Following sDOR: Give Children Autonomy

By Ellyn Satter, MS, MSSW, Dietitian and Family Therapist

What makes children fat? What makes them finicky? Read the table of contents of any major journal or parenting magazine for answers: Parents let kids eat too few fruits and vegetables, too much fast food, too-big portion sizes, too much “junk” food, too many soft drinks—I could go on. No child ever ate according to a prescription. So exactly how are parents supposed to get kids to eat more of the right food and not so much of the wrong food They aren’t, and they shouldn’t have to try. What children eat is not the problem.

How are parents supposed to get children to eat more of the right food and not so much of the wrong food? They aren’t, and they shouldn’t have to try.

The way children are fed is the problem

While it does come down to what parents are “supposed” to do, that supposing doesn’t have to make parents and kids miserable. Kids of all shapes and sizes eat what and as much as they need and grow in the way that is right for them when their grownups when parents follow the Satter Division of Responsibility in Feeding (sDOR). That is, grownups provide regular, appealing, sit-down meals and snacks and trust children to do their jobs with eating. How can I say sDOR is the answer? My recent webinar, Trust Children’s Capabilities with Eating, gives the evidence in convincing detail.

Children know what to eat

Fatter children eat no differently than leaner children: no more “junk” (high-fat, high-sugar, low-nutrient) food, no fewer fruits and vegetables. Cautious children with sensitive tastebuds learn to eat a variety of food, albeit more slowly. Children eat what they enjoy, and they push themselves along to learn to enjoy the food their grownups enjoy. Trying to speed children up slows them down, whether it is urging, applauding, giving a sticker for tasting a vegetable, or making a big deal about how much you enjoy vegetables. “Junk” food restriction doesn’t work, either, whether you are restricting yourself and passing it along to your child or restricting your child directly. Restricted children eat more “junk” food when it is available (certainly by the teen years when they are out on their own), are ashamed of themselves for eating it, and are heavier.

Children know how much to eat

Fatter children eat no more calories than leaner children; in fact, they eat fewer. Children eat as much or little as they need. From birth, trying to get children to eat less by giving them low-calorie (e.g. diluted formula or low fat, low sugar, high fruit-and-vegetable) food doesn’t work: they compensate by eating more. Trying to get children to eat more with high-calorie food doesn’t work either: they compensate by eating less. Children can be taught to overeat, but it takes a long time of unrelenting restriction or pressure. Restricting “junk” food is one way: Deprived kids eat as much as they can when they can. Instead, include “junk” food often enough so children become blasé about it.

Children know how to grow

Children grow in the way that is right for them. Consistent growth at any percentile on the growth chart is normal growth, even when it is beyond cutoffs for “overweight” or “failure to thrive.” Children faster and slower growth smooths out over time to a consistent pattern. Ill children whose growth falters gain back to their previous curve when they get better. Children whose parents are fatter tend to be fatter; children whose parents are leaner tend to be leaner. But when weight goes up or down suddenly and considerably, we need to take a closer look. Such sudden weight change doesn’t come out of thin air: something has to cause it. That something almost always includes parents’ not doing their jobs with feeding or intruding on their child’s jobs with eating.

Children defend their weight

The standard “treatment” to force children’s weight down is to put them on a diet of low-calorie food: fruits and vegetables, low-fat milk and meat, whole grain bread. Trust me: trying to get kids to eat vegetables and settle for low-calorie ‘healthy’ food, is a diet, even when you disguise it with “traffic light” lists (go, slow and no foods) or call it behavioral weight control. And it doesn’t work. Repeated US Preventive Services Task Force metanalyses of child and adolescent weight management programs show that even many-contact-hour, multi-professional interventions produce scanty weight loss. Given what we know about children’s ability to regulate their food intake and compensate for variations in caloric density of food, trying to force weight loss makes no sense whatsoever. Not only that, but “obese” and “overweight” children eat no fewer fruits and vegetables and no more fatty and sugary foods than children of “healthy” weight.

Raise children who have good appetite and good weight

How hard can it get? Well, hard. Do your part with feeding and trust your children to their part with eating. Block interference from one and all who tell you your child is too finicky, too fat, or too thin and that you should do something about it. Keep it up for 18 years. With such a challenging and relentless task, why would you volunteer for more by trying to get your children to eat their fruits and vegetables?