Plenty to Lose in Discussion of Weight and Self-Esteem

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Social Q’s

My 9-year-old daughter is fat. This is not entirely unexpected. My family runs thin; her mother’s does not (though my wife is not overweight). I believe that our daughter is old enough to hear the truth and the consequences of her behavior, like laying on the sofa instead of playing outdoors or eating candy instead of healthy foods. My wife disagrees strongly. She worries about the effect on our daughter’s self-esteem. This issue is becoming heated between us. How would you handle it?


I have picked up your question several times this week, hoping, each time, to find a kernel of compassion for you. Nope! (The closest I came was wishing that your employer might send you on a long business trip, keeping you away from home until your daughter turns 30.) Your wife is right: Telling your little girl that she is fat, or commenting frequently on her weight or the weight of others, will harm her self-esteem and increase the odds of her developing an eating disorder and other problems.

But worse, I can’t find the love in your question. As a dad, your job is to build your daughter up. Let her know that she is awesome just the way she is. (There are enough creeps out there who will try to make her feel bad, no matter how thin she is.) But you seem more wrapped up in blame and how your child’s weight reflects on you than her experience in the world. Please get smart on this issue before you do any harm to her. Start with a good pediatrician or child psychologist.

Make healthy food shopping and eating a family affair, not a punishment that singles out your overweight daughter. She will model your behavior. Same with exercise: a fun game of tag, for everyone, encourages physical activity without shaming her. You aren’t responsible for our weight-obsessed culture. But you do bear responsibility for how your child moves through the world. Get to work!

Promise Me This

I’m stuck. Two years ago, I told my son (in his 30s) that I was concerned about his health because of the amount of weight he had gained (about 50 pounds). He said, “I’ll take care of it, Mom,” and then he asked me never to mention the issue again. I promised I wouldn’t. But he continued to gain weight. This summer, he and his wife had their first child — my first grandchild. Now I’m worried and alarmed about his health and my granddaughter’s future. I feel that I must say something. May I break my promise?


A mama wants to save her babies, no matter how old they are, right? But judging from the conversation you had with your son a couple of years ago, it seems as if you are not the right person to do the saving here. Additional comments from you about his weight may be counterproductive. Keep your promise.

Try not to take this personally. Our relationships with our mothers (and fathers) are about as complex as they come. So, a simple statement by you, like: “I’m concerned about your health” may be heard by your son, after it passes through the mother-son hall of historical mirrors, as something like: “You are a disgusting pig and a constant disappointment to me. Why can’t you do anything right? Your sister Jennifer is perfect.” See what I mean?

Fortunately, if your son’s weight is indeed affecting his health, it will not be a secret to him, his wife or his doctor. You are not the essential diagnostician here. Better to leave the subject alone, as you promised, and trust him to handle it in his own way and time. Bonus advice: The next time you speak with him, let him know you think he’s wonderful — for absolutely no reason.

Be the Bigger Woman

I am a petite woman in my 30s. As an emergency room physician, I am constantly introducing myself to people. For years, patients have gone out of their way to inform me that I am very small and look young for my age. I have come up with various non-replies: “I’m ageless” or “I’m old enough.” But the constant commentary is starting to drive me crazy. I want to let them know that their remarks are inadvertently offensive. Any ideas?


If the setting for these comments were anywhere other than a hospital emergency room, I would happily help you concoct a reply that would sizzle on contact. As this week’s column attests, remarks about other people’s size or weight are not cool, and brand their makers as thoughtless or unkind.

But you are seeing these folks at their most vulnerable — terrified that they are having heart attacks or that their children have suffered complex ankle fractures. Their anxiety about your size may be a proxy for their fear about your ability to help them. Chastising them for (unintentionally hurtful) remarks that (understandably) upset you seems wrong in that moment. Redirect them, instead. Say: “Luckily, I am an amazing doctor.” That’s all they really care about.