Years ago, while caring for adults in a suburban internal medicine practice, I began to observe an interesting phenomenon. At the time, it was not unusual for my patients to bring along their children or grandchildren, fresh from a prior pediatric appointment just across the hall. Beautiful, bright-faced, chubby, usually well-behaved children. Their pediatricians’ well-intended recommendations on reducing rates of weight gain consisted of the standard, usually unsuccessful, content. My patients’ expressions told me that the advice was tiresome and frustrating. If they knew how to fix this problem, they told me, they already would have. 

Our conversations would then usually shift to my own patient, who was also working on waist lines, plus rising blood pressures and blood sugars. 

Stop dieting, I said over and over, and stop thinking about your weight. Shift your focus. Eat more vegetables and fruit. Don’t avoid nutritious fat; eat more avocados, scrambled eggs, olives, almonds, peanuts, anchovies. Skip the OJ, and eat oranges instead. Also berries. And apples, which are especially delicious dipped into peanut butter.

Stop replacing breakfast “cereals” when they run out. Why the quotes? Because the real meaning of cereal is grain, like millet, oatmeal, or bulgur wheat. Lucky Frosto’s, Captain Sugar, Raizin’ Weight and Sweetest Brand are not nourishing whole grains. If you would not feed your child brownies or apple pie for breakfast, then I would reconsider feeding them breakfast “cereal.”

Well, you can probably guess what happened next. Patients were proud to return to subsequent appointments with improvements. But the surprising part, the side benefit, was that the children experienced the same. Pediatricians saw weight curves bending toward normal. Families felt more empowered, less hassled. And I saw little bellies shrinking away with my own eyes. 

The research has shown that attempting to teach self-care to patients with early signs of dementia is mostly unsuccessful, but that including a caregiver in the conversation makes all the difference. So if a patient is struggling to remember important details about showering or toothbrushing, it will not help for someone to sit down with them and go over it all again. But if the meeting includes someone who provides regular assistance, it may actually do some good. That’s because human beings function best as part of a social system.

Successful lifestyle changes require not just designated patients, but also the individuals who oversee the lifestyle decisions for that family. And this is true for every single member of that household, especially those [like children] who have limited say in creating the environment of their home. 

Who purchases and prepares most of the food in your family? Who schedules trips to the pool and the soccer field? Who makes time for hikes or baseball games? Who makes appointments for checkups at the dentist or doctor? Who decides where to place lights and rugs? Who decides who sleeps where, and when is bedtime? Who says “it’s time to brush your teeth!”? This guidance and leadership is key to the health of your family. 

Human beings are social creatures; we are meant to function in groups. When the family member with primary responsibility for food purchase and preparation changes their own eating patterns, everyone benefits.