Weightzones

View Table comparing Weightzones with BMI Categories

How to address weight gain with your kids

Addressing the prejudice based on weight by addressing the language we use is a fundamental step in dealing with the “obesity epidemic”.

Numerous approaches are being taken to stem the “obesity epidemic”.  One seriously neglected area is that of eliminating the stigmatization surrounding obesity.  There are good reasons to address stigmatization; doing so will contribute significantly to the well being of all people who are obese. It will also enable all people to recognize and personalize the risk of high levels of body fat in themselves and their children, and thereby become more receptive to public health messages about this issue.

The message authorities are trying to take to an individual level in the community is that obesity is a serious risk to health:  If your child is obese then your child is at risk of serious long term health problems and you need to do something about it now, before it becomes a more entrenched and difficult problem.  To internalize this message however, parents first have to recognize that it might relate to a child of their own. They have to confront the fact that their own child might be obese and they then have to find out whether this is, in fact, so.

This is where it becomes tricky.  It is easy to distance ourselves from obesity when the media has resorted to illustrating it with extremes.  The children shown on TV articles about obesity have levels of fat that far exceed the threshold of risk.  They represent the severely affected end of the spectrum.  The reality is that levels of fat become a risk to children way below what is illustrated in the media.  Children we consider “well nourished” may be carrying levels of fat that are a risk to them.  Most children we consider skinny are within the healthiest range for levels of fat.

All children who have a very high level of fat once had a lower level of fat.  Parents need to recognize increasing levels of fat in their children much earlier than they currently do.  These are the parents who have most hope of stemming obesity in the future, by helping their children to hold their level of fat steady, so that they can grow into it, with a minimum of fuss and attention to the matter.  But who wants to say to one of these parents “Your child is obese”?  What parent wants to hear “Your child is obese”?  And so we hedge around the topic with euphemisms such as “a little bit overweight”, or “chubby”, or “slightly over-nourished”, or “its just puppy fat”, or “don’t worry, he’ll grow out of it” and hope that we don’t need to define it or confront it any more deeply or hurtfully than that.

But this is not good enough, and it is not fair on parents or children.
Just as it is impossible to explain to a parent whose child has leukaemia, for instance, why that child needs intensive chemotherapy unless you call the condition what it is; (leukaemia) it is impossible to explain adequately to a parent why their child might need intensive focus on their levels of activity, and oral intake, over and above what they are already doing, without telling the parent, explicitly, why this extra effort is so important in this particular child.
But we are hopelessly tangled in the current terminology.  The words are biased and hurtful even though, for the most part, they are not meant to be.

How to address weight gain with your kids

The single and simple change in terminology that I am proposing will enable health workers, parents and young people to address the issues of overweight and obesity in an inclusive and non judgemental way.
Instead of speaking with children, young people and their families about obesity and overweight we speak with them about “weightzones”.

Everyone has a weightzone. 

• The lowest weightzone is referred to as A0 (A naught)
• The healthiest weightzone is referred to as A1.
• The level at which risk associated with weight is first recognized is called A2
• The level which corresponds with clear further increases in risk is called A3

The message then becomes clear and simple.  We are aiming for an A1 weightzone in each and every one of us, but some of us won’t make that.  Our level may be A2 or A3, and that is OK because it is just a level, and we all have one.  Higher levels increase our risk, and we know that too.  We can also make it clear that while the people being illustrated in the media may be A5 or A6 weightzone, your child, who is in the A3 weightzone still needs to be identified and guided to optimize their health.

Rather than having someone who is “obese” aiming to become “overweight” (and the equally perverse situation where someone who becomes “obese” is no longer “overweight” according to the current labelling system.), we will have instead someone with an “A3 weightzone” aiming to reach an “A2 weightzone”.

A weightzone is neutral, universal and personal.  Children can be taught this as they are currently taught about cleaning their teeth, and keeping good personal hygiene.  Adolescents can be taught it as they are taught to monitor their pulse to evaluate their fitness.  They can be taught it as they are taught to recognize that we all have a blood pressure, and that our blood pressure level needs to be within certain bounds to be most healthy.  They can be taught that the best way to use their knowledge about their weightzone is as a private and personal guide for them, for the long term.  Some children may have an “A2 weightzone” (as per the BMI guidelines) that does not vary over many years, and they can then use this information to guide them into a realistic understanding of their weightzone throughout their life.

This approach does not negate good self esteem or pride in one’s body.  It does not imply, in the way that the term obese does, slothfulness, or lack of fitness or poor nutrition.  It does not imply an either/or solution or something that, if we find the right diet, we can forget about and “cure” ourselves of.  Being comfortable in one’s knowledge of one’s weightzone is a part of empowering people to manage their life in the best way they can for good health.

This is not to say that this new terminology can take away the despair and discomfort that many people feel at having a high weight.  It can’t stop stigmatization and negative judgements that people make about people with high levels of fat, but using neutral and inclusive language is a crucial step in the right direction.  Fat should not define who we are, and the language we use should not imply that it does.  Fat is just fat, and we need to remember that.

Further, instead of using labels such as "morbidly obese" for people whose bmi is above 40, the current category of "obese" can be split into higher weightzone categories such as A4 for those whose BMI is 35 to 40, A5 for those with a bmi of 40 to 45 etc.

In the case of children, this then avoids the current dilemma in which parents see the "obese" children shown on TV articles and believe that is what "obesity" is.   They then cannot believe that their child, who looks nothing like big as those children shown, could possibly be "obese" and therefore, could be at risk of the negative health consequences that they hear about in the media.

You can now explain to parents that for most children, the A1 weightzone is most healthy.  You can tell them that their child (for example) is in the A3 weightzone which means that they are at a significant risk of health problems related to their weight; that it is important that they work to hold that child's weight steady so they can "grow into" it; that that child is at risk of cutting up into higher weightzones and they need to be monitored for that; and that (if necessary) the children being portrayed in the media are usually already in the A4 or A5 weightzone, but that doesn't make it any less important to also recognise children who are in the A3 (and A2) weightzones.

You can then also stress the importance of following their child's weight trajectory over time to pick up early whether it is cutting up towards, or into, a higher weightzone.

This can be achieved very simply by monitoring their child's weight over time, either through their family doctor, or by using the steadygrow program which personalizes the weightzones for each child and charts that child's weight trajectory.  This gives parents the feedback they need to know whether what they are doing is working for their child or not and guides parents to seek help early rather than late.

Page last modified June 25, 2008.