How could I start a healthy lifestyle discussion?

There are lots of ways to start a healthy lifestyle discussion. You may be able to build on or use information you have already gathered as part of the encounter, or use a health problem you may have already identified to talk about their weight status.

Suggested discussion

“Our service/practice is committed to improving the health of all children, adolescents, and their families. We know that a healthy family lifestyle can play a big part in maintaining a child’s health.

There are some simple things you and your family can do to help the whole family eat well, be active and stay healthy.

Is it OK if I show this to you?

Here is some information: the first is a healthy habits and a healthy weight fact sheet and the second is the 8 for a healthy weight resource.”

How should I raise the issue of a child’s weight?

  • Put it into context. Talk about how weight influences a child’s physical health and how being above a healthy weight could affect the child’s social and emotional life, including their experience of school.
  • Use visual aids such as the BMI-for-age charts.
  • Take care with the language you use. Keep it as positive as possible and focus on terms such as ‘healthy weight’ and ‘healthy lifestyle.’
  • Think about who should be included in this conversation. You may choose to give feedback to the parent or carer alone or the parent or carer and child together.
  • Allow some face-saving. It may be helpful to talk about how parents or carers have a much harder job helping their families maintain a healthy lifestyle than 20-30 years ago.
  • Remind parents or carers, as well as yourself, that it’s difficult to tell if a child is at a healthy weight just by looking – that’s why you are doing the measurements.

Suggested discussion

“I am just looking at where Luke’s BMI places him on the BMl-for-age chart for boys. As you can see he is just above the 85th percentile which is just outside of the healthy weight range for his age. Is this what you were expecting?”

  • Now is the ideal time for you to advise the family that more information and support is available. Consider whether you can offer to manage the child, or whether referral is warranted.

What should I say if the child is above a healthy weight?

If the child is above the ‘healthy weight’ range, the best approach to take when explaining weight status is to stress to parents or carers that the calculation of weight status is a routine procedure used to monitor the healthy development of all children and adolescents over time.

The parents or carers can use the calculator themselves at home if they are concerned, or can follow-up with their GP.

Suggested discussion

“It is difficult to tell whether a child is growing in a healthy way just by looking at them, so it’s important to measure their height and weight regularly to help monitor their growth over time.

I’ve plotted how your child is growing on this chart. The chart shows he/she is above a healthy weight for their height and age. Have you seen your child’s growth plotted like this before?

What do you think of this?”

What if a parent or carer is not ready to discuss this issue?

Some parents or carers will not be ready to discuss the issue. Parents or carers may feel a sense of guilt about the family’s lifestyle behaviours and could become defensive when this issue is raised.

If this happens. you could say:

  • “It can be hard to practice healthy habits every day.”
  • “Most families could do with some assistance to improve their healthy lifestyle habits.·
  • “It is part of normal care to assess a child’s growth and development.
  • “It is a health professional’s role to discuss healthy lifestyle behaviours with all families.”

Raising this issue is not about placing blame or judging the parents or carers, but an attempt to help the family to be healthy.

Suggested discussion

If the parent or carer is still unwilling to discuss this issue, it is important to respect the parent or carer’s decision.

“It may not be a good time for you to discuss this now. Please feel welcome to talk about your child’s weight with me at any time in the future, or raise it with your GP.”

Provide an opportunity for further discussion by letting the parents or carers know that if they change their mind they are welcome to revisit this issue at any time in the future, or raise it with their GP.