Obesity is a complex, chronic disease that is challenging for patients and their healthcare providers to navigate. When it comes to childhood obesity, there are other complexities to consider, like growth, changing physiology, and development. However, in over two decades of working as a general pediatrician, I learned one of the most difficult tasks in managing childhood obesity is how to empower kids and families to make lifestyle changes while preserving their confidence and self-esteem. Kids develop a sense of self and are more vulnerable to messaging about their bodies. There is so much emphasis on weight and the Body-Mass-Index norms baked into the profession of pediatrics, and over the years, we have been focused more on numbers and charts and less on the whole child. I have been guilty of this in my career. With the palpable rise in mental health issues in children, I, like many colleagues, have been seeking out a better, more compassionate approach to obesity.

The Birth of "Touchpoints"

In 2023, the American Academy of Pediatrics published a new set of guidelines for managing childhood obesity, which placed more responsibility on pediatricians for counseling on lifestyle behaviors and nutrition guidance, even though we typically don’t have the kind of training in nutrition to do this well. I quickly went to work on a program for pediatricians called Touchpoints. This program would help pediatricians deliver the foundational treatment called out by these new guidelines, namely “Intensive Health Behavior and Lifestyle Treatment.” Without needing much comfort or expertise, pediatricians could use scripts with informational videos and handouts to cover almost twenty different lifestyle topics according to a family’s unique needs. Given the increase in mental health challenges, including eating disorders during the pandemic, I wanted to make sure the approach was weight-neutral, empowering, and family-centered. Topics like sleep, movement, and prioritizing family meals could build a toolbox of good habits which I hoped would also create a foundation of good health.

As I began using this new program with patients in my practice, I worked with one mom who struggled with what to do when her son reacted to certain emotions like anxiety. I noticed many of my patients dealt with uncomfortable emotions like boredom, loneliness, or sadness but relied on the same response: overeating. I started to think about experts who could help me with the topic of emotional eating with a compassionate approach.

Meeting Jill Castle

Jill Castle is a pediatric dietitian I met years ago when she was promoting her book with Maryanne Jacobson called, “Fearless Feeding,” This game-changing book is a comprehensive family-centered approach to nutrition and feeding from birth to high school. She also hosts a popular podcast, “The Nourished Child” which takes a thoughtful dive into topics around child health with various experts from different perspectives. I was delighted when she invited me onto her show to talk about Dr. Yum’s Preschool Food Adventure last year. Most recently, I was honored when she asked me to preview her new book, “Kids Thrive at Every Size,” a holistic approach to nutrition for kids of all sizes. As I read each chapter, it became clear how much it could help pediatricians reframe their view of childhood obesity and retool their interactions with children to be more holistic and empowering.

Coming Together

All these interactions finally led to this moment when our professional worlds would collide in an even bigger way. When faced with the task of creating a new Touchpoints module to address emotional eating, I asked Jill if she would consider helping me, and I was overjoyed when she agreed! In the early summer, we shaped the script, handout, and video for a new module we call “Eating Habits.” In this module, we aim to recognize that it is common to react to certain emotions with eating and that kids need not feel shame. The module reviews mindfulness techniques around food and helps kids grow a toolbox of other behaviors to help deal with emotional stressors. As usual, Jill had a skillful, thoughtful approach to the project, and we are so pleased with the result.

We are excited to include this module in the Touchpoints program this month. On Sunday, September 29th, Jill will join us in our booth at the American Academy of Pediatrics national meeting in Orlando. She will be signing copies of her brand-new book, “Kids Thrive at Every Size,” and our team will educate pediatricians about a new study on the Touchpoints Program. My story with Jill Castle underscores the importance of collaborations among our varying health disciplines and how much our work is strengthened by including different perspectives. I look forward to seeing how this project will be received by our Dr. Yum Project partner physicians and their patients.