growth and development, we need to give ourselves enough time to speak in a sensitive way, improve our ability to sense how the conversation is going and respond accordingly,” Grace O’Malley, PhD, MSc, MISCP, a pediatric physiotherapist at Temple Street Children’s University Hospital in Dublin, Ireland, and coordinator of the Temple Street W82GO Healthy Lifestyles Programme, told Healio. “We can normalize conversations about growth and obesity with families, but we need to practice these skills and keep improving. Overall, just be respectful, do not judge and remember each child or adolescent is an autonomous human who has the right under United Nations Convention on the Rights of the Child to health care, irrespective of their shape or size.”
Empower families with empathy
Children commonly experience disrespectful communication from health care professionals about their shape or size, O’Malley said during an online presentation at the European and International Congress on Obesity virtual meeting. Research describes “unacceptable stigmatizing” and biased attitudes from health care professionals from many disciplines and professional backgrounds, and professionals must call out such behavior when heard, she said.
“Some professionals might think that speaking gruffly to parents and children will shock them into taking action, but research shows that, in most cases, this does not happen and instead has an iatrogenic effect,” O’Malley said in an interview. “While we need to have these conversations using plain and direct language, we can empower the families we work with using empathy and compassion rather than trying to convince them — and ourselves — that we know best or have all the answers.”
Conversation pearls for clinicians
O’Malley said it is key for endocrinologists and obesity medicine specialists to be kind to the child and their parents.
“Get started today with asking if you can measure growth and explaining what results mean in child-friendly, person-first language,” O’Malley said. “Reflect on whether you have had a similar life experience to this child and how your own experiences influence your attitude and beliefs around obesity. Be brave enough to accept that you don’t have all the answers.”
O’Malley offered additional helpful tips for providers:
- Focus the conversation on growth, not weight. “As adults, we tend to forget about height as we are not getting taller anymore,” O’Malley said. “Always keep growth in your mind and conversation.”
- Focus on the development of the child and whether their health, play or social interactions are affected by their growth status. “For example, can the child participate in play and games with other children?” O’Malley said. “If not, ask why.”
- Ask open-ended questions so that you can piece together why a child may be accumulating excessive fat, which will help you work with the family on the best way to address this. “If you need training in this area, ask your professional body to provide education so that you are prepared to work in our modern world,” O’Malley said.
- Remember that you are not a sole practitioner. “There are many health professionals with in-depth training in nutrition, behavior change and exercise training,” O’Malley said. “Get to know them and refer to them.”
- Become an advocate for children and demand that they are treated equally by the health care system, the education system and the political system. “Raise up your voice of influence to demand change at the policy level and demand real change to our obesogenic environment,” O’Malley said.
O’Malley said practitioners should also be curious about how child health and development is influenced by biological, social and psychological influences at the levels of the individual, community and society.
“Plan on changing one of your own health behaviors so that you can experience the barriers and facilitators of this change and understand the challenges facing families today,” O’Malley said.
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O’Malley G. Talking to children about growth, weight and obesity. Presented at: European and International Congress on Obesity Annual Meeting; Sept. 1-4, 2020; (virtual meeting).
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