Obesity is a very difficult subject to discuss with loved ones, especially children. Unfortunately, the issue is complicated by feelings of guilt, shame, blame and embarrassment. We have unfortunately gotten caught up in the “blame game” surrounding this issue. We want to blame advertisers, the school systems, food advertisements, fast food, video games and TV. The fact is, these items, and many more, are to blame. But, what is sometimes difficult to accept, is that the solutions begin at home, amongst individuals and families. In order to address obesity successfully within our families, three basic themes must be kept in mind: Honesty, Hope, and Inspiration.


We owe it to our kids to be honest about the reality and risks of childhood obesity. In the news yesterday was a story about how hypertension is now a problem amongst children and teens, more than ever before. The main reason is obesity. Kids hear these stories as well, and if they are overweight, they feel it, and it hurts. There are the medical problems, of course, and if your child has asthma or diabetes, they are already experts on the medical risks of obesity. But even if overweight children are otherwise healthy, they still hate being overweight. I can promise you that.

A few months ago I took care of an obese ten year old with asthma. He was admitted to the hospital because of an asthma flare-up. When I went to see the patient and his mother in order to obtain a history and perform a physical exam, the subject of this child’s weight was being avoided by all of us. Finally, I felt the need to say something, so I asked the mother, “Does your child’s weight bother him at all?”

She quickly responded, “Oh no, he is just a healthy boy! All my boys are big eaters…they love their groceries!” And then she laughed, good naturedly.

After a while, she needed to step outside the room to take a phone call. I took the opportunity to engage the child who was sitting quietly on his bed. I sat down across from him and asked, “How are things?”

He didn’t say a word. He just started crying softly. Having grown up as a fat kid myself, I felt his pain, literally. When his mother re-entered the room, we began an honest conversation about obesity and its effects on asthma. Later, it came out that the child has been picked on at school. The mother had no idea. The family has never openly discussed the child’s weight issues! Even though the subject of obesity was a near obsession with this child because of his emotional pain, it was not a subject which could be discussed easily in their family.

I encouraged them to change that, to listen to their children, to identify cues, and to engage their kids in conversation always answering their questions HONESTLY and in a non-judgmental way.

This patient recovered from his asthma attack and went home, and hopefully he and his family took my advice and began a conversation on how to live in a healthier manner, and they ALL embraced a lifestyle of healthy eating and vigorous activity. The point is, the subject needed to be addressed and talked about. Rest assured, if your child is overweight, they know it and they deal with it, in their own way, every day.


There is a lot of helplessness associated with this problem. Some of it is learned, in the sense that overweight children most often have overweight parents, who may have been fighting their obesity most of their lives, trying fad diets, and buying exercise machines and joining health clubs, none of which has worked. They think nothing will work, and this helplessness and hopelessness is often communicated to the children, either explicitly or implicitly. We must replace the hopelessness with hopefulness. There are solutions and they do work. It takes commitment, will and dedication, but a child does not need to be overweight for life. It is not a life sentence, unless nothing is done about it! The best way for a child to have hope for the future is for his/her parents to be hopeful and optimistic. This problem should be addressed from a position of love, with mutual goals for improved lives.

Don’t add to the feelings of isolation overweight children often feel. As a society we have all gotten into this epidemic together, and it will be up to all of us , working together to get out of it. Suggest to your child that you work together to make your family’s life healthier. Explore websites like AllStride. Review the testimonials. Above all, BE HOPEFUL.


This follows closely behind hope. We must reassure our children that they and they alone, are in charge of making the right decisions for their own lives. And these little decisions, like whether to take a walk around the block with the family or stay in and play video games, or reaching for an apple instead of a Snickers bar, when lumped together, result in the huge decision to lead a long and healthy life. Reversing this epidemic begins with one decision at a time, one child at a time, and one family at a time. Once a critical mass is reached, the epidemic will be halted and eventually reduced. But this all begins with one child making one healthy decision – therein lies the inspiration. It is not overstating to say that your child making the right decision today is the first step toward reversing this life threatening epidemic for an entire generation. See how empowering this can be for a child who, up until know, has felt powerless? Try it, you will be amazed. You and your children are in control of the future of the health of our children, and thus, the future of our society!

John Monaco is a pediatric  critical care physician, with particular interest in childhood obesity. He has published three published books: Slim and Fit Kids, Moondance and Eternity and Too Small To Be Big.