Scott Webb: Obesity is a disease and with a rise in obesity in our children. It's great to have on Dr. Sherry Sakowitz. She's the director of Healthy Lifeways Valley Center for Pediatric Wellness and Weight Management, and she's here today to discuss developing and encouraging healthy eating and life habits in our children. Welcome to Conversations like No Other presented by Valley Health System in Ridgewood, New Jersey. Our podcast goes beyond broad everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. I'm Scott Webb. Doctor, it's so great to have your time. I have a couple of kids and various eating issues along the way.

One of them liked everything. One of them hated everything and everything in between. So for all the parents out there, how do we encourage our children to, Eat healthy? And what does that mean exactly? Because like when my daughter comes home from basketball practice or something, she's not very hungry and I just want her to eat something. And then other times when we have the time and she is hungry, then maybe the quality matters a little more. So from your perspective, your definition, what does it mean to eat healthy and how do we encourage that?

Dr. Sherry Sakowitz: Eating healthy means eating food that's going to nourish you and make you feel good. My philosophy is that all foods fit. There's no good or bad foods. There's good or bad portions, but I really try to, persuade my patient. To eat more real food and less processed food. So real food. We talk about protein, we talk about fruits and vegetables. We talk about whole grains and healthy fats, and we really try to discuss with the parents the importance of giving them real food instead of the processed snacks.

So that's what I would consider to be healthy. As far as how do you get your kids to eat healthy? I think the best way is to role model for your kids. If your parents are eating healthy, then the kids usually follow their parents. Their kids are great imitators. They like do what their parents are doing. So first of all, definitely be a good role model. I think another, , good idea is to include them in cooking with them. Have them, , cut up vegetables. Choose the recipes and kids love to cook and whatever they're cooking, they tend to like to eat.

Also as far as, maybe planting a garden with kids, they love to go out there and water the vegetables. And of course, if they are watching vegetables grow for several weeks, several months, and they're gonna wanna eat them and partake in them and cook with them. So I think those are a few good ideas in how to get them to eat healthy. And I hope it answered your question of what is healthy in my book

Scott Webb: Absolutely. And then all of us parents have been there where sometimes it's just about the quantity of food, just getting them to eat something. And then other times, as you say, we can focus in a little bit more on the actual quality of the food, fruits, veggies, things like that. What do we do if we have a child doctor who just says they're always hungry? Yeah. I had one of those kids, he was just always hungry. I'm like, how can you be hungry? You just ate. So What do we do?

Dr. Sherry Sakowitz: So first of all, you always have to believe a child. If they say they're hungry, you can't dismiss them and make them feel bad that they are hungry because they may be hungry. Even if a child is eating frequently throughout the day, they may not be eating food that is healthy in terms of making them feel full. They may be filling up on processed snacks, with a lot of sugar in them, and those foods are just not satisfying them. So what I would do is I would discuss with them, if they're hungry, I would listen to them, I would offer them foods that were, are gonna fill them up. And that's really what I would do. If they're saying they're hungry.

Scott Webb: Yeah, just sort of acknowledge it and, assume that they're not lying. Okay. I guess they're hungry. You do about it. And so my daughter, the other one, she's the snacker, she just grazes all day. And then it's difficult for her when it's mealtime to be hungry enough to eat a meal because she's been snacking all day. So how do we handle kids like that, that are the snackers, and how do we get them to understand the value of meals?

Dr. Sherry Sakowitz: So first of all, when we talk about a snacker, there's different types of snacks. So if they're eating snacks with high, nutritional value, for example, a protein and a fruit and vegetable, then I mean, that's almost like a mini meal. So when you're saying snackers, are you talking about like someone who's eating processed snacks all day long or somebody who's just eating mini meals throughout the day?

Scott Webb: Yeah, I see what you mean, right? Like there's, snacking on some grapes perhaps, and then there's snacking on something from the pantry that comes in a plastic.

Dr. Sherry Sakowitz: Like potato chips.

Scott Webb: Like potato chips. Exactly.

Dr. Sherry Sakowitz: If your child only wants to eat a snack, , don't interfere with what your child wants. I wouldn't have any rules in the house. I would allow them to have a snack, but I would encourage them to eat real food for snacks like proteins or fruits and vegetables, even a car. But you want them to underst. Snack time is when you are hungry and not just when you are bored or eating in front of the tv. So I would establish just like a routine that when you have a snack, you should be hungry and offer them healthy snacks.

Scott Webb: Yeah. And of course, , adults are sort of guilty of this as well, where you're just sitting around and maybe you're watching Netflix and you're bored and you find yourself with your hand in a box of crackers or potato chips or.

Dr. Sherry Sakowitz: So one thing I usually tell my patients is not to eat and watch screens at the same time, cuz it's really mindless eating when you do that. So I would try encourage your children to eat at the table, whether it be a snack or a meal, and no eating in front of the TV.

Scott Webb: Yeah, that's a great suggestion for all of us, not just the kids. The parents too. So doctor, what role does sleep have on weight? I know like my son was a little undersized and we used to tell him the more sleep he would. Get the better chance he had of growing and he did ultimately grow, which was good, but maybe it had nothing to do with sleep. But in general, what role does sleep have on a child's weight?

Dr. Sherry Sakowitz: Sleep is really, really important. We know through different studies that kids who have very little sleep, they tend to have an increased chance of having a high BMI. So there's definitely a direct relationship between lack of sleep and obesity. And we know through different studies that if kids don't sleep enough during the night, the next day, their hunger hormones are higher and they tend to crave more carbs. So I always tell my patients that I want them to get enough sleep for those reasons. Obviously sleep is so important for so many other things, but there definitely is a direct relationship between lack of sleep and being obese.

Scott Webb: Yeah, there is. And you mentioned BMI there. So the body mass index. How do we know if our child has a weight problem and should we be looking in the mirror a little bit ourselves? You know, is there a genetic component to it? I know that obesity is such a problem in this country for both children and their parents.

Dr. Sherry Sakowitz: As a pediatrician we define obesity by BMI. So the best way to tell if your child has a weight problem i s from their pediatrician. Your pediatrician will figure out the BMI and they'll, put it on a CDC growth chart and they'll get percentile. And if you, , are at the 95th percentile or above, then you are considered to be obese. If you're between the 85th and the 95th percentile, you're considered to be overweight, and that's really the best way to tell if your child has a weight problem. You can't just look at a child and know.

Scott Webb: Yeah, I hear what you're saying. And is there any sort of genetic component to this, to your understanding? My you mom is a bigger gal. She's six foot, and she was always a bigger gal and she just always believed that, you know, it wasn't her fault, she didn't overeat as a child, that she was just meant to be a bigger person. Is that a thing? Is it genetic?

Dr. Sherry Sakowitz: Yes, so there's definitely genetic component here. The study suggests about 40 to 70% of the time it is driven by genetics. I will tell you though, the genes load the gun and the environment and the behaviors is what's pulling the trigger.

Scott Webb: I see what you mean. Behavior, lifestyle for sure. And I know, , there's so many diets out there and fad sort of diets. Keto is just, you can't open the news or social media without reading about the keto diet. So there's just this sort of diet culture in America especially. And so much of it is about, Counting calories. How do we talk to our kids about food and nutrition and all the stuff we're talking about today, but without talking about calories, without getting them sort of hooked on that sort of diet, calorie counting culture, if you will?

Dr. Sherry Sakowitz: That's a great question because I know I grew up in this diet culture and I grew up with that, and that was definitely the wrong approach. We don't talk to kids about calories , what you can talk to your kid about is about the quality of the food. This is a really good food. It's gonna keep you full. There's a lot of nutrients in it. That's the best way to talk about food or this is very healthy for you. This will give you a lot of energy. And always go back to it will make you feel full. Those types of things. We never talk to kids about calories or dieting or, anything in negative in terms of those types of things.

Scott Webb: Yeah, I couldn't agree more. And as a dad of a 15 year old daughter, you know, and I know that she spends time on, TikTok and Snapchat, and we could do an entirely separate podcast about, what our kids see and what they think of themselves when they look in the mirror. And I guess I'm wondering what do we do? How do we react if our child says that they're fat?

Dr. Sherry Sakowitz: Okay, this is a very concerning statement. So you never want to make the child, even if they think that they're fat, you never want to agree with them. And you explained to them that. People come in all sizes. Some people are tall, some people are short. Some people have big feet, some people have small feet. There's different sizes and it doesn't mean anything. And I would definitely encourage your child to, say you're not fat, you're beautiful. Make them feel good about it. And you can, as a parent, just be very supportive. But you should never say to your child, yes, you are fat. Why don't you go on a diet, anything negative like that.

Scott Webb: Yeah, I mean, people get away with that kind of stuff on sitcoms, but in real life, obviously, you would never want to say those things to your kid. And what if somebody else does, doctor? What if a family member says something to your child about their body size? What do we do in those situations?

Dr. Sherry Sakowitz: Right. I mean, , I don't know if there's a right answer. I know what I would do. I would definitely speak to that family member. take them aside and tell them to please not talk to your child like that. And I would definitely talk to your child later about it and say, I heard them say that, that was not right. And I would definitely not dismiss it. I would definitely give it attention because obviously some children won't care, but some will care and it could cause eating disorders. It can cause all different kinds of issues down the road, make them feel bad about themselves, lose self-confidence. So definitely I would not dismiss it, I would, , talk to your child about it and definitely tell that other person never to do that again.

Scott Webb: So what if, we have a child who's overweight, , and it might be natural for parents to feel a little bit like it's their. Fault. Like somehow they've contributed to this, and maybe they did, maybe they didn't. But if they feel like they did, is that valid? And how do we sort of overcome that feeling? The stigma of having maybe an overweight child? What do we do?

Dr. Sherry Sakowitz: So first of all, it's nobody's fault and it's the responsibility of the pediatrician to let the parents know that we're living. In a time right now where there's so many factors that are causing obesity and we're really considering obesity to be a disease at this point. So like you said earlier, there's genetic influences, there's epigenetic influences, there's community influences, behaviors. There's so many things that are causing this, but it's definitely not the parent's fault. It's very hard because there is a lot of weight stigma that goes on and it's just something that we're all gonna have to learn.

That it' s the more and more that this message that obesity is disease and the more it gets out there, I think the more. Parents will understand. It's not their fault. The American Academy of Pediatrics just came out with their first clinical practice guidelines, and they're really stressing us that this is a disease. There's many different, reasons for it. It's nobody's fault. I think the more, and. This language is gonna get out there. The less weight stigma and the less guilty the parents are gonna feel. For example, if your child gets asthma, nobody blames it on the parents. Or if your child has high blood pressure, you don't blame it on the parents. And really, when a child has obesity, we shouldn't be blaming it on the parents.

Scott Webb: the parents, Definitely not about blame. It's about helping them and thinking about helping children and however everyone defines success, whether that's academically, socially, when it comes to their weight, their size, whatever it might be. Where can we direct parents doctor to help their kids, , to really like set them up for success?

Dr. Sherry Sakowitz: Okay, so first of all, I think the best place to start is your pediatrician's office. They usually have a lot of community resources available and know about them, so they may refer you to dieticians or they may refer you to a. Pediatric obesity specialist. , so I think the best place, like I said, is to go to the pediatrician's office, go from there. They'll probably give you a lot of good information where to start. And depending upon the degree of overweight or obesity, they will refer you to an intense health behavioral life treatment program.

Scott Webb: Yeah, that sounds good. And we were talking earlier about modeling and how kids look to us, especially when they're little, they see us in what we eat or how we talk or whatever it might be. If a parent really just doesn't know how to model healthy living, where can they go for?

Dr. Sherry Sakowitz: Okay, so great question. And I think it's really important that parents realize that they may not know what to do and ask for help in these circumstances. So again, I would start with the pediatrician, and see what they have to say. See what kind of resources they can offer. I think more and more of these lifestyle behavior or treatment programs are gonna be. Because these are the new recommendations from the American Academy of Pediatrics. And I think these programs are being set up to teach families how to live a healthy lifestyle. So I think that's probably the best place to go.

Scott Webb: All right. Well you know what, doctor, this has been really fun and educational and I think so much of what we talked about here today is really about getting the word out, especially about obesity and how to deal with it and how we can help our kids. So it's all good stuff. And as we wrap up here, if we were gonna enroll our child in a any sort of weight management program, what should we look?

Dr. Sherry Sakowitz: So what should someone look for in a weight management program? Definitely somebody who has experience. You don't wanna just find some person on the internet who is setting up a program for kids that doesn't have any qualifications. We wanna look for a registered dietician for, help with what they're eating, an exercise physiologist with help with what kind of activity. And if your child is overweight or obese, you wanna look for a doctor or a specialist who can help with possible medications or referrals for surgery if needed, depending upon the degree of obesity the patient is going for.

So definitely someone with experience. , obesity medicine is a whole new subspecialty and. , there are a lot of doctors who are being trained in this, and this is really the, these people are trained specifically to help families get healthy. So I would look for somebody who's trained in obesity medicine, and like I said, if you're just looking for someone with nutritional help, I would look for a registered dietician. And yeah, that's where I would start with those things.

Scott Webb: Yeah, that's perfect. Yeah, a real multidisciplinary approach. Folks who have trained and are skilled at working with younger folks with children, teens, adolescents, whomever. So really good stuff today. Doctor. Thank you so much. You stay well.

Dr. Sherry Sakowitz: Thank you.

Scott Webb:

And for more information about pediatric wellness and weight management at Valley, visit valleyhealth.com or call 201-316-8438 to make an appointment. And if you found this podcast helpful, please share on your socials and check out our entire podcast library for topics of interest to you. And thanks for listening to conversations like No Other presented by Valley Health System in Ridgewood, New Jersey. For more information on today's topic, or to be connected with today's guest, please call 201-291-6090 or email Valleypodcast@valleyhealth.com. I'm Scott Webb, stay well.