Of course, every story needs an ending. I was beginning to wonder whether ours would ever have one.
CHAPTER 15
When I first located the Centers for Disease Control’s kids’ BMI calculator online, Bea weighed just over eighty-eight pounds, which, according to the CDC, gave her a BMI of 22.1, putting her in the 97th percentile for her age. An important aspect of managing the program on our own is that in order to make progress, I needed a clearer, more concrete understanding of what the goal was. Numbers were going to have to come into the picture.
Bea looked healthier, but she was still technically considered obese. So where would the scale, as it were, tip? Assuming her height stayed constant, if by the end of the school year, four and a half months away, she lost eight pounds—a reasonable goal on all levels—what would that get us? According to the CDC, a 19.3 BMI, which was in the 92nd percentile, and a move from “obese” to “overweight.”
Okay, not bad. So what if she grew an inch during that time? That would bring her to a BMI of 18.6, which was in the 89th percentile, right in the middle of the “overweight” category.
I went on like this for a while, imagining potential future dates, weights, and heights. It was profoundly obvious that the nutrition doctor had been wise not to get us focused on numbers. You could go mad.
Bottom line: I wanted to know what Bea needed to weigh in order to enter the “healthy weight” category. To get an idea, I calculated what she would have to weigh at that day’s height in order to be considered healthy by the CDC. The answer was seventy-three pounds.
Wow. It was exactly twenty pounds from her starting point of ninety-three pounds. I like round numbers when thinking about weight. But it was a lot more than I would have thought! Looking at her body at the start of the process, I had wondered whether ten pounds might do the trick. When she lost the first few and I couldn’t really tell the difference, and the nutrition doctor had intimated we had a long road ahead, I considered that she might have to lose fifteen or so. I really hadn’t thought that such a small person, who was hardly the fattest kid you could imagine, could be twenty pounds away from where she needed to be.
I must admit to being demoralized. After all we had gone through—cajoling, arguing, doubting, manipulating, feeling isolated and judged, spending so much time and money—we were only a quarter of the way there.
I knew time and growth were on our side, slowly and delicately prodding Bea’s BMI in a better direction even without weight loss. I considered seventy-three pounds our new target. When we’d started the program, I had secretly hoped we could knock off enough pounds to have her at a healthy weight by the end of the school year. Now it was March, and it was clear that wasn’t going to happen. But could I hope she could do it by the end of summer? Five months to lose fifteen pounds didn’t seem reasonable. But what if she grew? I went back to the CDC BMI calculator.
The BMI calculator gave me an outlet for my anxiety and provided a navigational tool when I felt I had no road map. I wanted to have a concrete goal in mind, but I couldn’t be the one to decide what that goal should be. I didn’t want my own judgments about appearance and weight to influence that decision. I wanted no less an authority than the U.S. government to tell me what my daughter should weigh. Once I knew that, I could predict how long it would take to get there. Psychology experiments have demonstrated that a person’s pain can be ameliorated somewhat, simply by knowing how long the discomfort will last. And that’s how I felt as I typed in numbers to try to estimate how long it would take for Bea to reach seventy-three pounds.
I didn’t tell Bea about this goal, but I had it in mind. It surprised me that a child, ostensibly growing every day, could eat so very much less than she usually did and still lose weight at such a glacial pace. I felt that we were up against this fierce opponent who was not going to be easily vanquished and who was more brutal than I had realized. I had to be kind to Bea while also being ruthless in my fight against her obesity. Any instance in which we let down our guard—allowing Bea to skip karate, have an extra cookie, or get half of a big bagel instead of one little one—was ceding ground to the enemy.
So I felt little compunction about the sternness with which I approached our new tradition of Saturday morning weigh-ins. I likened it to how my husband had to take his blood pressure regularly to monitor his hypertension. It was a medical necessity. I tried to be offhanded or even jovial about it, but as far as I was concerned, Bea could not start her day until she had gone to the bathroom and was standing naked on that scale.
“I’m hungry!” she’d say when she awoke.
“Pee, take off your clothes, and weigh yourself first,” I’d say cheerfully.
Sometimes it didn’t go so smoothly.
“I want a bagel,” she requested one Saturday morning.
“Pee, clothes off, weigh self,” I sang.
“No!” she shouted.
“You can have the bagel. Just go to the bathroom and then weigh yourself. It takes one second.”
“I don’t want to.”
“Well, I’m sorry, you have to,” I said.
She relented, stomping onto the scale so hard I feared she’d break it.
I was super careful to be exceptionally upbeat and supportive no matter what the scale said. If it was down, I was celebratory, but in a low-key way.
“Down a quarter pound. Good job,” I’d say, nudging her off the scale.
If the drop was significant, I might get a little more excited. “Wow! Eighty-six-point-eight! You were eighty-eight last week!” On those weeks, I gave credit for her patience during the weeks the scale hadn’t moved. “See, you kept with it even though the scale didn’t move for a few weeks. I’m proud that you didn’t get discouraged.”
If the scale didn’t show any weight loss, I’d encourage her. “Same as last week. Cool. Let’s keep at it.”
It wasn’t until the end of April that the scale registered a gain one week. She went from 84.0 to 84.8 pounds. The previous week had been one of those big one-pound-plus weight drops, so maybe her body was just rebounding a little. Or maybe she’d had some extra food during the week, or just eaten too much fruit the night before. But I tried to make her feel okay about it.
“It’s fine, don’t worry about it,” I said casually.
If there was a clear reason for her weight to go up, I talked to her about it.
“I think that’s because we had that big dinner at Grandma’s house last night, and you’re still digesting it,” I once explained.
I felt it was useful for her to understand that overeating does indeed show up on the scale. She didn’t have to feel bad that she went a bit overboard at Grandma’s house—but she should be aware that it had some small effect on her weight.
We are lucky to have many things to celebrate in our lives, and I didn’t want those moments to be spoiled by guilt. I took the time to explain that special occasions are a part of life, and food is a big part of most of them. Weight management experts often warn us to be cautious about the connection between food and festivity, and certainly between food and emotions. “Don’t use food as a reward!” “Food shouldn’t be a requirement for every celebration!” “Watch out for emotional eating when you’re sad or bored or angry!” But I disagree. We have cake on our birthdays for a reason: it’s fun to eat cake, and social to share it. Eating does provide some entertainment when I’m bored, and some relief when I’m upset. I’m okay with that as long it doesn’t happen all the time. Emotions and occasions can sometimes drive eating, and I believe that if you’re conscious of it and aware of the connection, it has a place in life.
I was more concerned with everyday carelessness. Other parents often gave me grief for being too strict with Bea at any particular moment when she was presented with a tempting food no-no. But anyone who has tried to diet halfway can attest that partial measures don’t work.
“Can’t she just have a small piece? Just to try it?” a parent once asked, holding a slice of pie a
loft above Bea’s plate after she’d eaten her dinner and had some dessert.
No.
“They’re kids for such a short time,” a classmate’s mom said one day at the movie theater as I handed Bea a sad little bag of 100-calorie microwave popcorn and she gave her own child a big tub of the good stuff from the concession counter.
I can understand that viewpoint, but …
“It’s a special occasion,” others often declared, as an excuse for giving Bea a treat.
But special occasions aren’t really all that rare. In fact, they happen all the time. Today alone, as I look at my calendar, I see that Bea will be celebrating this month’s school birthdays at lunchtime, and had the privilege of enjoying a petit déjeuner with her French teacher this morning. And it’s just a random weekday! Both are opportunities for extra calories, and they have to be compensated for at afternoon snack and dinner.
I police David’s eating, too, just in different ways. For example, his favorite food at Chinese restaurants is moo shu vegetables, mainly because he likes the pancakes. He used to eat just the pancakes. He’d have five of them at least, sometimes seven or eight. And then he’d be so crippled with constipation the next day that he’d be wailing in pain and unable to move. So we forced him to add the vegetables and to eat only a few pancakes. That’s just obvious parenting. No one feels weird when I tap his hand and say, “Hey! Enough pancakes!” or ask, “David, how many moo shus have you had?”
When the mother of a heavy child exercises control over that child’s food intake, it’s impossible not to read more into it than if the interaction occurred between a mom and a normal-weight child, whether it’s “That mom is too permissive; that’s why the kid is fat” or “Good thing she’s intervening—that boy could stand to lose some weight” or “That poor kid, her mom is nagging her about food just because she’s a little chubby.” Everyone’s personal associations, value judgments, and emotional responses to my limitations were always hanging over us.
The nutrition doctor had a rule that discussions of weight should be confidential and that food choices shouldn’t be dictated to kids. Rather, in a private environment, we should be working together to plan what Bea ate. Which, in ideal situations, we would. But for overweight children, most situations are not ideal.
CHAPTER 16
“Even if I fit in and I’m not fatter than the rest of the kids, that’s who I was: the fat girl,” Bea told me tearily. “And that’s who I’m always going to be. Even if I change, I’m always going to be known as that person.”
She was responding to her changing appearance as her weight moved down slowly but surely through the spring. She was within ten pounds of the goal of seventy-three. When dressed in certain clothes, Bea could pass for a normal-weight kid. That was new.
People had started to notice the difference. A neighbor in the elevator exclaimed, “Look how thin you’ve become, Bea!” Parents of her classmates told me how great she looked. Even a seven-year-old friend, his mother told me, remarked that “Bea looks skinny.” Another mother used the same word at a chess tournament to acknowledge Bea’s transformation. I put aside my usual defensiveness about words such as thin and skinny and happily accepted that they were compliments in this case.
In every instance, I made sure that people understood that Bea had worked very hard to get healthier—giving her credit for the achievement, so it wasn’t just chalked up to a growth spurt or something, but also shifting the compliment away from approbation for being thin, and more toward congratulations on having adopted healthier habits.
But Bea didn’t welcome all this attention. To her, it was a reminder that she wasn’t like everybody else. I was confident that her young friends would soon forget that she had been overweight until second grade. But to her, someone commenting on her weight was an inherent reminder of the fat girl she used to be, and of the struggle that continued to set her apart from the other kids. It was impossible for me to discern whether Bea’s discomfort with the compliments she was getting were attributable to embarrassment at the reminder of her former self or just the awkwardness of attention to one’s body at age seven.
Bea still had her belly—and when I cuddled her at night and in the morning, I still enjoyed squeezing and kissing it. I wanted to convey to her that I loved all of her, even as we were both working so hard to make her a little smaller.
It was a daunting challenge to impart to Bea the idea that my refusal to let her be an unhealthy weight was different from a desire to make her thin. I knew she probably didn’t grasp the difference, especially since my weight was healthy, but that fact did not exempt me from being disappointed that I wasn’t thin. While I tried to stop expressing negative feelings about my own body out loud, I also tried to make sure Bea knew I loved hers.
I was focused on Bea, but in dieting alongside her, I was losing weight consistently, too. It was gratifying to see that by regulating my eating for the sake of setting an example for Bea—not allowing myself a gargantuan muffin for breakfast or two PB&J sandwiches for dinner—I could actually sustain a lower weight more easily than I’d been able to previously.
And I had never, ever in my life eaten so nutritiously. I was averaging three apples a day. I was even eating salads, since my husband insisted on them, and they were “free.” Protein was an everyday occurrence. I was making progress.
I celebrated the kids’ achievements with gifts for certain weight milestones. David got a present when he finally—victoriously—stepped on the scale and saw it had passed the fifty-pound mark. He picked an electric pencil sharpener. And Bea and I periodically chose a certain number lower than her current weight and tied it to some item she wanted.
Associating achievement with a specific number on the scale was likely not a strategy a doctor would have approved of, especially since we tended to celebrate in such superficial, girly ways. But I’m unapologetic. It felt right. It would be great if Bea could be motivated to stick to her diet entirely by the promise of reduced risk of type 2 diabetes, but that’s not reality.
I’m aware that some experts say that our “reward culture” is bad for kids. But Jeff and I—and 100 percent of all the other parents we know—have been rewarding our children for achieving goals and improving their behavior since they were babies. There were gifts (bribes?) for potty training, for not fighting, for suffering through flu shots, for remembering to dress themselves and brush their own teeth in the morning. And why not? To a large extent, our new way of eating was a difficult and often annoying form of behavior modification, and adhering to it seemed to merit incentives as well.
I suppose I could have insisted she choose a gift with some gravitas, something that related to her achievement: a kit for growing organic vegetables, an encyclopedia of the human body, a special reusable snack cooler. But she wanted clothes, so I got her clothes. A few strappy summer tops from the Gap. A white, flouncy flower-girl-type dress from Crewcuts. The latter was particularly sweet because it was a dress she had wanted but hadn’t previously been able to fit into even at the largest size.
She often asked whether she could get a hair feather as her gift, and I said no. Not because I felt it sent the wrong message, but because I kind of irrationally hated those hair feathers. In the spring of that year, salons were gluing or clipping colorful, thin feathers into kids’ hair all over the city. A few of Bea’s classmates had them, and she really wanted one. She also wanted pierced ears. (She also really wanted braces—go figure.) Some things had to wait.
In many areas, I encourage my children to accept aspects of themselves that fall outside the norm. I celebrate David’s choice of pink as his favorite color, even as his peers try to shame him out of it. I don’t make my kids attend some extracurricular activity they’re not interested in, just because “everyone else” is. I don’t even like the word normal. But as far as Bea’s weight was concerned, I yearned for her to be normal. In this case, there was a correlation between a medically healthy weight and a socially acceptab
le weight. Being normal in this area meant maximizing her opportunities in life.
I wanted Bea to love herself and her body. I wanted to find the perfect line between insisting she not be unhealthy and encouraging her to accept herself as she was once she was at a healthy point, even if it meant she was still heavier than most of her friends or the girls she saw on TV. I wanted her to be vigilant about her eating in order to not cross the border back into obesity, yet not be obsessed with food and her weight. I didn’t know whether achieving that balance was possible.
CHAPTER 17
When the summer arrived, I started to get concerned about Bea’s height.
Having not set foot in a doctor’s office for many months, I measured Bea’s height as best I could at home, standing her up against a wall and drawing a pencil mark at the top of her head, then measuring that. These readings were obviously not exact science, but even in their crudeness, there was no mistaking the fact that she was not taller than four foot six. The measurements never, no matter how I tried to stretch them, ever exceeded the height I remembered her being measured at back in January.
This worried me for two reasons. On the dumbest level, I was bothered by the fact that her BMI measurement was not being helped by the growth I had expected. All the hopeful projections I’d typed into the CDC BMI calculator, in which I’d guessed she’d grown an inch, three-quarters of an inch, even half an inch—were irrelevant. She was still four foot six. And whereas a goal weight of seventy-eight pounds rendered her healthy for her age at four feet seven inches, at four feet six inches she’d have to get down to seventy-five pounds.
Three pounds doesn’t sound like a lot. To give you a sense of proportion, it’s equal to an average-height woman (like me) having to lose four pounds, which I can do in around two weeks. But given the rate to which we’d slowed, I knew those three pounds were going to take a while. Bea was losing a pound a month at best.
The Heavy Page 15