Childhood obesity is a health concern and source of frustration for many families throughout the United States. A recent study conducted by the Center for Health Statistics found that one in five children in America are now overweight. This number has tripled over the past twenty years. Many factors, such as lack of physical activity, poor diet, and widespread advertisement for fast food are contributing factors to this epidemic. Parents can engage in an indirect strategy of eating disorder prevention by promoting healthy eating habits.
Although obesity in children can lead to medical complications such as hypertension, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance, the wrong approach to this sensitive topic may cause lifelong psychological scars. Many of the adults with acute eating disorders that I have counseled throughout the years recall the negative comments of their parents about their weight, which exacerbated their negative self-image.
One of my clients, Sara, was forty-five years old when she sought outpatient therapy in my Torrance office following her fourth discharge from a residential treatment center. From her teenage years, she has been in and out of inpatient eating disorder facilities. She has lost the most productive years of her life battling with her eating disorder.
From birth, she had a bigger structure and was at the 65th percentile for weight most of her childhood. She told me that her father used to play with her older sister, throwing her into the air all the time when Sarah was a child. When Sarah asked him to play with her, he told her, “You are too big, I would play with you if you were not so heavy.”
In order to gain her father’s approval, Sara stopped eating breakfast and dinner, to the point where she was going to bed hungry each night, for years. As she lost weight, she gained approval from her parents and peers, which triggered the onset of her anorexia nervosa. Though her father’s negative comments were not the only contributing factor triggering Sarah’s eating disorder, they hugely impacted her self-esteem.
I work with many parents in my counseling sessions who find that their weight-management strategies often backfire and lead to negative psychological consequences with no real results. It is important to keep in mind that it is normal for your child’s weight to fluctuate in various stages of their development. However, if you perceive sudden changes in your child’s weight and/or you have concerns for his or her physical health, it might be helpful to support him or her in developing healthy habits.
Below you will find few of the recommendations that I have seen to be helpful for families I have provided psychotherapy and consultations for over the years.
Avoid Discussing Weight Concerns in Front of Your Child
As far as possible, don’t take your children or teenagers with you on initial visits to a pediatrician or psychologist if your focus is discussing their weight. Although there are many qualified professionals specializing in the field of eating disorders, I have heard horror stories about how weight concerns are discussed in front of children. This can have a negative long-term impact on your child’s self-esteem.
It is a good practice to talk with your child’s providers alone. After agreeing on an approach, you can convey whatever messages are necessary yourself to your children or facilitate a conversation around your child’s wellness in front of a professional. Make sure you are monitoring the content of these conversations in order to prevent your child’s perceiving and internalizing that his or her value is based on weight.
Adopt a Family-Centered Approach
Being the only family members that must make changes in their eating and exercise routines while other members continue to maintain their eating habits is often confusing and frustrating for many children. In order to create a long-term change in your child’s well-being, it is important for the entire family to revisit their relationship to food and exercise. As a parent, you need to model the changes you would like your child to make in his or her life.
Instead of focusing on diet, promote overall health and well-being for the entire family. Some of my clients create family challenges at home to encourage increasing physical activity. During these challenges, family members receive points if they engage in a certain amount of physical activity each day. For example, every 30 minutes of moderate physical activity is counted as a point, and each family member can earn up to two points each day. This way the entire family can participate in a challenge and you can praise each other for adopting a healthier lifestyles that will have a long-term impact.
Make Healthy Choices Easy
You children will be more likely to eat healthier food if it is easily accessible. Instead of labeling food and snacks as good and bad you can frame them as everyday food and sometimes food. For example, as a parent you could buy more varieties of everyday foods such as fruit, vegetables, and dairy and limit the kinds of sometimes foods such as chips, cookies, and fries that you buy on your trip to grocery stores. Remember, the key is not to eliminate the sometimes food but just to practice moderation.
Having healthier options easily accessible, as by putting fresh fruits on the table or adding fruits and vegetables to your children’s favorite dishes, you will make it more probable that they will experiment with these foods. This may encourage them to make the transition to eating healthier themselves.
The process of change may be slow initially, but by focusing on slow and steady changes you can help prevent your child from adopting a yo-yo approach to dieting, which will slow down his or her metabolism.
Food is Fuel
Educate your children to view food as fuel, not as a way to cope with overwhelming emotions. Many parents feed their children when they are sad, angry, or bored, which in turn teaches them to seek out food as a primary coping tool.
Although all of us may engage in comfort eating from time to time, the more resources we have for how to effectively manage our emotions, the easier it will be for us to substitute other successful tools for food. Many of my clients who struggle with binge-eating disorders as adults were taught in their families of origin to soothe their disappointments and sadness with high-fat, sweet food.
As parents, you can support your children utilizing their other coping mechanisms on a regular basis. Although many of the teens I work with are able to identify other coping skills when they are not experiencing overwhelming emotions, they feel paralyzed in the moment and resort to food for comfort. In order to help children use coping skills when they need it the most, I work with many parents to create coping corners and coping boxes for their children to use when they experience negative emotions.
Coping boxes are designated places for your children to keep a few soothing objects so they can have these things handy when they need them. Some objects that people put in these boxes are their favorite scents (lavender, tea, coffee, or scented candles), sentimental pictures (of your favorite movie star, a family member, or the family pet), favorite calming music, and/or soothing material to touch. You can direct your children to their coping boxes when they feel overwhelmed and are struggling to calm themselves down.
Promote Engagement in Pleasurable Physical Activities
I firmly believe that, given the right opportunity, every child can find a physical activity that they can enjoy on a regular basis. Many people develop aversion toward exercise after being forced to exercise for weight loss and being bullied because of not doing it well enough. A child is less likely to continue engaging in a physical activity long term if they do not enjoy doing it.
Not everyone is into running or playing competitive sports. In order to support their children’s weight management, parents often need to broaden their definition of exercise. For example, one of my clients used to refuse to go to the gym or engage in any physical activities, because she had had several experiences since middle school where she felt shamed and ridiculed in public.
It wasn’t until we thoroughly explored, one by one, a list of activities she used to do as a child that she rediscovered her passion for dance. Although she was hesitant to return to it, she finally decided to try a hip-hop class outside her neighborhood. After several sessions, she enjoyed it so much that she made it part of her regular routine. Going to the hip-hop class not only helped her increase her physical activity, but it also drastically improved her mood.
In your effort to help your child adopt a healthier life style, it is essential to be mindful of the messages you are sending about his or her body. Many of my clients pin their entire self-worth on their size and shape due to the messages they learned and internalized as children. Remember, your children’s self esteem and mental health are as important as their physical health; as a parent one of your main roles is to serve as a protective factor filtering the messages they receive from their environment.
Dr. Nazanin Moali is a clinical psychologist and eating disorder specialist who has completed an Accredited Postdoctoral Residency (APA) in the treatment of eating disorders in adults and teens at Kaiser Department of Psychiatry. Dr Moali offers individual and family therapy at her Torrance office and also online for her clients’ convenience.