An excerpt from Your Child Is Not Their Weight: Parenting in a Size-Obsessed World, with permission from the American Academy of Pediatrics, 2026.

A friend and colleague who is a doctor in adult medicine made this comment to me several years ago: “My patients with kids have a harder time with their health than those who do not have kids!”

I pointed out to her that the “patients with kids” she was talking about were some of the same people I saw in my clinic, parents! As pediatricians, we probably talk with caregivers as much as we talk with children. It was a funny paradigm shift for my adult medicine colleague to realize her patients were also parenting.

As caregivers for our families, we would sacrifice anything for our children, often to our own detriment. As my friend noticed, parents spend so much of their time caring for their children that they end up sacrificing their own health and well-being in the meantime.

Navigating health changes within the family

If a parent has diabetes and has to cut back on sugar and limit their carbohydrates, they could feel torn between putting their whole family on a similar meal plan or eating differently themselves. I used to practice pediatric gastroenterology and took care of children with gluten allergies (celiac disease). Parents, stepparents, and other adults caring for children all told me, “It is just easier if the whole family follows a gluten-free diet.”

Navigating a change alone in a family can be difficult, whether you are the adult or the child, but sometimes you have to do that; maybe you have to take a special supplement or a medication or have to avoid a specific food because of an allergy.

What you are doing for yourself, as a caregiver, may not be the right thing for your child. Parents who have shared their bariatric surgery story, including how they now have to eat small, protein-heavy meals, have come to realize that their meals will look different from the ones they may serve their children. It can lead to confusion and sometimes loneliness as they feed their family one meal and end up eating a different meal before or after the family.

When it comes to our health, if we must follow a special diet, engage in specific exercises, or take a medication or supplement, we have to be careful when communicating these changes and figuring out the best way to navigate them within the household. Our children may not understand why we are doing these things, may be frightened by the health concern, or may try to copy behaviors without understanding why.

This leaves us as parents with a quandary: Do we explain everything going on with our health, do we hide it, or do we settle somewhere in between?

Talking about your health (not weight) with your children

The principles for talking about bodies are similar to those for talking about your own health. If you are dealing with any health issues that require changing your health habits, here are a few tips in approaching the conversation with your children:

Be honest. Explain the issues at hand and what changes you plan to make to address them. Continue to be careful about how you talk about food and health (particularly with younger children) to remove judgment about their eating or prevent fear of future problems. Instead of saying, “Daddy has high blood sugar levels because he used to drink a lot of sodas,” explain what diabetes is and why Daddy has to eat less sugar now. If talking about high blood pressure, explain that a lot of things can cause high blood pressure (e.g., genetic makeup, diet, stress), taking care not to blame yourself or something you used to do, like, “I used to eat a lot of bacon and did not exercise, so that caused me to get high blood pressure,” thus avoiding equating a 1:1 relationship between a health habit and your blood pressure. This can scare children, which can either lead to overcompensation (your child avoids all sugar and displays signs of an eating disorder) or elicit the opposite reaction (eating a lot of sugar because they are scared it will be taken away from them). Finally, note that some efforts are just for adults and not necessarily for children: “Daddy’s back sometimes hurts, so he is doing this special exercise to help manage that.”

Keep things positive and within reason. While we always want health changes to be for the whole family, every family is different. In our home, we go to work and school at different times, so we are not able to have breakfast together on most weekdays. Our breakfasts differ because some of us prepare breakfast the night before to save time and the rest of us do it that morning. If you change to a high-fiber breakfast to help with cholesterol, it is OK to say, “This food gives me energy. It is part of a balanced breakfast, and I like it. It will also help with my cholesterol.” Or if switching up a workout routine, try, “I do this exercise to be strong and help my body stay that way,” or, “Taking a walk helps me have a better day and not be grumpy after work.” It is also not a requirement to provide reasons for a change. Some children, particularly younger ones, may not even ask why oatmeal is now being served a few days a week. A more common question is likely to be, “Why can we not get breakfast from the drive-through on the way to school?” Your response can be as simple as, “I would like to have breakfast at home more often,” without an in-depth discussion of cholesterol.

Talk about your own body as it is, without criticism or comparison to others. For example: “I have a birthmark on my cheek. Sometimes I wish it was not there, but it is also a normal part of me, and I have grown to like it.” When it comes to your health, keep body size and shape out of it. Criticizing our body or someone else’s body implies that there are “good” and “bad” bodies. When you comment about someone else’s weight gain or loss, the value of the weight change comes through to your children. Make sure your children hear you saying great things about your body even when you do not always love yourself. Having your child hear you say how much you love showing off your shoulders in a new dress conveys and teaches them self-confidence. Even better, express excitement about reaching a goal not related to your size: “I finally completed a 5-mile walk. I rock!”

Recognize and honor familial differences in bodies. For instance: “My grandmother had the same hair as me. I love seeing her when I look in the mirror,” or, “Our family members all have a gap in their front teeth. Some have had braces to change the look. When I see my tooth gap, it reminds me of my father’s smile!” For myself, my right eyebrow has these wild few hairs that grow straight up and curl, just like my father’s. People comment on them and sometimes ask why I do not pluck or trim them; one person even reached up and tried to pluck them (not cool!). It would be reasonable and easy for me to trim those few eyebrow hairs, but I do not because they remind me of my father. Children may have inherited something about their bodies that they do not like and often cannot change. Practicing loving their bodies, and not commenting negatively about them, can help them build up their own self-esteem and positive body image and learn to appreciate the uniqueness in everyone.

Joey Skelton is a professor of pediatrics and of epidemiology and prevention and author of Your Child Is Not Their Weight: Parenting in a Size-Obsessed World