Lightening weight-related conversations for kids with autism

When kids with autism and their parents meet with their clinician, everyone may feel awkward as the clinician struggles to find the right words.

Neither clinicians, nor parents are eager to talk about body weight. But left unaddressed, it could potentially impact on a child’s health and well-being.  

Autism Spectrum Disorder (ASD) now affects one in 68 US children and young people. Recent figures show that more than a third of children with autism are classified as overweight or obese.

“Children with autism have a number of challenges that can make it difficult to manage weight,” said Dr. Amy McPherson, a senior scientist at the Bloorview Research Institute (BRI).

Many kids with autism take medication for anxiety and a common side-effect is weight gain. For some, poor coordination can make physical activities challenging. And others might have unusual eating patterns that limit the foods they can eat, which can impact their diet.

“Because it’s such a sensitive topic, these conversations are difficult for everyone, and people often come out of them feeling very negative,” said Dr. McPherson.

Clinicians search for the right words, or the right way to raise the subject, worried that parents might get offended. Parents may feel weight is just another concern to add to their already long list of stresses.

“Sometimes parents can also feel blamed even through that’s not the intention of the health care providers,” said Dr. McPherson.

To make these conversations easier, Dr. McPherson and her team created a resource for clinicians called Fostering Positive Weight-related Conversations.

It’s a free resource that represents the culmination of years of research to help clinicians be more comfortable discussing weight with families, including one page devoted to kids with autism.

While clinicians are using this resource, Dr. McPherson and her team are now working on creating a similar resource aimed at parents, and how they can have body positive conversations with their children.

She plans on completing this new resource later this year. In the meantime, she has a number of tips for parents of kids with autism to help start and guide their conversations.

Focus on behaviour, not weight

Dr. McPherson suggests talking about growth and health, not about size and weight. “We know people at many different weights and sizes can be healthy, and so that’s really the emphasis,” she said.  

Keep the messaging based on strengths and abilities

“With autism sometimes kids can take messages in a way that may not be healthy,” she said.

In other words, conversations should focus on what you can do, not what you can’t, and what’s good for you, not what’s bad.

For example, messaging around limiting sugary snacks could be interpreted as not eating sugar from any source, including healthy sources such as fruit, which could prove problematic.  

Be more aware and accepting of body diversity

“We try and emphasize body diversity and that people can be healthy in different ways,” said Dr. McPherson. “There’s often an assumption when people live in larger bodies that they are living a terribly unhealthy life, and very often that’s not the case.”

Get creative with activities

It can be difficult to find meaningful activities for children with autism, especially if they don’t like team sports or group activities. She encourages parents to get creative – even dancing in the living room is a physical activity, so too are interactive video games that get the body moving.

Be open to different forms of success

Success doesn’t just mean losing weight. It could mean better eating habits, a more active lifestyle, or even a healthier acceptance of themselves. It even could mean more comfortable conversations about weight between a parent and child, or a clinician and child that leaves them feeling encouraged and optimistic.

As she continues to develop her parental resource, she noted, “One of my primary focuses is how the child feels when they leave the conversation.”