As more schools open for in-person learning and some organized sports resume, many children — like adults — are returning to the world after having packed on extra body weight.
While data is sparse on whether there's been a rise in children's weight over the pandemic, some health professionals have seen worrisome signs.
Suzannah Stivison, a pediatric nurse practitioner in Kensington, Md., told NPR that some of her patients put on what she calls "the other COVID-19" — as in, 19 pounds.
A loss of daily structure, in school and extracurriculars, left kids looking for a sense of control that she said many have found in eating.
"One of the ways that we regained a routine and a schedule within our families was most likely, for a lot of people, around meals," she said.
Stivison herself admits slipping into an unhealthy pandemic kick.
"I never have Cheetos in my house. But all of a sudden, they appeared," she said. "And this has been a phenomenon that I have seen in lots of houses. Eating became something we could control. And it was it's also something we use for comfort."
Virtual appointments have made it difficult for health care workers to conduct their regular height and weight assessments. But research has shown that children tend to gain weight during extended sedentary periods like summer vacation, when fewer are getting regular exercise through organized sports and physical education.
Parents who are concerned about addressing their children's weight face tricky hurdles. Those unprepared can contribute to the various stigmas around eating disorders and diseases like obesity, which have their own consequences on children's physical and mental health.
But there are supportive ways parents can help get their kids to get back to a healthier lifestyle, Stivison said.
It's less about talking and more about setting an example, she said.
Talking in the abstract about risk factors such as Type 2 diabetes and heart disease, she said, doesn't really work, especially with younger kids.
"The thing is, is that kids know they're heavier than their peers. They know they get out of breath," she said.
Instead, parents can model good habits like exercising an hour a day or keeping the house stocked with healthier foods.
"It really comes down to the modeling and the opportunity we can control what food comes into the house," she said. "And so guess what? I've stopped buying Cheetos."
The good news, Stivison said, is that healthier behaviors among kids should bounce back as people start to return to their normal rhythms.
Parents who've become more lenient with screen time, for example, will likely reinforce those limits, she said.
"Screen-time rules for kids being two hours or less came from the fact that increased screen time correlated with higher weights and BMI," she said. But during the pandemic, she said, "I have even been supporting families, saying, 'OK, playing video games with friends who are, you know, in their own house playing video games — don't consider it screen time. Consider it social time.' "
But as parents start to get their kids vaccinated, she said, "that in and of itself will likely help this problem to a great degree."
Samantha Balaban and Melissa Gray produced and edited this interview for broadcast.
LULU GARCIA-NAVARRO, HOST:
Kids are getting back in the groove as more schools open for in-person learning and some organized sports resume. But many children, like adults, are returning to the world - how shall we say this politely - less in shape than they were before the pandemic. How do you address this with your child or should you even address that? Joining me now to talk about this is Suzannah Stivison. She's a pediatric nurse practitioner at Capitol Medical Group in Kensington, Md. Welcome to the program.
SUZANNAH STIVISON: Hi, Lulu. Thank you.
GARCIA-NAVARRO: So data is a little hard to come by because a lot of appointments have been telehealth, right? And we can't get accurate height or weight assessments. But what have you been seeing with your patients?
STIVISON: So what I've seen sort of runs the gamut. I would say we have had children affected and put on the - what I refer to as the other COVID-19. Then we've had kids stay the same because they were on elite hockey teams or soccer teams that were able to continue their rigorous training. And then we've even had the other extreme. We've seen some significant eating disorders in much younger patients than we would normally see.
GARCIA-NAVARRO: Tell me what that looks like. Why is this happening?
STIVISON: So it's what is not happening. That's not just to refer to the activities and sports that these kids were formerly doing. It's that they lost everything - their entire structure, routine and regiment. So it left a lot of kids looking for control. And one of the ways that we regained a routine and a schedule within our families was most likely for a lot of people around meals. We saw tons of adults getting into bread baking, right? In my house, I did do the shopping, and all of a sudden, there were Cheetos in my house. I never have Cheetos in my house. But all of a sudden, they appeared. And this has been a phenomenon that I have seen in lots of houses. So eating became something we could control. And it's also something we use for comfort.
GARCIA-NAVARRO: So how do you address this? Because there's a lot of stigma around eating disorders and about medical conditions like obesity. How do you, as a medical professional, address this when kids come in for their appointments? Because you don't want to body shame and you don't want to parent shame, but you do want them to realize how important it is for them to get back to a healthier lifestyle.
STIVISON: It's true. And the thing is, is that kids know. They know they're heavier than their peers. They know they get out of breath. And so it really comes down to modeling what food is coming into the house. Are the parents active for 60 minutes per day? And especially the older the kids get, I don't think talking about it is useful. And so when I'm talking to kids, I talk about the health risks and then I say, but I understand that this is really hard to hear. Not only is it a difficult discussion, but you're 16 and I'm talking about Type 2 diabetes and heart disease, which are so abstract. And when we're dealing with the abstract, particularly in children who have not completed their psychological developments or might be, you know, stuck at a psychological development, those things are not going to help. And so it really comes down to the modeling and the opportunity. We can control what food comes into the house. And so guess what? I've stopped buying Cheetos, right?
GARCIA-NAVARRO: Well, I noticed the way you said Cheetos just appeared as if they had sort of magically been sent by the Cheeto gods...
GARCIA-NAVARRO: ...When we know that actually it's something that we do, we bring into the house as parents. What do you think is going to happen as we start to go back to our routines? I mean, do we need massive interventions? Or do you think that things might actually stabilize once people are able to get back to what is a sort of normal rhythm of exercise and behavior outside the home?
STIVISON: The good news is, I think that a lot of this is going to be seamless. So the screen time rules for kids being two hours or less came from the fact that increased screen time correlated with higher weights and BMIs. So what's going to seamlessly happen as we return to our more normal life is less screen time because I have even been supporting families saying, OK, playing video games with friends who are, you know, in their own house playing video games, don't consider it screen time. Consider it social time. That's going to change next year. When I start to vaccinate my 12-year-olds, my 14-year-olds, as we get that safety data hopefully by the end of this summer for the vaccines. And that in and of itself will likely help this problem to a great degree.
GARCIA-NAVARRO: That's Suzannah Stivison, a pediatric nurse practitioner based in Kensington, Md. Thank you very much.
STIVISON: You're welcome. Transcript provided by NPR, Copyright NPR.