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Article by Sandy Bauers, For The Inquirer

istock_kid-overweight-dinnertable-3x2If your child has weight problems, it won’t help to focus on the numbers on the scale. Reminding kids about weight can lead to dangerous dieting tactics and unhealthy eating.

Family meals help develop balanced eating habits and foster communication. Slideshow icon SLIDESHOW
5 questions: How to talk to kids about weight
That’s the main message in a recent report by the American Academy of Pediatrics (AAP). The researchers found that adolescents whose parents focus instead on healthy eating and physical activity are less likely to have eating disorders or turn to unhealthy weight control methods.

This information is more important now than ever. The rate of teen obesity has quadrupled in the last 30 years, according to the academy.

For perspective, we recently spoke with two experts at the Renfrew Center, established in 1985 in Philadelphia as the nation’s first residential eating disorder facility, treating girls and women age 12 and over. Its 17 locations nationwide also include Mount Laurel and Radnor. Corrine Kopp, who has degrees in psychology and social work, is site director of the Renfrew Center of Southern New Jersey. Lauren Rooney is that center’s regional nutrition manager.

When the AAP said parents should focus on healthy eating, not weight, what did they mean? Why is this important?
Kopp: The report is really broadening the conversation with children and adolescents for both parents and providers. It’s incredibly important. Children’s and teens’ minds are very impressionable. They’re already inundated with unhealthy messages around weight. Broadening the picture takes the fixation off the number. When the focus is on weight alone, people begin to define themselves based on that number. When they see their worth as just that number, they’re minimizing their value.

If the only thing that’s important is the weight, then all that would matter to the patients we treat – or, really, anyone – might be whatever they are doing to manipulate their weight. We see patients who are bingeing on large amounts of food. We see patients who are undereating. They might not be eating starches or fats. We also see patients that are purging or using laxatives or diuretics.

We’ve definitely seen an increase in preteens, teens and adolescents who are not only overweight, but also obese and underweight. These issues are very much interrelated.

Rooney: Diets just don’t work. Although a multitude of factors contribute to eating disorder development, dieting is the most common. Diets can lead to the abuse of diet pills or laxatives or binge-eating behavior. Those that diet are also labeling food as good or bad. If they are consuming foods labeled bad, they would think of themselves as a bad person. It can lead to this very unhealthy relationship with food and with their bodies.

The academy’s report suggested that families have more meals together as a way to combat eating problems.
Rooney: Family meals are essential. They are a place where we can develop balanced eating habits and create communication within our families. They are an opportunity for parents to model healthy eating behavior – how important it is to have variety, balance and moderation in our diets. Our children are picking up on that.

Any opportunity to share a meal is an important one. It gives parents an opportunity to check in with their children about their day, to ask about their friends.

Kopp: If a child is struggling with overeating or undereating or harmful dieting behavior, the parents are more likely to miss it if they’re not sharing family meals. If they are sharing, they might, for instance, notice changes in mood or behavior or eating patterns that might be a red flag. Then they could talk about it with their child or with a health-care provider. Early identification is better.

Another recommendation was to promote a positive body image for your child. How does a parent do it?
Kopp: It comes back to teens being so inundated with all these negative messages. If they have a positive body image, a positive view of themselves and their bodies, they are going to have a healthier outlook on everything and not be so likely to diet or develop an eating disorder.

One thing that’s important is that the parent or other role model not be commenting on their own weight. If a parent is standing in front of a mirror, really scrutinizing their body, the child is probably going to do the same thing. If they are talking about needing to lose weight or this not being right or that not being right, the child may not be able to understand that the assessment is just of the parent. The child might think, “They must be talking about me, too. I must also need to lose weight.” They’re taking this as a lesson rather than just a comment that Mom or Dad made. It seems innocent, but the impact can be significant.

Instead, parents should talk about the good things their bodies can do. Maybe Dad goes to yoga and he’s been working on this one pose, a headstand. He can talk about his body’s abilities – how his muscles are able to support him doing a headstand – as opposed to proportions or height or weight.

Or, the parents could focus on a discussion about how their daughter went out with her friends and they went for a walk. Was that fun? Or, hey, you like new foods, how about trying some tomatoes?

But those numbers on the scale are important, right?
Kopp: Yes. A health-care provider will have an eye on that. But that number is not the discussion with the child. That will go something like, what do you do for fun? What are your hobbies? It would be a collaborative conversation – what the child is interested in, what activities the family can provide support for, what they can do together – rather than a blanket statement, such as “Why don’t you go for more walks?”

What should a worried parent do?
Kopp: Definitely the first place to start is getting in touch with a provider that knows eating disorders. They need to find someone who can give them an appropriate assessment and, if needed, intervene early. One of the things we know is that the earlier the intervention, the easier the recovery.

I would emphasize that recovery is possible. People can change, and they can lead a healthy lifestyle that isn’t based on weight.

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