My 10-year-old daughter asked if she was fat, and it gutted me

“Why? Because I’m fat?”

No mom wants to hear those words from their 10-year-old daughter, least of all a pediatrician whose life mission is built around improving the social-emotional health of kids and their parents. Yet there I was, taking them in, feeling them pound on my heart.

I’d been talking to my oldest child, Makena, about her extreme distaste for exercise. “I don’t want to walk down the hill to school,” she told me, “Because then I’ll have to walk back up it at the end of the day.”

I am a Stanford-trained pediatrician and American Academy of Pediatrics (AAP) spokesperson. I understand (and agree) with the AAP’s recommendations that Americans should pay more attention to the quality of the food we consume, that we increase our activity level, and that, as parents, we model healthy eating for our kids.

At the same time, implementing those recommendations is more complicated than ever. Like most women, my relationship with my body is fraught. I’m still scarred from the ’90s workout videos I watched at age 13 and the yo-yo diets I tried all through my twenties. Our culture’s relationship with food isn’t as evolved as we think it is, either. Conflicting messages about body love and body ideals fill our smartphones: Everywhere we look, photoshopped images of painfully thin women sit juxtaposed next to thought pieces extolling us to love our bodies even if they don’t look like those unrealistic standards.

There are also the nuances of my unique child to contend with. Makena is autistic. She senses almost everything more sensitively. Tight pants are a no-go. Scratchy tags ruin a day. A bead of sweat collecting at her brow? She’s had just about enough of this hike. At the same time, Makena is overly pragmatic. Nevermind that we just flew around the world to see Japan. There’s sushi back home, so no need to try it while we’re away. That combination makes motivating her to move for the sake of movement near impossible.

What’s more, Makena is on the softer side. She inherited my curvy genetics. She’ll take a croissant over a carrot any day (even though we supply her with plenty of fresh fruit and vegetable options). Add her sensory sensitivities to her genetic predispositions, and it makes promoting more nutritious food options even more challenging to navigate in our household.

Let me be clear: I’ve never in my life called my child “fat” (I’m so scarred from observing body-shaming in my own home as a child, I’m dead-set on giving the opposite perspective to my own girls). Even so, there’s no way for this generation to fully escape social media’s influence, or even the beauty standards of their peers. Body consciousness is everywhere. In a 2016 study, children as young as age 3 even expressed body confidence issues.

Which is all why this moment with my daughter feels so complicated and so critical to get right. My book knowledge is rattling around in my head, calculating BMI percentiles and health complications she may face in 10 or 20 years. My past is circling like a vulture, tempting me to put the same weight-based shame on my child’s shoulders I still carry on mine. Her neurodivergent needs are front and center, reminding me all kids are different. 

And that’s when the right thing to say hits me.

I looked my daughter right in her sweet little eyes and told her what I wish I’d known at a much younger age: the truth.

1. The answer is ‘no.’ I don’t want you to move your body because you’re “fat.” I want you to be healthy, not a certain size or weight.

2. Your body doesn’t need to be fixed because it’s not broken. It does, though, need to be taken care of because it’s the only one you’ve got. That means you’ve got to give it what it needs to be healthy and strong: foods that will give it energy, movement, hydration, and plenty of rest.

3. Your body is something you can be proud of just the way it is. It might be different from others’, but that’s what makes it special. As you grow, it will change, and then it will change again. That’s what’s supposed to happen.

Finally, the big one:

4. “Fat” and “skinny” are just words. We only think of one as good and one as bad because that’s what girls and women have been told for such a long time. I grew up thinking you had to be small to be valuable. But we don’t have to play by those old, stupid rules. In fact, we can change the rules altogether.

Sometimes we shield our kids from the truth because we’re afraid it will hurt them. We think they won’t be able to handle the reality of our cruel world. I know, though, they can handle the truth. And, because they still live in a world full of contradictory body love imagery and rhetoric, our kids have to know loving their bodies will still mean making a conscious choice, at least for the foreseeable future. Our kids need us to teach them what they’re up against so they can fight it full-force. If we don’t, they’ll grow up carrying the same weight-based generational traumas we do. If we do, we’ll give them the chance to break those curses once and for all.