"Mommy, Am I Fat?"

Shocking but true: Kids as young as 5
worry about their weight, their height, and their looks. That's why it's crucial to boost your child's body image early in life.

Body Image Problems Start Early

Kiah Hart scrutinized herself in the dressing-room mirror. "These pants make my butt look big!" complained the petite 10-year-old. "I'm so fat!" Kiah has been self-conscious about her weight since age 7, says her mom, Katie, of Portland, Oregon. And Kiah's insecurities are echoed by kids across America -- many of whom, like Kiah, are not overweight at all. In Centereach, New York, 10-year-old Patrick Brady refuses seconds and dessert, saying "I don't want to get fat." His mother, Lorel, says that even at age 6, her lanky son pulled his belt tightly to accentuate his trim waist. What's going on here? "There is huge societal pressure to have the ideal physique, and it's affecting girls and boys at alarmingly young ages," says Alison E. Field, Sc.D., an assistant professor in the department of pediatrics and medicine at Harvard Medical School, in Boston. Recent studies reveal that children as young as 5 worry about their weight. Girls want to be smaller, and boys, more muscular. Influenced by the media, peers, and even their parents, some kids are forming unrealistic body images.

And this quest for perfection extends beyond weight. "Kids are growing up with an all-or-nothing mentality about appearance," says Kathy Kater, a social worker in St. Paul, Minnesota, who specializes in preventing eating disorders. "The message children hear is that if they're not as thin or tall or beautiful or handsome as they possibly can be, they're inadequate." This can cause a dissatisfaction with their looks that might lead to early dieting or bodybuilding and perhaps even depression and eating disorders.

Research shows that by middle school, as many as half of all girls feel bad about the way they look. That's why it's so important to nurture body confidence in the preschool and elementary-school years, when self-image is being formed. Here's how parents can help their children become more comfortable with the bodies they were born to have.

Talk about Body Types

Help children realize that people come in a variety of builds, from petite to large. "Explain what's beyond their control," Kater advises. "Most of how we look is determined before we're even born." Use family pictures of aunts, uncles, and grandparents to illustrate how body type is genetic -- and emphasize that those family members' accomplishments have nothing to do with size. Kids need to know that looks do not limit their potential, says David L. Rimoin, M.D., Ph.D., chair of pediatrics and director of medical genetics at Cedars-Sinai Medical Center in Los Angeles.

Examine your own expectations.

Parents need to understand that everyone grows at a different rate. "I see many parents who are concerned that their boys are too short and their girls are too tall," Dr. Rimoin says. Some go to extremes, requesting growth-hormone injections for their healthy children in an effort to nudge them to socially acceptable heights. The reality is that some kids simply spurt sooner than others, Dr. Rimoin notes. A child's body can change dramatically as puberty approaches, so it's important to prepare yourself and your kids for what's to come. "It's normal for bodies to round out before shooting up," says Kater, who suggests you start talking to kids about puberty when they're around 9 years old.

    Keep children moving.

    Model healthy habits by incorporating physical fitness into your family routine. Walk to stores and parks instead of driving; go for family bike rides on the weekends. "Being active can help give kids higher self-esteem and body confidence," Dr. Field says. However, you should stress how exercise makes you feel, rather than how it makes you look. Say things like, "Isn't walking fun?" and "This feels so good!" suggests Brenda Lane Richardson, coauthor of 101 Ways to Help Your Daughter Love Her Body.

      Don't make a fuss about food.

      Offer a well-balanced diet, but let kids decide how much they eat. This teaches them to respect internal hunger cues. Don't use food as a punishment or reward, or insist that children clean their plate. "Food should never be a moral issue," says Jaimy Honig, M.D., head of nutritional medicine at Beyond Care, in Branford, Connecticut. "Everything's okay in moderation, even for children who are overweight." It's better to keep some junk food in the house, rather than none at all. If you make foods forbidden, kids will feel deprived and may resort to bingeing and dieting, which can impede growth and set them up for eating disorders.

        Discuss Teasing

        "My 6-year-old was upset one day because she couldn't do the monkey bars, and a friend told her it was because she was fat," says Patricia Hayes, of Wayne, New Jersey. Hayes reminded her daughter about all the things she can do -- and Hayes reassured her that she'd be able to master the monkey bars soon. Build kids' resilience to teasing by teaching them how to respond (see "Teasing Tactics," below).

        At the same time, make sure that body consciousness doesn't become body obsession. "If your child says, 'I'm fat,' respond in a way that reshapes the comment, not the child," Kater says. "Answering, 'No, you're not,' only affirms that fatness is a bad thing." Instead, say something like, "Even if everyone ate the same food, we'd still all be shaped differently."

        Know when to worry.

        Children are notoriously picky eaters, and that's usually not a problem. "Most kids do not eat three perfect meals a day, yet still take in enough calories to be healthy," says Ira M. Sacker, M.D., director of the Helping to End Eating Disorders (HEED) Foundation, in Plainview, New York. However, you should be on the lookout for behavior that might signal a problem. If your child frequently monitors calories and worries about her weight, or if she exhibits sudden or unusual dietary changes, your antennae should go up, Dr. Sacker says.

        For example, at age 5, Justine Gallagher, of Bethpage, New York, started limiting portions and rejecting favorite foods. She was growing taller yet not gaining any weight. Then her kindergarten teacher noticed that Justine had developed a peculiar habit of eating paper. "When I asked Justine why she ate paper, she said, 'I don't want to get fat,'" remembers her mom, Yvonne Gallagher. Gallagher saw an eating-disorder expert, and discovered that Justine was anorexic. If you're worried about your child's weight or height, talk to your pediatrician.

          Celebrate other qualities.

          There are many aspects of identity beyond looks, such as creativity and humor. "I've learned to focus on the inside, not the outside," says Gallagher, whose daughter is now 11 and recovering from her anorexia. "I used to tell Justine how beautiful she was every day," she recalls. "Now I say things like, 'You're a wonderful friend.'" Praising kids' special traits and talents helps them build a positive outlook that will last a lifetime.

            Watch Body Language

            "We have to be careful about the body messages we send our children," Dr. Sacker says. If you're moaning about your thunder thighs or wishing you were taller or shorter, children will absorb your insecurities. Don't make negative comments about your child's physical characteristics, either, Richardson adds. Even good-natured ribbing about baby fat and chipmunk cheeks can make kids feel flawed.

            Dispel media myths.

            It's hard enough for children to feel confident in a world where pop stars make flat abs and buff biceps look like the norm. Help kids understand that most people do not look like that. Don't put down their idols, but do encourage your children to think critically about media images. "If we see Britney Spears on TV, we'll say, 'What on earth is Britney wearing?'" says Portland mom Katie Hart. "My husband and I try to find the absurdity in it, so our daughters come to understand that those outfits are pretty unrealistic for most girls."

              Find real-life heroes.

              Help children choose role models in your family and your community who are a more accurate reflection of reality. "Kids need to see that most women are not size 2 and stick-thin, and most men are not perfectly muscular," says Richardson. Children will come to understand that contrary to media messages, success comes in all shapes and sizes. And the next time they look in the mirror, they'll be more likely to smile at what they see.

                Copyright© 2004. Reprinted with permission from the August 2003 issue of Parents magazine.

                  All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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