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In middle school, I asked my mom if I could go to fat camp. I wanted to lose weight and for once in my young life be a skinny girl, so away I went. I clearly remember that first mortifying day when all of us kids lined up \u2013 girls in leotards, boys in swim trunks \u2013 to take our \u201cbefore\u201d photos. We got weighed and measured, our fat pinched, every unwanted inch discerned. Our \u201ccalories in\u201d were counted to the milli-bite, and \u201ccalories out\u201d were tracked with every step and jump in the exercise of our choice. That set me up for a lifetime of this-or-that new diet fad or fitness routine in my never-ending quest to be thin \u2013 to have that perfect body that every girl but me seemed to have. One summer in high school I decided to drink nothing but orange juice for a month. I tried my hand at bulimia in college along with several of my girlfriends, but wasn\u2019t dedicated enough to stick with it. As with most women on this journey, I yo-yo\u2019ed between 3 clothes sizes \u2013 my skinny clothes, my fat clothes, and my average clothes.<\/p>\n
Am I fat now? No one in their right mind would say so. In fact, at 46 years of age, I\u2019m down to the pre-wedding weight that I was at 32 years, and back in my skinny clothes. So then why, every time I look in the mirror do I only ever see a \u201cfat girl\u201d staring back at me?<\/p>\n
Turn on the radio or TV, or look on the internet, and immediately you\u2019re bombarded with messages to \u201close the weight once and for all,\u201d \u201cget the body you\u2019ve always wanted,\u201d or some other get-thin-quick scheme. I\u2019m struck with how this elusive goal has pervaded my being since childhood. I\u2019m struck with how not a single one of my girlfriends doesn\u2019t have their weight or their clothes size or their diet on their mind at some point during each and every day. I\u2019m struck as a pediatrician at how many of my patients as early as kindergarten \u2013 girls and boys \u2013 have disordered perceptions around food and their bodies. I\u2019m struck as a mom at how anxious I am about how to talk to my beautiful, loving, spunky, hilarious but a little-too-chubby 7 year-old daughter about her weight without setting off the perfect storm for a lifetime of disordered eating and body dissatisfaction. I\u2019m struck with the memory of my best friend in college who lost her battle to bulimia and ended her life at the too-young age of 27.<\/p>\n
I could rant about how society and media has \u201cdone\u201d this to our girls and boys, giving them distorted views of what the \u201cperfect body\u201d is and how to achieve it. I could go on about how the Twitter firestorm over Lady Gaga\u2019s supposed \u201cmuffin top\u201d is a sign of what\u2019s ailing our children. And that hopefully movements like the documentary movie Embrace and Dove\u2019s \u201cCampaign for Real Beauty\u201d are paving the way for \u201cbody positivity\u201d and \u201cbody acceptance\u201d to replace \u201cbody loathing\u201d and \u201cbody shaming.\u201d<\/p>\n
But, the fact remains that we have a long way to go. And our current generation of parents (us!) has a duty to understand how to raise healthy happy children who love themselves and their bodies, are neither too fat nor too thin, and are thriving \u2013 body, mind & spirit. We need to understand the lifelong impact of body dissatisfaction that starts in childhood, and what we can do to help our children develop positive body images and views around food for their lifetime.<\/p>\n
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A study<\/a> from August 2016 showed that body image concerns start as young as preschool and are pervasive throughout childhood. Almost one-third of preschool staff reported having heard a child call themselves \u201cfat,\u201d and 10% heard a child say they felt \u201cugly.\u201d By the age of 3-4 years, kids have clear ideas of what bodies \u201cshould\u201d look like, and some 4 year-old children already know strategies to lose weight. Healthcare professionals reported that they had \u201cseen signs\u201d in nearly \u00bc of 3-5 year-old children that they were \u201cunhappy with their appearance or bodies.\u201d This number jumps to nearly half of 6-10 year children reporting that they are unhappy with how they look. And startlingly, around 1 in 5 children had already rejected food because they were worried \u201cit will make me fat.\u201d<\/p>\n Here are some additional statistics from the National Eating Disorders Association (NEDA)<\/a> and the National Association of Anorexia Nervosa and Associated Disorders (ANAD)<\/a>:<\/p>\n Body image problems are not limited to girls. I am seeing an increasing number of boys in my holistic pediatric practice with distorted body images, unhealthy eating behaviors, and pathologic eating disorders. In boys, body dissatisfaction and disordered eating often arise in adolescence, not as a quest for thinness as it is for girls, but as a quest for leanness and increased musculature. And this body dissatisfaction can last a lifetime in men, as it does in women. One study<\/a> found that the vast majority of men surveyed had anxiety about their body shape and appearance, and nearly 40% would sacrifice at least a year of life or more in exchange for the \u201cperfect body.\u201d<\/p>\n A negative body image can have lasting psychological, emotional and physical implications for the rest of your child\u2019s life. Body dissatisfaction is one of the most important risk factors for developing an eating disorder. Eating disorders are not just “mental illnesses.” Eating disorders can have serious, potentially life-threatening physiologic complications, and anorexia nervosa has the highest mortality rate of any psychiatric illness. Not only is body dissatisfaction associated with higher rates of eating disorders, negative body image places our kids at much higher risk for low self-esteem, anxiety and depression, and alcoholism\/substance abuse.<\/p>\n Parents play a critical role in shaping their children\u2019s body image and satisfaction, or dissatisfaction.<\/p>\n A 2013 study in JAMA Pediatrics<\/a> found that kids whose parents discussed eating habits by focusing on weight, telling their children they were heavy or could get fat if they continued to eat the way they did, were more likely to adopt unhealthy eating behaviors such as extreme diets, fasting, using laxatives, or binge eating. Kids whose parents focused on healthy eating without judgmental statements about weight or size were less likely to have eating problems. Focusing on weight instead of healthy eating significantly increased the risk for overweight teenagers of developing unhealthy eating behaviors. This effect was especially strong when fathers had these discussions with their daughters.<\/p>\n Children, Teens, Media, and Body Image<\/span><\/a>, a 2015 report by Common Sense Media,\u00a0 found that 5-8 year-olds who think their mothers are unhappy with their bodies are more likely to feel dissatisfied with their own. As moms, our own dissatisfaction does not even have to be spoken. It may be expressed in the way we look at ourselves in the mirror, or step on the scale and sigh, or carefully choose the foods we’ll eat or not. As our children look at us and see a beautiful, perfect mother in front of them, how are they to interpret their mother looking at that same image and moaning in disgust or disappointment?<\/p>\n As parents, our words are powerful, even the most well-intentioned. A 2016 study<\/a> in the journal Eating & Weight Disorders found that a woman\u2019s dissatisfaction with her adult weight and having a higher body mass index (BMI) were both associated with her memories of her parents making any<\/strong> <\/em>comments about her weight. Even among young women with normal weight, those who recalled their parents commenting about their weight were more dissatisfied with their own body weight. Previous studies have shown that women who were told they were \u201ctoo fat\u201d or put on diets as children were more likely as adults to be obese or have disordered eating. What is different about this study is that it looked at any parental comment, positive or negative.<\/p>\n Our goal as parents should be to promote a healthy body image in our children, no matter what size or shape they are. Whether they are struggling with being overweight or underweight, our challenge remains the same \u2013 how to ensure that our children are at a healthy weight while maintaining a healthy lifestyle and satisfaction with their body.<\/p>\n So how do we as parents help our kids be \u201csatisfied\u201d, even happy, with their bodies, and develop a healthy, positive attitude toward food and their body image as they mature into adulthood?<\/p>\n Guidelines for parents to instill a healthy body image in their child:<\/span><\/strong><\/p>\n With an epidemic of childhood obesity and its long-term serious health consequences, there may be times when we as parents must discuss healthy weight with our kids. But how do we balance this with the equally important need to preserve positive body image and prevent a slippery slope into disordered eating?<\/p>\n\n
How parents shape their children\u2019s body image<\/h3>\n
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<\/p>\nHow can parents promote a healthy body image in their children?<\/h3>\n
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How do you talk to your child if she IS overweight\/obese (without damaging her body image?)<\/h3>\n
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