Your Child Is Not Their Weight: It’s Time to Break Free from Hidden Shame, Pressure, and Food Stress

Dr. Wendy: Thanks so much for joining me in the conversation today with my friends, Dara and Joey. If you would like some support putting this into practice in your home, first of all, go out and buy their book. Your child is not their weight. Let's make it a best seller because quite honestly, it has the information and the support that all families need right now. And as you're looking for additional support, putting that into practice in your home. All right, my friends, I want to invite you to join a very, very special conversation today. Two of my friends who are helping parents raise their children, let's just call it in a size obsessed world. I am here to welcome I really appreciated how ⁓ were telling the stories about what families were experiencing ⁓ breaking it down by both ⁓ the parent and the child were thinking ⁓ feeling, which ⁓ resonated so much with ⁓ work that I do with families ⁓ what's on the inside. ⁓ is it that ⁓ experiencing in the relationships with food and body and each other? I would love ⁓ Learn how I work with families at wendyshofermd.com. Remember, while I'm a doctor, I am not your doctor. So this podcast is for education, not medical advice. Take what fits, leave what doesn't. And remember, you are the parents creating the change your family needs. Dr. Joey Skelton, pediatrician and Dara Garner-Edwards, family counselor, ⁓ and their co-authors, along with Melissa Moses, a registered ⁓ of the new American Academy of Pediatrics book called, Child Is Not Their Weight, Parenting in a Size Obsessed World. ⁓ They are a part of the Brenner FIT, ⁓ ⁓ is for families in training. ⁓ kind of know what were your thoughts with kind of weaving in those stories throughout your book.

Dara Garner-Edwards, MSW, LCSW: that you notice that because Joey is a storyteller. loves stories ⁓ we had more stories than we could possibly fit in the book. But the combination of his love for stories and then adding sort of my social work angle of the thinking and feeling and exploring what's happening underneath for the family ⁓ into a really nice way to weave the chapters together.

Dr. Wendy: ⁓ Brenner Fitt program at Wake Forest University School of Medicine. And what I love and want to really highlight with this conversation today is really how we share a commitment to kind family centered care that is protecting relationships while supporting health. And so I want to just thank you both so very much for joining me today.

Joey Skelton: Yeah, I grew up near Jonesboro, Tennessee, it's storytelling capital United States, and have a huge festival there and things like that. But I think I mean, I think we very quickly said we we want to tell stories that people can relate to that sort of illustrate these these concepts when we do a sort of a parenting class for everyone that's starting our our program.

Dr. Wendy: and really joining the community with family and focus. It's really invaluable to be able to highlight how there's a village out there, a movement of really ⁓ identifying allies in health for our families right now. So thank you. Yeah, yeah. know, it really, it's something where I just wanna kind of strike up a conversation, kind of picking up from where we were a couple of weeks ago when we were kind of having our

Joey Skelton: And that's what we regularly hear is one of the most valuable things is, hey, that family has the same that I do, or they are experiencing the same situation. So trying to recreate that in the book. And yeah, I think it was Dara that said, we need to show ⁓ sides, what the parents are thinking, what the child's thinking, because oftentimes it's very different. I mean, there's not a week that goes, not a clinic that goes by that I'm not saying, hey, when you make a comment, are you sure you want seconds? Happy to be here. Thank you for having us.

Dara Garner-Edwards, MSW, LCSW: Thanks for it.

Dr. Wendy: pre podcast conversation. And ⁓ one of things that really stood out to me was how the two of you really dedicated your professional careers to supporting families struggling with weight and eating habits. And ⁓ the book to like it really shared so much about ⁓

Joey Skelton: You're just trying to make sure your child's not gonna overeat. You're trying to do that from a place of love and to help. Your child hears, my mom thinks I'm fat because she's telling me not to get seconds with that. And so trying to illustrate that in the book that that was a very quick thing that we wanted to add. I think the stories was one of the first thing every chapter we want a story and then trying to show those perspectives.

Dr. Wendy: that drive and that passion. And so I was hoping that maybe you could share a little bit about the mission and philosophy behind you writing the book. In such a beautiful example that you put right there, because I'm sure that there are parents that are listening right now. They're like, OK, I totally do that. And I'm just wondering, like using that example, ⁓ the of the conversation go? Like what would you offer for a parent to maybe consider or try to do differently if anything?

Joey Skelton: Dare, do you want to start? Cause you I was going to say you start first. Dare and I've been working together. think we're going, we just passed 18 years. So sometimes we'll finish each other's sentences as you can tell. But, you know, I think I, you know, I started back, I think during my chief resident year, 2002, 2003, when I got interested in this and knowing that there was a need, you know, we need more people. At that time, there were very few people. were very few.

Dara Garner-Edwards, MSW, LCSW: Joey, you start. ⁓

Joey Skelton: think I again, there's again, as Dara said, I'm a storyteller of several different ways to sort of to illustrate that. know, oftentimes it's, highlight this heavily in the book is, you know, we don't like do as I say, not as I do. You got to model the behaviors you want to see. ⁓ And what really want to do is to set up the structure and the environment in the home for your child to succeed. ⁓ And so ⁓

Dr. Wendy: If you want to see change in your child's eating habits without pressure, constant mealtime battles, or the shame you grew up with, you're in the right place. Welcome to Family in Focus. I'm Dr. Wendy Schofer, the pediatrician helping parents lead meaningful change without harm. Here we focus on the connection and practical shifts that help families thrive at every size. Let's get started.

Joey Skelton: programs, weight management programs for kids in the country and was sort of a warning to address that need. And ⁓ I think coming here and then finding, you know, sort of a partner in crime would dara with this is ⁓ someone else who really looked at families. ⁓ I think, you know, as you know, all the research behind addressing weighting kids is about including the families. And what I was realizing very early on in my career and when I moved to Wake Forest, ⁓ And oftentimes it's not in the words that we say, it's what we do. We can tell our kids, I love them, but you gotta show that you love them. They gotta feel that love. And it's sort of applying same ⁓ to comments we might make or not make during a meal. especially when it comes to meals, it's that period of, it's about spending that time together and your child feeling that love. ⁓ And oftentimes very easy to point out. in 2007 is that we want to include all the families, but generally what is included is who you're seeing in clinic. It's the kid and one, maybe two parents. You're not there a window to the whole family. And I kind of remember bringing this up to Dara when, you know, I first interviewed her and we started working together is, you know, the idea about whole family and family systems theory. And she's like, Hey, I got a social work background. You're, you're speaking my language. You know, this ⁓ You know, you've made those comments before, do you see much of a difference with that? And typically it's like, no, you're right. It hasn't made a difference, even though as parents we want to do something. And so sometimes just being present, just being there, know, the adolescent medicine 101 is, do you want me to offer some advice or help problem solve on this, or do you just want me to listen? That's, the first thing when your kid comes to you about an issue and that's sort of step number one. The idea of, know, we want the family to change behaviors, but you gotta get to know the family. And it's, you know, I think it's a Sir William Mosler quote of, it's better to know what person has a disease than what disease a patient has. And I think that applies to this, is that you really gotta get to know families. Every single family is different. And it's not just the two people in your clinic there are representative of an entire family. And that family is...

Dara Garner-Edwards, MSW, LCSW: It's so hard for parents to let go of that worry about their child. Like, not just with our topics here, but in general. What we really want to do is help families know, help parents know, let go of the worry. That's how you're going to relax and communicate to your child that your weight is okay. Your size is fine. What we want to do is focus on health. And we don't mean we're going to focus on health, but we really mean weight. We really mean we're going to focus on wellness, wellbeing all around. We're going to eat together. We're going to work as a family on this. Parents are going to role model.

Joey Skelton: I would call it a lower case family of it's their extended family, it's their close family friends, it's their neighborhood, the community, it's what the schools they go to. There's so much that make up that fluid nature of someone's family and we need to know a lot more about them if you're really going to provide some help to them.

Dara Garner-Edwards, MSW, LCSW: We're going to have that structure. We're going to remove blame and shame and criticism about our eating. We're going to enjoy meals. The less stress, the better at meal time. And that is super hard. It might almost be easier to do a diet sometimes, which we don't recommend, of course. But letting go of the worry. my Brenner FIT experience started by, I was in a social work job. My boss said, what do you want to be when you grow up? I thought I was grown up at the time, of course, but lots to go. ⁓ I said, you know, I'm working with kids with HIV right now, ⁓ I'd really be interested in working with kids with obesity. There was not a program at our hospital the next day. I met the new nurse for the Brenner FIT program. ⁓ trusting that this approach with no shame, no blame, no criticism, no guilt can really make a bigger difference lifelong. and that turned into a job about nine months later. So it was how life happens.

Dr. Wendy: Yeah, so very important and yet it feels like it's the opposite of all the different skills that we've been taught or all the things that have really been prioritized in our culture. Letting go of worry, it's kind of like, how the heck do you do that? What is step one to letting go of worry?

Dara Garner-Edwards, MSW, LCSW: It was impressive to meet a physician who wanted to work with families in the way a social worker would work with families. So we got started off really well. We were able to design the program from the beginning. And I remember being really excited one day when our dietitian wrote on a care plan that pop tarts were going to be the breakfast plan because our goal was to have breakfast and that's what was available. And I just couldn't believe that that would actually be happening and be okay with the expertise of a Listen to Dr. Skelton. Listen to the doctor,

Joey Skelton: Well, just... No, but we always sort of laugh. It's almost like trying to tell someone, ⁓ you know, don't be depressed. That's horrible. You know, you wouldn't do that. But we tell people a lot, don't worry. Don't worry about it. you know, and that's... We want to say that to parents too, but we also... It's hard not to pass up that worry. And that's what we hope that we're accomplishing with this book is like, hey, here are the things you can do that are positive that...

Dr. Wendy: ⁓ is there a story coming?

Dara Garner-Edwards, MSW, LCSW: dietitian because they knew our goal. Our goal was that may not be the long-term plan but that's absolutely what works right now and what's gonna start where the family is which is a key social work part of our training. Start right where they are, move forward one step and do what works. Take off the stress, just support families and they're gonna do better when they've got that support whatever better means for them.

Joey Skelton: you know, won't cause conflict that hopefully can bring you ⁓ closer together. And I think, you know, I don't think we have a story around this, you know, and but this is what you hear a lot from, you know, different folks in the body positivity movement are, you know, I'm me and my weight are not a problem to be fixed. And I think sometimes for, you know, this is coming from a physician, we're very type A goal oriented is, you know, and that's a hard conversation, I think that.

Dr. Wendy: I am just struck by hearing this because there's so many different parts of this. mean, first of all, Dara, you kind of like put it out there into the world. You're like, this is what I want to do. And you just created it like totally created it. Exactly. Exactly. And then seriously, like meeting people where they are, including, you know what? We're at Pop Tarts right now.

Dara Garner-Edwards, MSW, LCSW: It arrived.

Joey Skelton: we are not always successful in having with parents. If they see, need to fix this problem. My child has a problem with their weight and I need to fix that. And for us to say, slow down, don't talk about the weight, don't do that, that's oftentimes not what they wanna hear. They want to fix this problem and you almost wanna say, what your child's gonna tell you is, I'm your child, I'm not a problem. I need to be loved unconditionally. Again, you reframe it, gosh, sound like.

Dr. Wendy: Like that sounds vastly different from the approach that I think that most people would think about, you know, how do we help families with nutrition, with growth, with weight? wondering was that something that was just always kind of like making sense ⁓ to start or is there kind of like a transition to be able to say, okay, well, maybe pop tarts are okay.

Joey Skelton: Dara now, we've been working together too long as I'm like a counselor. But you you just kind of want to reframe it ⁓ it's your is not a problem to be fixed or to be loved and to be supportive. Because if you're really going to see a difference in weight and health, it's going to be through that love.

Dara Garner-Edwards, MSW, LCSW: I think for me that made sense, but I wasn't sure it was okay medically or nutritionally, right? Like behaviorally that made sense. And then to find a team that could say, yeah, this absolutely makes sense. Our goal is to eat and let's eat what's available. But it was certainly a long process. We did not start off there day one. We started off with what probably is more traditional lifestyle changes then evolved as we...

Dr. Wendy: so very beautiful.

Joey Skelton: Did I do that right, Dara? Did I sound like a shrink there? Okay, good.

Dara Garner-Edwards, MSW, LCSW: You did great. reframed and used all the right words. Nice job.

Dr. Wendy: ⁓ god. So what I'm hearing is don't focus on the things that you don't want to do. So don't focus on the worry, but focus on what it is that is moving you in the direction that you want to go. As I hear you talking about, you know, the love and the collaboration and making changes as a family and family meals, those are all things we want to see more of.

Joey Skelton: you

Dara Garner-Edwards, MSW, LCSW: followed the research and grew to understand families we were working with and what they needed.

Dr. Wendy: it really sounds like you have like ⁓ Avengers, like everybody's kind of like coming together and like all these different skills and kind of clicking. ⁓ I appreciate hearing like, okay, it's not like we just all appeared, ⁓ ⁓ there was some evolution and kind of seeing what was happening with, research trends and seeing what's working as well. Joey, do you have, ⁓ you look like had something. ⁓

Joey Skelton: Yeah, I'm going to reclaim my masculinity and say that, you know, it's like a coach. It's not about you want to win the game. You got to focus on the process and practice. Okay. I got it back now. I feel better now, but, it is, it's, know, we, say it's, it is a watch pot never boils sometimes. And, you know, that's why, you know, it's smart goals. You know, we've kind of been through a lot of that training is, Hey, let's focus on the things in in front of us that we can control. And oftentimes I am having this conversation with parents is like, Hey, a lot of this is.

Dara Garner-Edwards, MSW, LCSW: You

Joey Skelton: Yeah, Wendy, it's so funny that you said the Avengers. ⁓ I know Dara's laughing. We're now part of this larger ⁓ advocate health system that we across five or six states and 40 different hospitals. And I think there's seven children's hospitals and we're slowly putting together the kind of a coalition of the weight management programs at these other sites. genetic, it's environmental, there's a lot of stuff that's not in our control and you're going to drive yourself crazy trying to control every little bit of that. And guess what? If you're driving yourself crazy, you're probably driving your child crazy too. Our bi-monthly meetings are called the avengers So that you say that of the idea of kind of pulling all these folks together with that. I just thought that was kind of serendipitous with that. But ⁓ think, you know, think Dara nailed it that, ⁓ you know, it's funny. This is still a thing that we're not struggling, but we're adapting is and says, you know, even your most hardcore.

Dara Garner-Edwards, MSW, LCSW: think families can relax a little bit when they hear their doctor say that. As a counselor, I might say that and they're like, maybe I'll listen, maybe it's too wishy washy.

Dr. Wendy: Wow.

Dara Garner-Edwards, MSW, LCSW: doctor says it, it has a different ring in their ears. Same thing for our dietitian. When our dietitian says this food is fine, this is wonderful, you don't have to fix or change or eat a specific way, you don't have to cut out foods, you don't have to count calories or measure portions to do this.

Joey Skelton: weight loss program for kids and still say it's about health, it's not about the numbers on the scale, but what's our number one outcome in this field? And that tends to be the numbers on a scale and trying to broaden that. the story that we would usually use for that is, you know, a family that's drinking a lot of sugar, sweetened beverages and they're eating out a couple of times a week and they make big changes. They cut down to one time a week, they cut out sugar, sweetened beverages. They may not see a change in their weight. We ideally think there probably would be, but you know,

Dara Garner-Edwards, MSW, LCSW: that rings differently than when I say it or when a friend says it. Hearing those experts that know their child and know their family in our program works really well. And hopefully in the book, can hear that too from the experts.

Dr. Wendy: Well, and even as you're describing that, I know all these things. Like these are the things I share. And as I'm hearing you say that, I'm feeling like, ⁓ that's just like stress relieving to be able to hear that. You don't have to do all these things. You don't have to focus on all these things that are just adding more to, you know, parents' plates and just so much more stress and one more thing to do. And quite honestly, one more thing to clash over.

Joey Skelton: weight is a complex issue. There's a lot that goes into that. There's genetics or physiology, there's our environment, endocrine disrupting chemicals, if you want to get kind of wacky about But we still kind of keep that. ⁓ So a great change that this family made, but it didn't impact our weight. And how are we going to leave them feeling? Like they failed? Like that wasn't enough? Yeah, there's, ⁓ it's, and I think we talked about this before, there's a new term and I've confirmed Janet Lidecker had sort of coined this term. She's a psychologist at Yale and the parental over-evaluation of weight is a new thing they're starting to look at and measure and some of the harm that it can cause. that's, and what that's really kind of getting at is that's what kids oftentimes feel like. Now, to defend the parents. that maybe these changes weren't worth it. so we've tried to incorporate some more behavioral goals to say, hey, you guys did great. You don't see a change in weight yet, but your body is healthier because of these changes you made. You didn't fail just because ⁓ weight didn't change. ⁓ ⁓ everyone struggles with that because we're still sort of focused on what are the short-term six month changes? You look at all the publications that are from the pragmatic studies from real life programs. They're wanting to help their kid. Their kid may be unhappy with their body weight. They may be dealing with health problems. ⁓ They want to do something. And the parent is trying to do what they know to help. it can sometimes be done in way that that's all the kids feeling from the parent. It's they feel like the parent, yeah, they love me. Yeah, they support me. But they are so hung up on my weight. And it's almost always six month changes. Maybe they'll extend out to a year. But what are we really interested in? Yeah, of course we're interested in improving health in the short term, especially for kids that might be struggling with some health issues. But what do we really want? What's our long-term goal? You know, our long-term goal is that kids are launching into adulthood with better health, with good habits in place. They can continue to sustain and feed themselves. Shoving that into a clinical program, that's hard. And that's that parent of evaluation of weight. And we see that quite often. it's, you know, sometimes, and I've had some very blunt talks with parents of like, hey, you know, just stop. You know, stop talking to your kid, quit reminding them. I know you're trying to help. I know you want to help. You're doing this from a place of love, but your child is getting this message is that, You know, I think we've been pretty lucky here with, environment that we practice here, but not everyone's all that lucky. And I'm sure you have faces too, Wendy. Sometimes we call it converting people. You know, sometimes you gotta get people to understand the complexity that this is not just a weight loss program. is weight losses, know, may not even be a goal for some families, but it's a way more complex and deeper. What's all, thing is important to you is my weight. know, ⁓ sometimes we fall victim to that with grades with kids or with sports performance. And we have to be careful to love all of our children and make sure that we're putting as much emphasis on all the different aspects and qualities for our childhood. They just don't feel like it's all about their weight. And when I first heard that term, heard Janet speak at conference this year. I mean, it's still, it's just reverberating with me of just. deeper issue than that. It's sometimes hard to convince people in the medical world of that.

Dr. Wendy: hear you on so many levels. I think in particular, you know, those in the medical world are kind of like the hardest to try to really welcome to this type of conversation, the conversion strikes me is the way that you describe it, you and the way that you write in the book, like it's really taking what you're describing as a very complex. ⁓

Joey Skelton: wow, there's a small number of the families that we see that we can't get past that and that we know the parent loves all of their child, that kid is really feeling like my parent doesn't like me because I'm in a bigger body. And we gotta be careful with that.

Dara Garner-Edwards, MSW, LCSW: And it's so unintentional as you said, it's not what the parent wants to be communicating, but it is what the child feels and experiences so deeply when their parent comments over and over about their size or their eating, see right through that. If we're limiting their eating and we say it's for whatever reason we say it's for, kids see right through it and interpret it as I'm not okay, my body's not okay and I need to change my body.

Dr. Wendy: concern issue. mean, this is like societal cultural in the, you know, so many different areas. And yet you make it so much simpler. I mean, you took a really big subject and you have a very accessible book that you wrote. And so that's.

Dara Garner-Edwards, MSW, LCSW: And that can lead to disordered eating and eating disorders. And we hope this book can prevent those things as well.

Dr. Wendy: Yeah.

Joey Skelton: I appreciate that greatly because it didn't feel like that some days.

Dara Garner-Edwards, MSW, LCSW: Thank you. You

Dr. Wendy: I would love to hear more about that because I think that there's some magic that you're really working here in taking complexity and making for families. ⁓ And it stands right out with the title, Your Child Is Not Their Weight. I mean, it sounds like you're directly addressing that overvaluation of weight. And I can't help but think from the context of how it's not just parents. I mean, there's such an overvaluation of weight in our medical experiences and our medical interactions and in our culture. I would love to see and hear a lot more about

Dara Garner-Edwards, MSW, LCSW: teamwork, lot of discussions back and forth, input from all three of us to get there to figure out how do we say this? How do we get to that? It was not simple, but that was our goal was families could read it and as we talked through different steps we would get feedback. Well, go deeper, say more and often our response would be, but we need to keep it simple. need it.

Dr. Wendy: Yeah. where that research is going, how broad is that?

Joey Skelton: Yeah, and and what are the you how do you undo it? What are what are the real risks of it? You know, how can you how can you change that? Yeah, it's it's it's tough. It's it's a tough one. Again, it's not a ton of our families, but every once in a we sort of get that. And it tends to be when we have a parent that has lost weight they want the same for the kid. And again, it comes from such a good place. I don't want my child to have health problems. I don't want my child to be teased. I don't want my child to be held back by this.

Dara Garner-Edwards, MSW, LCSW: readable, practical, understandable, and trying to go deep enough and find, you know, target what really is going on and underneath different challenges as far as whether it's the meal planning challenge or bullying or weight bias, so many different topics. Explain them, identify, and also help parents take a breath.

Dr. Wendy: Yeah.

Joey Skelton: But hey, treating weight is extremely tough. You managing weight, changing your weight is an extremely tough thing to do. And so there's, again, there's, what are we all talking about? There's a lot of fear and there's a lot of pressure. Those aren't really good emotions. God, sound like, I sound like Derek. Derek, we're gonna have to work separately for a while, I think.

Dara Garner-Edwards, MSW, LCSW: Find their spot and give advice that can work in a book where you're not able to interact and go back and forth with them on something. But all emotions are okay, Joey.

Joey Skelton: How do you explain something that's so complex in a simple way that could be put in a book? I mean, it's kind of an impossible task, but we had the benefit of approaching 20 years. I think one time we added up our present team, Dare and I added up. We had over a hundred years of experience within our team. Melissa's been on our team 15 years, Dare and I have been there 18. Yeah. Don't don't turn that counselor beam on me right now. But but it's it's kind of funny that with what we do as a multidisciplinary interdisciplinary team, just because we're all focused on sort of the same mission, the same family, you begin to learn these other areas. I mean, we are so guided by by family system theory of just, you know, there's so many layers to family and the, know, the first order change that has to happen of, hey, we're going to.

Dr. Wendy: Thank you. All feelings are welcome, Joey. Come on.

Dara Garner-Edwards, MSW, LCSW: you

Joey Skelton: 15, 12, till we've got this sort of long-term group, and then we had more than 100 years of experience of meeting with a really diverse group of families all across every spectrum that you could think of. And ⁓ we did have a lot that we, a deep well that we could draw from, but it is kind of an impossible task. It's something that's so complex. One of my ⁓ researcher ⁓ calls below the skin and above the skin, know, behaviorally, psychosocially, genetically, physiologically. you know, we're going to eat out less, but the second order change that needs to occur to make those things stick. Hey, we need to learn to sit down to a meal together. We need to learn to change our schedule. I structured the home, change how we parent, you know, things like that. It's really that idea that really peering through that dyad that you see in clinic and getting a picture of the whole family. know, heard Darren and Melissa do a whole lot ⁓ visits than I do and, them seeing a family home, you know, just seeing a little bit and, you know, the comfort that families feel. that's exactly the reason we did it. You know, when, when Sarah Horderman with a double AP sort of approached me about this idea, I'm like, I do not have the time to do this, but Melissa and Darryl did with me, then I think we kind of have to do it because we needed sort of more of this out there. And, ⁓ and, and was also the part of having a good editor, Catherine Sparks, who, some days I called her lots of names without. just getting to know them even just a little bit better and what sort of insight that gives on things.

Dr. Wendy: If a parent is recognizing that overvaluation of weight in themselves, what will they find in the book that can help them from day to day?

Dara Garner-Edwards, MSW, LCSW: There's information on how to talk about weight with your child. There's information about how to talk about any changes you're making with your own health. Interestingly, we really don't want to talk about weight with our child. It's something that it's not taboo, but it's so sensitive and it's not necessary. We need to talk about how wonderful their body is. We need to talk about weight in certain situations. Like if they were starting a medical program related to

Joey Skelton: behind her back, but she was doing her job. She was doing her job of like, I don't understand what this means, which can, know, any of us that fall victim, when we get too much into a subject, we use our own language, our own terminologies and stuff like that. And she would say, I don't understand this. What do you mean by this? And it was, it was difficult, but that's exactly what she was supposed to be doing. And it helped, helps her to draw, draw you out.

Dr. Wendy: that because I'm hearing once again how it's all the Avengers coming together, including the ones that are like, you got to tell me a little bit more about what it is that you're doing and clarifying because I can see that in the book

Dara Garner-Edwards, MSW, LCSW: weight. Yeah, we need to prepare them that that's coming. If they have questions about weight, yeah, we need to talk about that. And if they're being bullied about weight, we need to talk about that. There may be other opportunities where they're just situational. Something's on TV or they heard something from a friend and you can bring up topics that way. But for the most part, your child's specific body size and weight, not really something that has to be discussed. More important, affirm. who they are, what they are, what they do, how well their body works for them and with them, build that self-confidence, that independence, that body image that's positive.

Joey Skelton: Yeah, it's sorry, I'm going to tell a story here. Maybe not story, it be sort of a metaphor or something. But you know, it's, I remember when my, if my wife came home from work and had a bad day, the emotions of that, I know she's not mad at me, but it can feel like she is sometimes. You know, it can feel that and you know, sometimes she needs to say that, hey, it's not you, let me get this out. But if we don't address that, it can feel like if she snaps at me, feels like she's mad. That's kind of what kids can feel, I think. When these things are being said, or, know, Dare, I remember you talking about this one time, I don't think it made it in story, but the look. Kids have told us that before, of like, hey, mom's spaghetti is great. It's my favorite meal. And I go back for seconds and I get the look. And a lot of parents say, hey, I didn't say anything, but like, kids can tell. We don't hide our emotions very well. And we gotta be careful. think you counselors call that emotional climate, or actually researchers call that a lot too, is what is the emotional climate around food, around meals, around physical activity and stuff like that. with my ⁓ my own children are completely different. And my older child, like a lot of kids, quit being interested in a lot of the traditional sports because of ⁓ of toxic reasons as far as competition and cost and things like that. ⁓ taking the time to find the things that he enjoyed instead of what think a lot of our parents will do is like, well, they need to start exercising like I do. Hey, adults, exercise is boring. You know, why do we have TVs and headphones and stuff like that? And that's not always true, but some of the most sustainable physical activity are the physical activities that we like and that bring us joy. That's why most people who institute, and it's talking about adults, who institute a regular exercise program They're usually doing that with a friend or a spouse. They're doing that with a partner, a supporter. And so the idea of, and that's an enjoyable thing. And so how can families be that built in support, not that built in food police, that built in reminder clock of how much you're supposed to exercise and stuff like that.

Dr. Wendy: So I'm wondering as you're writing the book and all the wonderful stories, if there is one thing that you want parents to take away?

Joey Skelton: Hmm. You get to go first there. I'll have to see what you say versus what I say. probably, it's probably, can tell it's probably the same, yeah.

Dara Garner-Edwards, MSW, LCSW: You Hmm. I want parents to relax. I want parents to know that their child is okay and that there things they can do to support their child without having to criticize and they're not trying to criticize without having to fuss about weight without having to fuss about food. Eat together, play together, eat at home more often if you're able to do that. But Respect also, you know honor your foods your family foods Joey and I talked in the book about our favorite foods and

Joey Skelton: She's like, I fussed at her about that. Here's where I draw the counselor line. I fussed her about, no one says honor your foods, but she's exactly right. We need to honor the foods that are important to our family. We talk about this a lot. So, yeah.

Dara Garner-Edwards, MSW, LCSW: you

Dr. Wendy: Pennsylvania Dutch girl. I really appreciate hearing that. As someone who grew up with all the finest baked goods, in particular, I'm talking about funnel cake. Okay, let's be honest. I'm totally talking about funnel cake with all the powdered sugar on top. Yes, honoring it. Honoring it. That is so much a part of my heritage. And so much of the messaging was like, you can't do this. And so it was kind of like chopping off. an arm, know, Dara had pointed out before about my blanket that's here in the back. You know, this was made by my grandmother, just like the funnel cake. That's a part of me. Yeah, honoring that. I so appreciate

Joey Skelton: And Helga Guzman, ⁓ and Helga Guzman is over our teammates has been with us for 16, 17 years. And we, we have this paper written. We've never finished it to submit it, but we've always wanted to write a paper that says, leave my tortilla out of this. Cause you know, she, she takes care of our Spanish bacon population, but that's, that's what we hear of just, you know, these criticisms of food. you know, weight problems were not caused by tortillas. Tortillas have been around longer than. you know, the obesity epidemic has been around. And so she's, we've always wanted to craft that, leave my trotilla this. I'm like, hey, it's important to have these foods. You you tell me I can't ever have grits again, that's gonna be the last conversation we ever have. And you know, the idea that there's room for all food. Food is so much, so much more than about weight and being able, ⁓ God, here I go. To be able to honor that, you know, with what do with that. And so, and so I think, I think what I want to take, and this is not. quite answer your question of what you want people to take away. But what we're really trying to do here is sort of thread this needle about, know, how can we live healthier lives without making our kids feel bad about their body, their weight, their eating habits, and things like that. And on the other hand, part of the threading the needle is, you know, being able to offer support and guidance doing harm. I mean, I think we're approaching weight management. in a population that has a two to three higher prevalence of eating disorders. So how do you do that? And I think that's why I actually want a lot of health care providers of all ilks and all varieties to read this book to sort of understand that. Like, hey, you're doing weight management. If you're addressing issues around nutritional and physical activity, sleep and weight, you're doing in ⁓ a population that's at pretty high of eating disorders and even not eating disorders. of poor self-esteem, body image, and how can we still try to lead healthier lives without causing some harm with that? And you see that who our book is dedicated to is, think Dara came up with this, is it's dedicated to all those parents that were raised feeling bad about their bodies in a dieting culture and want to do things differently with their kids.

Dr. Wendy: This is just resonating so much with me, you know, with that concern about we want to be able to help without inflicting harm. And what I'm hearing from you is so much about the long-term consequences on confidence and body image and, you know, seating, eating disorders. All of this is falling under mental health as, you know, there's been so much focus on the physical health on the body. and we've just been neglecting what's actually happening on the inside. And so I appreciate hearing that as the threading of the needle. It makes me wonder and, ⁓ I'm gonna go there. Is your clinic described as a weight management clinic or have you kind of reframed how that's approached? Because I've heard people kind of like tossing around with, you know, how they frame what it is that they do at their clinic. How do you approach that with this very holistic approach?

Dara Garner-Edwards, MSW, LCSW: I wish we had a magic name that described what you were wanting when you came to see us and also what you were getting when you came to see us. Because people are referred medically, we're a medical clinic, so they're referred for weight. And they're expecting obesity care or weight management. And what we do is try to shift that. Take the focus off the scale. The more we look at the scale, the worse that number is gonna get. Take the focus off of the body. Child does not need that, as you said, with mental health concerns. We do not need to criticize the body. That is who they are. They are wonderful. It does not need to be fixed. It does not need to be changed. It does not need to be a certain shape or size. and finding that right word that would describe how to get them to us and also get them what we give them, get them to understand what we are giving them. We haven't found that word yet. So we do describe ourselves as both obesity care or weight management, depending on where we're listed. And then we try to say, we're here to support you with any health concerns related to weight. magic word we don't have, sorry.

Joey Skelton: And part of that, because again, we also listen to our marketing friends that say, you know, call it what it is. You know, don't beat around the bush too much with fancy names. We've all fallen victim to that. And so a lot of what we do ⁓ also hit them ⁓ up front with, you know, what the science shows. This is not a dippy approach. I mean, this is what the science shows. If kids have poor body self-esteem. They're actually not gonna do well in weight management. They're gonna be at more risk of eating disorders. Pressure and restriction are gonna backfire. That's actually probably gonna end up leading to more weight gain. On the other hand, I also like to call out a lot of where there's huge gaps. There's a huge gap. There is some literature that actually supports that idea. If you take a behaviorally based approach, you can prevent a lot of these problems. But there's also still a huge literature. How did those family dynamics ⁓ affect that? You know, I've got a ⁓ colleague at Ohio State, Keely Pratt, and that's been our obsession for 10 years is how can we actually measure more about family dynamics and communication? There's still huge gaps in sort of the complex nature of the family with this, but we do hit people right up front with like, hey, here's what the research shows. And that's why I talked about that sort of orientation class as we decide some of these are the most difficult concepts. You know, and we use a lot of El and Satyr's division of responsibility. And so we bring these. tough topics up up front so we can start people sort of learning and chewing on that and trying to digest a lot

Dara Garner-Edwards, MSW, LCSW: I'll say that that evolved from a story. One of our patients early, early on came to their clinic visit to meet us with a suitcase expecting to stay until they got better. And we're an outpatient clinic program. So we learned we need to clarify expectations from the beginning. And so we created different ways to provide information by video on our website. this orientation class where families can get more information before they even begin the program so they know what is coming and what to expect as much as possible.

Dr. Wendy: Wow, that is remarkable. ⁓ Wow. Well, I want to thank you both so very much. I could geek out with you for hours about collaborations and what's similar, what's different, but also about how much work there is being done to be able to support families and children who are struggling with weight. And so I want to thank you for taking this time. Truly, I want to thank you. I would also like to find out, the books, and I don't know if you have, I have my advance copy. Do the official copy that we can show?

Dara Garner-Edwards, MSW, LCSW: I I have some.

Dr. Wendy: I gotta make sure I'm not showing something. ⁓ there you go. ⁓ it's so beautiful. Your child is not their weight. Okay, because I wanna make sure that people can see this on the video. There you go.

Joey Skelton: Yeah, no. you

Dara Garner-Edwards, MSW, LCSW: Get it up here.

Joey Skelton: It's released next month. We're very happy. We got a really good review from Publishers Weekly, and so they got that on the cover. It's released on St. Patrick's Day because books are released on Tuesdays, we've come to learn. So I don't think any of us are Irish. I don't think that was deliberate, but it's been released on March 17th. You can order it from all the Amazon, Barnes & Noble, from the AAP website. That's the ones I know about,

Dr. Wendy: Beautiful. Beautiful. I would love to just put it out there if you have any additional thoughts, anything that you want to share with parents.

Joey Skelton: I always said if I could do one public health campaign, it would be eat family meals together. Turn off the electronics, eat a meal together, even if it's what we call an assembled meal where you're getting a rotisserie chicken and a bagged salad, but just spend some time together and learn how to do that old fashioned thing.

Dara Garner-Edwards, MSW, LCSW: Yeah, cheers to family meals, I'll ditto that. Just eat, enjoy, no guilt. Funnel cake for dessert.

Dr. Wendy: You Okay, there we go. So I feel like we are the three amigos. We're all going to agree on the family meals, the importance there. I'm going to make sure that in the show notes that there is the links for the book as well as how to reach you through the clinic as well. And so I just want to thank you so very much. This has been really powerful to be able to help really connect with parents and to be able to offer them additional resources as well as hearing more voices that we're in support and that whole thing that you're talking about working with your child. We're all in this together in that spirit of, you know, collaboration and allyship and really, you know, creating a very different path for our families. So I thank you.

Dara Garner-Edwards, MSW, LCSW: Thank you.

Joey Skelton: Thank you for having us. We've listened to your stuff before and we're excited to do this.

Dr. Wendy: Awesome. All right. Thank you.

Dara Garner-Edwards, MSW, LCSW: Thank you for including us in all the work you do as well.

Dr. Wendy: Thank you. Thank you.