Prevent and treat child overweight and obesity

From birth, feed according to Satter's division of responsibility

 

Address your child’s weight with the division of responsibility in feeding


You can prevent child obesity, from birth, by following Satter’s division of responsibility (sDOR) in feeding: you do the what, when, and where of feeding and let your child do the how much and whether of eating. You can treat obesity by restoring sDOR and letting your child’s natural ability restore eating and growth that is right for her. On the surface, the intervention is simple enough – so simple, in fact, that you may feel you are doing nothing at all. In reality, you do a tremendous amount when you follow sDOR and thereby do good parenting with feeding. You keep up the day-in-day-out of family meals and structured snacks throughout your child’s growing-up years. Then you keep your nerve and trust your child to eat as much or little as she needs and grow in the way that is right for her.

Because following sDOR is rewarding and supports the quality of your family life, you will be able to keep up the considerable effort of maintaining pleasant and rewarding family meals and sit-down snacks. Then you can forget about strategies for getting your child to lose weight:

  • You don’t have to try to control what and how much your eats . . .  and you don’t have to try to get her to control it, either.
  • You don’t have to try to get her to eat more “healthy” foods such as fruits and vegetables, whole grains, and other low-fat foods.
  • You don’t have to be the food police with so-called “unhealthy” foods – the high-fat, high-sugar stuff.
  • You don’t have to give up Friday night pizza nights or movie popcorn or hide tempting foods so your child doesn’t get them.

 

Child overweight: Helping without harming

Feeding dynamics and eating competence based prevention and intervention

By Ellyn Satter

Learn to follow the division of responsibility in feeding


On the right are resources to help you learn how to feed based on the division of responsibility. Read Your Child’s Weight: Helping without Harming and watch the feeding videos to get a clear understanding of good feeding based on the division of responsibility. Observe how children naturally behave with eating, Be considerate without catering in your meal-planning. Each meal needs high- and low-calorie foods as well as one or two foods your child generally eats. Then adjust your expectations of your child. When you apply sDOR, your goal is not to limit him to a certain amount or type of food, but for him to feel good about eating and show evidence that he knows how much to eat. And be prepared for the long haul. He will only feel good about eating, eat the amount he needs, and grow consistently when you accurately apply sDOR and continue to follow it.

Evidence that your child eats the amount she needs

If you have been restricting your child, it will take him a while to recover his trust that you will let him eat as much as he wants. It will also take him a while to become sensitive to his own feelings of hunger and fullness. At first, he is likely to eat a lot, especially of foods you haven’t let him eat before. But after a few weeks or months, depending on his age, he will begin to show evidence of his ability to regulate her food intake. He will:

  • Feel good about eating
  • Come willingly to meals and snacks and behave appropriately there
  • Do most of his eating at regular meal-and snack-times
  • Be relaxed about getting enough to eat
  • Be relaxed about eating all kinds of food
  • Come to meals and snacks hungry and eat until he is satisfied
  • Manage how much he eats without worrying whether it too much or too little
  • Grow at a consistent percentile or shift gradually up or down

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Your Child's WeightTo discover the joy and reward of following the division of responsibility in feeding and letting your child grow up to get the body that is right for him, read Ellyn Satter’s Your Child’s Weight: Helping Without Harming .


Family Meals Focus ~ No. 34

To see what feeding looks like when parents follow the division of responsibility - and when they don't (and to find out that feeding your child is not all that much different), see Ellyn Satter’s Feeding with Love and Good Sense DVD II. For home use version, click here. 

Make an informed choice: sDOR or conventional treatment?

You are likely to be advised to follow some sort of restrictive diet with your child to try to get her weight down. Your adviser may tell you to follow the division of responsibility in feeding along with the other methods listed below, but that is just wrong. You can not both try to get your child to eat certain amounts and/or types of food and follow sDOR. Trying to do both will hopelessly confuse you and your child. However, the choice is yours. To help you make your choice, understand what such treatment involves.

People who advise restricting children’s eating to slim them down seem to think that children who get “too fat” simply eat too much of the wrong food or move too little. The solution is to get the child to eat less or move more. Forever. Below are common conventional methods of child weight management. Even if such a method is called non-diet, or non-restrictive, or a point system, it is still a diet.    

  • Having a target or cutoff point for the child’s BMI (Body Mass Index): Defining the child as overweight if BMI is above the 85thpercentile, obese if BMI is above the 95th and trying to get the child’s weight to level off or go down.
  • Emphasizing what and/orhow much the child should eat: Trying to get the child to eat more low-calorie foods such as vegetables, fruits, skim milk, and whole grains, and fewer high-calorie foods such as sweets and fried food. Imposing portion sizes.
  • Emphasizing what and/orhow much the child shouldn’t eat: Trying to get the child to eat fewer high-fat, high-sugar foods.
  • Emphasizing exercise for the purpose of slimming. Giving the child guidelines or activities that emphasize how much to move.
  • Targeting interventions toward the child: Giving the child (rather than the parents) instruction in food selection or prescriptions for activity.
  • Miscellaneous: Giving calorie prescriptions, limiting eating out, particularly at fast-food restaurants, encouraging eating breakfast, all for the purposes of weight management.

 

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