Your Child's Weight: Helping Without Harming

by Ellyn Satter M.S. R.D. L.C.S.W. B.C.D

This groundbreaking book gives clear evidence that children gain too much weight because of how, not what they are fed. Satter's calming, practical and carefully documented voice empowers readers to feed well, parent well, and let children grow up to get bodies that are right for them. Packed with Satter's ever-popular feeding stories, Your Child's Weight offers clear guidance for professionals as well as parents.

Genres: Parenting, Nutrition, Nonfiction, Health, Food

472 pages, Paperback

First published June 13, 2005

Reviews

[Katharine · Rating 5 out of 5]

This is the third Ellyn Satter book I've read ('Child of Mine' and 'Secrets of Feeding a Healthy Family' were my first and second). As a dietitian who was both raised in and is raising a child in our very weight-centric culture, I stand by my previous recommendation: at least one Ellyn Satter book should be required reading for all parents. Her Division of Responsibility (DoR) of feeding is so beautifully simple, effective, and evidence-based, and it's the answer to so many child feeding concerns. This book, specifically, is perfect for both health and education professionals who work with kids, as well as parents of children who are concerned about their child's growth OR who have been told they should be concerned about their child's growth. It is written for both professionals and laypeople, and addresses ALL child growth concerns using the principles of the DoR, plenty of examples, and a wealth of research. Parents, caregivers, and health professionals can breathe a collective sigh of relief that kids are designed to grow in a way that's right for them, and all we have to do is support them. This may require discomfort on our part as we undo lots of habits and preconceived notions that end up harming more than helping, but it restores the beautiful internal regulation with which our children are born, and therefore leads to a rich, peaceful family feeding dynamic. HIGHLY recommend!! (**I also recommend 'How to Raise a Mindful Eater' by Maryann Jacobsen as much as any Ellyn Satter book!)

[Kendra · Rating 3 out of 5]

For someone without any children, I read quite a few parenting books (and blogs). I suppose I could try to justify this quirk with the fact that I work with children, and these books help me to be a better teacher/tutor/babysitter. There is truth to that, but the primary reason I spend so much time reading up on parenting is that I hope to one day be a parent, and I figure that it's a good idea to get a jump start on this reading now, before kids come along and I find myself too time- and sleep-deprived to get any reading done.

As I look toward one day being a mother, there are several aspects of parenting that I'm nervous about terrify me, but the one area that has me the most anxious revolves around the issue of nutrition and feeding. Given my own history with eating disorders, I recognize that I will have to be very intentional in this area that likely comes naturally to most parents; in spite of this - or perhaps because of it - I am determined to do all that I can to raise children who have a healthy relationship with food and their bodies. Knowing my desire for parenthood - and my equally strong desire to raise emotionally and physically healthy children - my dietitian recently recommended several books about raising healthy eaters. The first of these books was written by Ellyn Satter, a family therapist and registered dietitian, and one of the leading experts in the area of child feeding dynamics.

Your Child's Weight: Helping Without Harming is primarily written for the parents of overweight children, but the concepts of feeding and parenting addressed in this book are relevant for families of every size. At the core of the book - and the subject of the first several chapters - is Ellyn Satter's Division of Responsibility, which states that when it comes to feeding, it is the parent's job to provide structure, support, and opportunities, while it is up to the children to choose how much and whether to eat from what the parents provide. In other words, parents are responsible for providing regular meals and snacks, consisting of food that they (the parents) have chosen and prepared. Meanwhile, parents must trust that their children will eat the amount that they need, that they will eat an increasing variety of food, and that they will grow predictably. Satter understands that overcoming tendencies toward either restrictive or permissive feeding will be difficult for parents, but she insists that implementing the Division of Responsibility will serve to establish trust: between parent and child, and also between a child and his or her own body. It is Satter's belief that child weight problems are primarily behavioral problems that can be ameliorated through healthy feeding dynamics.

After making her case for the Division of Responsibility, Satter spends several chapters explaining how these feeding practices should be implemented for each age group, from infancy through adolescence. Satter also devotes sections of her book to the topics of family meals and physical activity. The book's final chapter is dedicated to helping parents understand their child's growth. According to Satter, a child is genetically predisposed to grow in a certain way, and by plotting their child's growth on a chart, parents can get a clear picture of whether or not their child is growing in a way that is right for him. Satter's thoughts on this matter differ from those of many health professionals: rather than focusing on how a child compares to the height and weight of other children, Satter is primarily concerned with whether or not the child's growth has been consistent. For instance, when encountering a child who is currently at the 98th percentile for weight, many pediatricians would recommend that the overweight child be placed on a diet. Satter, however, would look at the child's history to see whether or not the child had been growing at the the 98th percentile since birth. If that is the case, Satter would argue that the consistency of the child's growth indicates that this is a healthy weight for him. Rather than trying to bring their child's weight down, Satter would encourage his parents to help him accept his size. This idea of measuring a child's growth against himself - and not against the growth of other children - was new to me, and has reframed the way I understand the correlation between health and weight.

Despite the fact that this is a book about feeding, there is relatively little focus given to food and nutrition. I believe that this is intentional, stemming from Satter's belief that "how you feed is far more important than what you feed in terms of allowing your child to grow appropriately." Satter does give some very broad guidelines regarding food selection, but emphasizes that eating attitudes and behaviors play a far greater role in a child's health and well-being than the specific foods that they eat. (For instance, Satter believes that a family meal enjoyed around a table at McDonald's is healthier for a child than a balanced, home-cooked meal mindlessly eaten in front of the television or on the go.) I can appreciate Satter's desire to relieve some of the pressure (and possibly alleviate some of the guilt) that parents feel regarding food selection, but some more thorough suggestions would have been helpful.

While I have difficulty embracing some of principles laid out in Your Child's Weight, I appreciate the intent behind Satter's philosophy, and I found the concepts within the book to be informative and thought-provoking. I also cannot argue with the science behind Satter's ideas, which are supported by credible studies and reliable sources. Unfortunately, I was not impressed with Satter's actual writing. The book is filled with grammatical errors, awkwardly written passages, and redundant references to other sections within the book (as well as to other books that Satter has written). Detailed case studies are used throughout the book to illustrate various principles, and while these anecdotes are helpful to a point, they are frequently drawn out and add unnecessary length to what is already a very long book. As much as I was intrigued by Satter's ideas, I struggled to make it through this book. Nevertheless, it was a worthwhile read, and I hope to one day implement some of Satter's strategies when raising and feeding of my own children.

This review originally appeared on my blog: http://kendranicole.net/childs-weight...

[Mikey · Rating 4 out of 5]

DISCLAIMER: This was a required reading for school.

This book should be a required reading for all health professionals that work with the overweight or obese pediatric population (even if sparingly). The central thesis is introduced and bolstered strongly within the first two chapters. There is not necessity for professionals to read further. Later text is likely geared towards non-nutrition professional audiences, employing redundancy to establish comprehension.

The foundation is quite hypothetical although interspersed with (cherry-picked) footnotes. Alongside it’s dated (2005) publication it is easy to become dubious. Nonetheless, current professional texts often bear credit to Satter’s perspective and her guided hypotheses have a better foundation. Rewritten today, after another decade of research in pediatric obesity, she could present a stronger argument. There is merit to her approach even if in the absence of intended end points (e.g. reduction in pediatric obesity prevalence) . Still, I would caution that the text presents a simplified etiology and blanket recommendation to a complex issue. It will not work for everyone but it will be helpful for most. Comparatively, the perspective introduced is rarely employed being overshadowed by conventional therapeutic approaches which may actually serve better as adjuvant.

[Golnaz · Rating 4 out of 5]

Read this book for school but would highly recommend for new parents or parents of young kiddos. Such a great and important approach to feeding that sets our kids up for success with food and health and teaches them how to have a positive and healthy relationship with food! Four starts instead of five because there is some repetitiveness and as a dietitian, I didn’t love the nutrition chapter. However, specific nutrition recommendations are not the purpose of this book, rather a healthy approach to feeding and feeding behaviors.

[Ashley Malan · Rating 3 out of 5]

I debated on how many stars to give this book because the overall message of the book is wonderful and could improve so many families lives but the actual book as a book in itself was overly redundant (thus the 3 stars). I read this lengthy book front to back and I would say two-thirds of it could have been eliminated. If, however, one plans to just use this book as a resource to merely skim through it, read selective chapters and summaries, than Satter's repetitious writing style would actually be beneficial.

In terms of her feeding methods, I agreed with most of what she had to say though there were a few grey areas for me. At times she would use research and opinion simultaneously but state it more as fact as opposed to what it really was.

For instance, research suggests that parents who force their children to eat a certain portion of food each meal takes away the child's opportunity to learn how to self regulate their own hunger (agreed). Coercive or restrictive parenting at the dinner table (e.g you must eat this before you leave the table...or...you can't have any more of that because you already ate enough) produces children with eating problems down the road because, again, they are unable to self regulate (agreed). Therefore, Satter concludes that parents should not make their child eat anything they don't want to out of what is offered to them (not even one bite of something). This is one example of where I partially disagree. Research indicates forcing or restricting portions of food on a child can affect their ability to self regulate. However, there is no way that research could conclude that making a child try one bite of something (while allowing them to spit it out if they don't like it) would affect their hunger and/ or ability to self regulate. One could argue that making a child try a bite could ruin the meal if an argument erupts thereby ending a happy family dinner. But, I would argue back that an authoritative parent who is consistent with rules can make a rule that one must try a bite of everything (with the option of spitting it out if they choose to) while providing a consequence for those who choose not to follow the rule. If a parent is consistent with this rule (like any) and follows through with it while remaining rational and authoritative, but not authoritarian, there shouldn't be a daily battle because the rule is what it is. Kids learn, understand and have an easy time accepting rules given under consistent authoritative parenting. Satter herself backs this notion in a number of places throughout her book but fails to recognize the possibility in this area.

Despite minor annoyances with the book, I would certainly recommend it (or at least recommend they read a summary of it online) to every family. It truly can improve your child's health and the well being of your relationship with them.

[Sara · Rating 4 out of 5]

I wholeheartedly agree with this book!! I wish every parent would read it, because I think it would stop a lot of kids from having eating disorders. The main idea is that any food restriction or dieting that you pose on a child does emotional harm, which will do more damage. Simply love your child for the size that they are, and help them to feel the same.

[Marla Calvert · Rating 2 out of 5]

This book challenged a lot of my preconceived notions about weight and how it predicts future health outcomes. As a family doctor with a strong interest in nutrition, the book was recommended to me over and over. The basic premise is so simple: parents decide what goes on the plate and when the child eats. The child decides whether to eat, how much. All eating should occur sitting down together as a family. The challenging part is not this central philosophy which makes perfect sense, but the fact that Satter seems to argue that what you put on the table doesn’t really matter, as long as you provide it in a supportive way. She literally argues that fast food is not bad from a nutrition standpoint. She recommends fruit juice as a healthy addition to meals. She recommends providing an unlimited supply or bread and butter with meals. I agree that giving our children a message that they should be dieting and restricting is harmful, however I struggle to accept that sitting down together to eat McDonalds as a family will solve the problem of obesity in this country. I believe the problem is in both how and what we eat, and while I’m taking some good information about feeding dynamics and positive body image from this book, would not recommend for a balanced or comprehensive look at how weight in childhood relates to weight problems down the road. Another pet peeve is the way sources are cited at the end of each chapter WITHOUT dates!

[Luci · Rating 5 out of 5]

This book is an excellent overview of the causes and potential corrections for child weight problems. Crucially, Satter refocuses our attention from individual measurements of weight or stature to analysis of a child's growth over time, which is a better indicator of any potential problems.

The fundamental message of this book is that parents need to recognize a division of responsibility in feeding a child, in order for that child to remain in touch with their own internal hunger signals, grow normally, and develop eating competence in adulthood. The balance of this responsibility needs to shift over time as the child grows and demonstrates various competencies. Above all, parents need to manage their own impulses and societal pressure to restrict or otherwise control children's eating and movement, as these types of restrictions are actually the cause of most child and adolescent weight problems.

The book is a clear, compassionate guide to help caregivers navigate their approach to a highly contentious issue in current society. I would recommend it to all parents.

[molly · Rating 2 out of 5]

This is simply out of date in terms of the science at least, which I wish I had known going in. For example, it is clear now that early exposure to potential allergens is protective, and the recommendation is to cautiously introduce them in the first year. Just one clear example where this text is out of date.

However, Ellyn Satter`s ideas about nutritional division of responsibility come highly recommended by friends, so it was good to read a little more. I have to admit I skim read a lot of it since it was repetitive. In the end it seems pretty intuitive, but interesting to read this theory on how to give your kid a good basis in lifetime eating habits. Not sure I agreed with all her theories, but the idea of trusting your kid (and yourself!) to eat the right amount just feels right, even if it's not always a perfect veggie medley. I grew up with not great eating habits and was hassled about my weight from a young age, so I am determined to do this differently.

[Katherine Lickley · Rating 5 out of 5]

I'd recommend this to anyone with responsibility for feeding a human being. A child, overweight or not. Or an adult. Yourself!

The advice is wise, and grounded in experience and research. Some parts I found moving, when I came across something that has been part of myown distorted relationship with food. If reading it for yourself, you can apply the same guidelines as are given for a child who has developed problems with eating, and re-parent yourself into a healthier and kinder relationship with food, and with activity too.

The only part I didn't 100% agree with was not encouraging children to try new foods. My instincts tell me that for my son it is beneficial to be encouraged to just try a tiny taste of something at a meal, in addition to any parts that he already knows he enjoys. For another child, a more completely hands off approach may be preferable though.

[Becki · Rating 2 out of 5]

I abandoned this book around page 170. It was just *very* redundant. The basic premise is good: I'm in charge of the what's offered, when, and where if eating whereas my kid's in charge of what's actually eaten. But I got that the first time she said that...and certainly by the 5th and 12th expounding on it.
I did skim the remaining chapter's opening summaries and graphics.
Oh, and it forced me to give it a rating. So 2 stars it is.

[Janelle Hanick · Rating 5 out of 5]

Excellent book for all parents to read

[Brittany · Rating 3 out of 5]

Concept is great. It’s like intuitive eating with more structure. The book was so repetitive I couldn’t finish it, but I will be implementing its principles.

[Cassandra Pickens · Rating 4 out of 5]

Some important takeaways:
Restrictive and supervised or controlled eating and activity for weight control (and making size, shape a focus) is destructive.
If you criticize your own size and shape and continually try to change it, you aren't modeling physical self-esteem.
Show love (as much as food) and limits (what is served).
Include "forbidden foods" so they are less exotic and tempting.
Serve bread. It's a fine filler.
The problem is societal expectations/judgement, not the child.
Parents are responsible for the what, when, and where. Children are responsible for the how much and whether.
Parents who worry about child's weight and restrict or try to make them think actually raise fatter children.
Accept your child's size and shape and avoid interference.
Children don't distinguish between flaws in weight and flaws in themselves. They are viewed as the same. For kids, one flaw = total, all flaws.
Create better snacks and defined stack times.
Focus on what and when, not how much.

[Catherinesheetz · Rating 5 out of 5]

I have three children - one was beginning to eat too much, one was underweight and not gaining enough and one was just steadily underweight. This book helped tremendously. All three are the weight they are meant to be and growing well now. Her book helped me correct well-intentioned habits that were actually harming my children's eating patterns.

[Sariah · Rating 5 out of 5]

I absolutely loved this book...it was so insightful for me in terms of how to allow food its rightful, healthy place in a family--feeding the body, nurturing children's growth, pleasurable enjoyment, as opposed to a potential flashpoint for control issues etc. I loved it.

[Kathy Szczesniak · Rating 5 out of 5]

In my opinion, all parents and/or future parents should read this book whether or not he or she has a weight problem. This book gives great information and advice on how to make meal times fun and enjoyable while helping your child grow strong and confident.

[Jill · Rating 5 out of 5]

great book--loved the thinking behind satter. can't wait to go home and try out some new eating ideas with the kids.

[Annie]

I'm reading this book during my down time at work

[Leanne · Rating 3 out of 5]

Worth a skim, but that’s it. I felt like the author took 400 pages to say what could have been said in a few sentences.