Dear Therapist:

Thank you so much for your insightful column each week. I gain a tremendous amount from your suggestions and advice. I am hoping that you can guide us. We B'H have a wonderful almost 10-year-old son; he is a fantastic kid, smart, conscientious, studious, well-behaved, bright, a real baal middos and a budding talmid chacham. He brings us a tremendous amount of nachas. The problem is that he likes to eat and has been steadily gaining since 5 years old. First it was 10 pounds, then 20, and now more each passing year. At almost 10 years old, he is 130 lbs.  As I see it, he is not very athletic, has a big appetite, and won't touch a salad or vegetables. He had been seeing a nutritionist who suggested utilizing punishments or rewards to motivate him. Will that work? Should we punish our wonderful child for gaining too much weight? We have tried rewards with minimal success. Is he just too young to understand the importance of healthy eating and the consequences of unhealthy habits? We would be grateful for any suggestions or advice.

Response:

I certainly understand your concern, and you are right to question the advice of the nutritionist. Although kids may respond positively to reward and punishment, there are facets to consider other than whether this will result in the desired weight loss.

One aspect to consider is your son’s motivation to lose weight. Does he understand the consequences of being overweight? If not, is this something that you believe should be discussed with him? If he does recognize the consequences, is he motivated to lose weight? If he is, are his reasons positive ones? Does he want to lose weight because he wants to be healthier, to feel better, and to be more active? Or does he view the goal of weight loss from a negative perspective, wanting to lose weight due to feelings of shame and embarrassment?

If your son doesn’t seem to be aware of the effects of being overweight, you can have a discussion with him about these. Naturally, you would take into account factors like his sensitivity in order to frame the conversation in a neutral manner.

For a variety of reasons, it’s important for your son’s motivation to come from a positive place. Clearly, you don’t want him to lose weight because of fear or shame; rather you want him to do so out of a healthy, responsible interest in reaching a particular goal. In addition to the obvious long-term emotional impact that negatively-based motivation can cause, people generally respond better to positive motivation. This is usually true with regard to short-term goals, and even more so in the attainment of an ongoing pattern.

At the age of ten, children often do not recognize future consequences, and therefore do not feel the need to change things that have no immediate impact on their lives. Even if your son intellectually understands the negative effects of being overweight, he might not be motivated to change at this point. This doesn’t necessarily mean that he never will be. If the issue is framed properly, at some point in the future he will hopefully decide on his own to change his behavior. If this happens, it’s much more likely that he will be able to maintain this in the long term.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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