An Obsession with Body Image Can Lead to Anorexia

How do kids become obsessed with their body image? It doesn't take much. Glamour magazines left lying around the house. A self-conscious declaration of "Ugh, these pants make me look fat." Raising an eyebrow as someone takes a second helping of dinner.

If you've done any of this, and you have kids, you're sending them a potent message: In a culture obsessed with weight, they need to be thin.

For five years now, public health officials, doctors and the media have sounded the alarm on the nation's obesity epidemic, warning of the health dangers of eating too much and exercising too little. Our problem with weight is well publicized and hard to ignore.

But while we're learning to watch what we eat and exercise more, we haven't learned how to talk effectively to our kids about weight and body image. And our culture hasn't stopped glorifying rail-thin fashion models and airbrushed celebrities.

This combination of idolizing the "perfect body" and fretting over a national weight problem is a lethal mix for impressionable kids.

Parents know it. Puzzled about how to respond, they swap stories of their 7- or 8-year-old girls asking if they're too fat.

Lynn Grefe, CEO of the National Eating Disorders Association (NEDA), sees it. The incidence of eating disorders is up (NEDA estimates that 11 million adults and kids have had some kind of eating disorder); the number of treatment centers nationwide is growing; and treatment providers are seeing younger sufferers - more girls and boys alike, she says.

Among her own recent encounters:

  • A phone conversation with a panicked mom, whose 4-year-old daughter thinks she's too fat and has stopped eating;
  • An 8-year-old on a feeding tube to fight the ravages of anorexia; and
  • A parent's letter telling Grefe that "by the time you read this, my son Matthew will be dead" from an eating disorder.

"I want to call for a moratorium on body talk, just for a week," Grefe says. "Just one week. Can you imagine? One week where we stop talking about people's [weight] and their butt size, and we talk about their character instead.

"Yes, there is a problem with childhood obesity. But we're not talking about healthy body sizes in any of this," Grefe says. "Everybody is talking about this ideal weight - these pictures of models in the magazines. That isn't achievable! You see young girls looking at these pictures, many of them airbrushed. Does a 9-year-old girl know that?"

Physicians also acknowledge the problem. Renowned obesity researcher David Ludwig, M.D., Ph.D., director of the Optimal Weight for Life (OWL) program at Children's Hospital Boston, focuses on guiding overweight kids - and their families - to live healthier lifestyles, rather than ordering them to drop pounds because they're too heavy.

But, he says, "most children we see in the OWL clinic are all too painfully aware of their weight issue. After all - all a girl needs to do is watch TV or open a fashion magazine to feel badly about her body."

The media isn't the only problem here. Parents can play a crucial role in guiding their kids to reject media and popular culture views about beauty and thinness. But many don't know how. Child health advocates say that some well-meaning parents can even make matters worse - unwittingly giving the impression that an overweight child isn't good enough.

Where We Slip Up
That's hard for any parent to hear. We want our kids to live happy, healthy lives, and warnings about too much weight or obesity have us justifiably concerned. Unfortunately, we may be expressing that concern in damaging ways.

"It's pretty hard for parents who are weight pre-occupied to say anything to their child. The kid knows what you're trying to say; you can't fool a kid," says Ellyn Satter, a family therapist specializing in feeding issues and the author of numerous books on eating behavior, including Your Child's Weight, Helping Without Harming.

"Consider what's going on between the parent and the child regarded as being too heavy," she says. "The parents worry about every mouthful the child takes in. They try to get him to eat less, slow down, all these things."

Ironically, when a parent or the child himself tries to limit food intake, research has shown that the child ends up gaining more weight. "They'll sneak," Satter says. "They end up cheating anyway, even though they don't want to, because they're so hungry."

And when the child gains more, how does it affect the parents? "They're angry, ashamed, thinking they're not good parents," she says. "The parent-child relationship in these situations is not very good."

One parent Satter worked with came to realize that her obsession with her daughter's weight was destroying their relationship. "She told me, -I realize now that I didn't like [my daughter] very much,'" Satter says. "-We'd have this constant thing going about how much she was eating. … Now I see so many things in her that I couldn't see before because I was just so focused on the weight.'"

If children detect that you're preoccupied with their weight, it backfires in every way, Satter says. "They feel worse about themselves, they don't feel capable or even smart. It's not the weight per se, it's how the child sees himself in the parent's eyes."

A Better Way
So how do we teach our kids about healthy eating, reverse unhealthy weight gain and not destroy body image and confidence in the process?

Ludwig's approach - to encourage whole families (not just an overweight child) to eat nutritious foods and get enough exercise - is advocated by doctors and dieticians alike. Better to create a home environment where fruits, vegetables and opportunities for fun physical activity abound than to simply order one child to run around the block and keep away from that Hostess Twinkie.

Ludwig also says he doesn't focus on the abstract consequences of obesity when he talks to a child patient. Instead, he talks directly about that child's experiences - difficulty keeping up with peers in sports or feeling lethargic and mentally fuzzy after eating junk food.

Other experts in child health, nutrition and body image offer parents this advice:

  • Don't put your child on a diet or restrict her meals and snacks. Along with Ellyn Satter, nutritionist Francie Berg is adamant about this. Berg, the author of 12 books on food and weight issues, heads the Healthy Weight Network, an organization devoted to analyzing research and public thought about obesity, and promoting healthy lifestyles over food restriction.

    She most objects to weight-loss programs and even the federal dietary guidelines that limit total daily calories and various types of food. Restriction, both Berg and Satter insist, doesn't work - and it's dangerous. "All of a sudden, it's eating fewer calories than you want, eating less," Berg says. "There is so much focus on obesity, we're forgetting the people who are under-fed, under-nourished. … A lot of people are dying of underweight, under-nutrition and dangerous attempts at losing weight."

    Once you've created a healthy environment and stopped obsessing about food intake, weight issues usually resolve on their own, Berg and Satter say.

  • Create a "division of responsibility" in your home. This is central to Satter's counseling work with families and kids who have eating issues. Give parents the responsibility of stocking the home with healthy foods and creating meals, and give kids the responsibility of eating those foods when they're hungry and stopping when they're satiated. "You don't impose certain menus or amounts of food," Satter says. "Parents take leadership with family meals, leadership with making sure kids aren't snacking all the time and leadership with the structure of snacks - when kids can have them and how."
  • Don't send bad messages about body image. "Are you talking about your own butt, your own size? Are you saying you feel fat? " says Grefe. "Fat is not a feeling. We have to get rid of some of that jargon."
  • Learn about different body types, healthy weight ranges and growth changes. During puberty, for example, girls are supposed to put on more weight to support their reproductive systems.
  • If your child asks if she is fat, don't evade the question. Find out why she's asking. Are other kids teasing her? Is she comparing herself to magazine models? Once you understand what's behind the question, you can address it. Let kids know that everyone is shaped differently, that models aren't always what they appear to be. Give them advice for handling teasing (such as calmly ignoring it until the teaser gives up).

If your child does have a weight problem, be truthful and matter-of-fact, says Satter. Approach the subject in a loving way; focus on your concern for the child's health over a lifetime, not his weight at this moment.

Just remember, notes Berg, 85 percent of American children have no weight problem at all. A preoccupation with weight can send the wrong message, especially when most kids simply need well-rounded, healthy meals and regular physical activity.

Deirdre Wilson is national senior editor with Dominion Parenting Media and Parenthood.com.

© Parenthood.com, used with permission.

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