Dr. Crystal Lim is the chair of health psychology at the University of Missouri and has spent much of her career working with children who are overweight.
She spoke about how the treatment of excess weight has changed over time, as well as about how families buy-in and small changes can increase overall health for youth – regardless of size.
Missouri Health Talks gathers Missourians’ stories of access to healthcare in their own words.
Dr. Crystal Lim: So, we know that weight bias and weight stigma – that's something people experience in a lot of different settings. We know, from a pediatric or child perspective, they face it at school. So, academic functioning is impacted, but they also face it at home, as well.
So, what I talk to families a lot about is how can we be supportive, but not shaming, and that's a really important balance.
So, I would say, in the past – like, we're getting better, but in the past people thought shaming patients when they're trying to lose weight is going to help motivate them. Well, we know for some people, that actually doesn't work at all – they're more likely to do the opposite.
So, what we're really trying to take is an individual approach that's strength based.
So, oftentimes, families I see in the context of a weight management clinic, they've been trying to eat healthier and be more active – all the things people know we're supposed to do and it's really hard to do, but they're coming up with barriers.
"I always describe my job as a psychologist is to help families break down a goal and make it, you know, easier steps. So, one step at a time. we can't change everything that we eat all at the same – it's not sustainable."Dr. Crystal Lim
So, it's my job really, to help them understand: is that [excess weight] because the child is teased and bullied, is it because there's other underlying ADHD that's not treated, you know, what's available in the household.
And really trying to help people build momentum and build that self-esteem that they can make changes and it doesn't have to be all at one time, but really help them make these gradual step-by-step changes.
So, I always describe my job as a psychologist is to help families break down a goal and make it, you know, easier steps. So, one step at a time. we can't change everything that we eat all at the same – it's not sustainable.
It, also when you think about the context of rural environments, we have to really think about the context, the community that the family is living in, and make small gradual changes.
So, we call it a motivational interviewing approach. So, we really try to meet families where they're at and really go from there and let them really be the guide, right?
I work a lot with parents and parents are the experts on their children, and so, it's really been able to partner with the whole family in terms of making changes that will be sustainable and then long lasting.
So, it's not meant to be a short-term diet approach, but really, we're coming at it now from this is a chronic medical condition that needs chronic management.
And we know things like our eating, our physical activity, our sleep – those all play important roles and really trying to help identify areas that families are willing to work on and help support them in that process.
My job is also, I see it [as] to prevent the development of other chronic medical conditions like Type II diabetes and other things, as well, so that people can be healthy, functioning adults, and be able to do all the things they want to do – no matter what their size is.
