First, " try and finish it " is hardly forcing a child to eat - I’m not of the opinion that only literally forcing food down a child’s throat counts as “forcing a child to eat” , but “try and finish it” doesn’t make it. Being forced to sit at the table for hours until the plate is clean is another story.
Second- these are strangers. You don’t know what’s going on. You don’t know if the kid has/had an eating disorder. You don’t know if the family is traveling and this kid has a habit of half-finishing a meal and wanting to stop for food again an hour later.
Some people who have what they’re eating frequently criticized will also grow up to have eating disorders.
Parents shouldn’t be trying to make their kids eat things the kids can’t stand, or routinely trying to make them eat when they’re not hungry. But nobody should be criticizing strangers’ food choices. You’ve got no idea what else is going on in that family, or what else they’ve eaten or not eaten that day or that week.
Even if they should (and as noted a stranger really has no idea what is the backstory) parents are highly unlikely to alter their parenting for the better because some stranger criticized them in public. Impacting a family wide dysfunctional relationship with food is possible with professionally facilitated group work over multiple sessions. Possible. Shaming parents in public? Will only cause harms. Maybe to you.
Don’t wait to be told to mind your own business and then stop. Just mind your own business in the first place.
To the op. Another instance of medical cause is medication related: atypical neuroleptics like Abilify are sometimes prescribed to kids, autistic children with severe aggression most commonly. A common side effect is a huge increase in appetite and sometimes massive weight gain. Thinking about it that may be the most common clear medical cause I see.
Thinking more there is another medical cause I’ve seen a few times. Severe obesity sometime happens in survivors of certain childhood brain tumors as a result of damage to the parts of the brain that regulate appetite and metabolism.
I’ve known way too many parents of kids with bad eating habits who use the excuse “They’re a picky eater, it’s the only thing they’ll eat!” when they give their kids diets of sugars and refined white flour products.
I don’t know of any cases of kids who died because they chose to starve themselves to death rather eat a plate of chicken, fruit, and vegetables.
When kids are hungry they will eat what’s available. They don’t have the means to drive to the store and the cash either. If your kitchen is full of juice boxes, potato chips, captain crunch, and oreos then that’s what they are going to feed on.
If all you have is milk, apples, raisins, almonds, and cheese sticks then they’ll feed on that.
When kids get hungry enough they will eat what is available. Until then you might be putting up with a raging tantrum that goes on for hours, and interferes with any other activity that needs to be done. I can totally understand the parent that will make macaroni and cheese for the fourth night in a row, because at least the kid will eat it.
In my research, (with n=1 kid), refusal to eat is often an attempt to delay until a more desired food choice is available. The parental commands to eat what is in front of you are not trying to force feed a kid, but rather to get some nutrition in the kid, which hopefully leads to a small (or no) dessert. It’s much better to have a kid with a full stomach eat a small dessert than let a kid with an empty stomach try and fill up on candy. Usually this is more along the lines of “if you want dessert you need to finish what is there” than “you need to clean your plate.” “I’m only hungry for ice cream,” is not a valid excuse to skip dinner.
As for why there are so many overweight kids today? My guess is that it is for much the same reasons that there are so many overweight adults. The answer to that is still “we don’t really know.” The technical side is understood: people eat more calories than the burn. But that is a completely useless answer in understanding why that happens. Genetics plays a part, but we can assume that there hasn’t been some huge shift in the genetic makeup of society over the last 50 years.
Clearly many things have changed in the environment that is leading to the obesity epidemic. Genetics plays a role in individuals’ vulnerability to these environmental risk factors. What are these risk factors? Cheap, liquid sugar; low levels of antibiotics in the environment; advanced food science designed to create “can’t eat just one” snacks; viruses; other infections; milkshakes disguised as coffee. Certainly many more things, and possibly some of those I mentioned will turn out to not be important.
I did, a few times when I worked in restaurants. In each case, I saw a mother (always a woman, anyway) feeding a child who was obviously old enough to feed themselves, and no, the child wasn’t mentally or physically disabled; they just had a few bites left on the plate and the child didn’t want to eat it. We’re talking about kids of school age, old enough to be embarrassed by this kind of thing.
I always kinda sorta hoped the kid vomited all over the car on the way home.
Back on topic: morbid obesity in a child with no metabolic or genetic issues, who doesn’t have a family history of it and wasn’t that way as a younger child is frequently a symptom of trauma, often sexual abuse.
I saw a piece on the news a few years ago about a 12-year-old girl who was going to have lap band surgery for this very reason. She KNEW she needed to limit her diet, but her body did not and could not tell her when to stop eating, and IIRC this youngster was under 5 feet tall and already weighed about 300 pounds.
And then there was this. Her daughters still participate, and all of the members, both new and old, remain morbidly obese. It almost makes me wonder if that is a condition for membership.
Did you hear that story a few days ago about a teenage boy who ate nothing but junk food and ended up permanently blind? I suspect something else was going on, most likely a genetic issue which may also have been a factor in his extremely limited diet. (It’s not uncommon for people on the autistic spectrum to have very restricted diets, often due to texture issues.)
I googled those Rainbow groups. Wow! They were all obese. Every freakin’ state has these girl groups and 98% of the girls were big. The adults pictured with them were big too. So sad.
Ah, but we did not pick how much* or what went into our plate. And “you’ll eat what’s been put in front of you” did not refer to amount: it refers to stuff which made us throw up. How does making your child sick equal good discipline?
Until I started being the one who plated the food, but note that this doesn’t apply to restaurants and hotels.
I think all of that’s a factor; but I think another factor is, paradoxically, our modern emphasis on the importance of being thin (often more thin than is at all easy for a particular body to maintain) and on the “sinfulness” of eating. While there’s been a streak of this in the society for a long time, especially as it applied to adult women, the emphasis on it even for young children and for most men is relatively new; and we’ve got considerable evidence by now that going on calorie-restriction diets changes metabolism to the point at which eating “normally” can cause weight gain. And shaming children for eating is I suspect likely to lead to their being more likely to gorge on treats when they get the chance.
I was lucky in that my own mother had a very good ability to judge the difference between a child who was literally nauseated by a particular food, and one who would just rather move on to dessert. (There’s a family story that once when I said I was too full to eat some part of the main dinner, and my mother said “You must be too full to eat dessert, then”, I said “I’ve got a separate compartment for dessert!”) I think it’s in large part because I was never made to eat something I really couldn’t stand, and was never made to eat more than one small taste of something I’d never tried before, that I now happily eat a lot of things I couldn’t stand as a child.
Making (or trying to make) a child eat things they really can’t bear is not only bad discipline, it often backfires.
That sounds like Prader Willi, although it doesn’t ALWAYS mean a child will be morbidly obese.
If they don’t get help though, it can be scary. There was that one girl a few years ago whose mother just indulged her and let her get to almost 700 lbs, and she didn’t make it. They found her lying in her own filth, covered in bed sores, and the mother ended up being arrested for child neglect. shudders
The following is IMHO and how I advise parents of almost all children as a pediatrician in that role (not to a stranger in a restaurant). Three rules, the first two of which are not hard for most parents but the third one a bit tougher for many.
Offer a wide variety of healthy food choices as part of the family meals inclusive of vegetables and fruits. (And model eating them yourself!)
Do not allow any more than small amounts of special treat unhealthy choices.
After that be done.
Don’t be a short order cook. Don’t be a food fascist. Don’t cajole. Don’t threaten. Don’t bribe. Don’t critique. Do not allow food to be a power battle or an item of power. Given rules one and two being followed your child will eat when hungry, stop when not hungry, learn to pay attention to those internal cues more than external ones, and over time eat a balanced diet. If you are anxious do a multivitamin for* your* sake.
Absent something like some of the pathological conditions discussed in this thread we really do best by providing those two guardrails and then trusting our kids to navigate within them.
Could we please get back to the OP? A child who is morbidly obese may well have one of many rare conditions. Prader-Willi is certainly one possibility since it can involve intellectual disability as well as obesity. So is Bardet-Biedl syndrome, which causes progressive vision loss as well as obesity. Cohen syndrome can cause obesity, intellectual disorders and crippling muscular issues, though the excess weight is normally not in the arms and legs. Froelich syndrome can also cause obesity. And there are a host of others.
There are also medications such as certain anti-psychotics, that can cause obesity, although perhaps not as extreme as in the OP. However, there’s nothing that says the child couldn’t have both a genetic/glandular disease AND a condition requiring anti-psychotics.
In any case, we have in the OP a child who has extreme morbid obesity, possible intellectual issues, and needs assistance to walk, all of which indicate something beyond mere negligent parenting. What a difficult, heartbreaking situation for the child and his family.
