Two of my patients came into the office today with their mother for check ups. I was a bit late coming in to see them so, started of with the all too familiar apology. Then we chatted about the heat and then summer books, movies, camps and camping. I asked what questions they had and, they asked if they needed shots (one did, one did not – always awkward to explain, that one). All the while I realized I was stalling, dancing around the issue at hand.

Both children have weight problems. Technically speaking, their body mass indexes or, BMIs  are well out of the normal range or, in the range we physicians rather horribly term “obese.” They are both attractive, happy, smart and one is really quite funny. They like each other, they are respectful and fun. How on earth am I to find the words to tell them and their mother that… they are dangerously overweight without wounding their young confidence? Without alienating their mother?

I breathed in and began with the usual questions and followed with a display of their growth charts. It turned out the family had already been discussing change. They were walking each night. They were trying new veggies and thinking about serving sizes. I asked about what they thought I wanted them to drink?

Ah, there was the change to focus on. I offered the rule of thumb that one 8 oz cup of juice a day has enough calories to cause a 15 lb weight gain over a year. That one usually works. But the mom looked at me and said with an exhale

I get it. My 17 y/o son has a close friend that I adore. They have know each other since preschool days. I have watched this boy move from sandbox play to stellar sports play,  through cowboy costumes to awkward gangsta-style hats and now to be a rather stunning, clean cut young man. He is at my house often and when he arrives he walks straight through the door, around to the kitchen and opens the refrigerator. Spoon in one hand, he then heads to the boy-den in the garage with his bounty. It makes me happy every time. There is something in my refrigerator that he wanted? Cool.

We get such joy out of feeding our children. I cook well, my kids eat well and usually healthfully. My refrigerator staples are rather boring from a kids perspective. But, every now and then I will head off to the store and come home with some major treats. Watching the glee that comes as the kids root around and find these treats is fun. I feel, oddly as if I have done a good job. But after a bit, I get a bad taste in my mouth (and it is not from the chips 🙂 )

In fact, doing the right thing by our children means being a bit tough. Don’t buy the juice. Definitely skip the soda. Cut up the apples and put them in a central location. Skip the chips. You’ll never know what they learn to like. My friend the cowboy-gangsta-lacrosse star? He devours, container after container, case by case, high-protein, low sugar greek yogurts. And, go figure, all this time I thought I needed to bribe them with junk.