In my private practice as a psychotherapist specializing in eating and body-image problems, I have seen teens and young adult women with eating and body-image problems that stem from growing up in homes where certain foods were off-limits. Many of their negative associations come from painful memories that go back as early as grade school. My knowledge of this awards me the opportunity to address this issue with parents of children in this age group early on, in an effort to prevent eating disorders later. From the first time a mother feeds her newborn baby, her attitude toward food and eating can leave an impression. A mother who is anxious while feeding her newborn and doesn't pay attention to hunger cues can set the stage for problems with food later in childhood. By the time preschool comes around, the attitudes and approach mothers have toward food sets the stage for how kids may feel later about food and eating. If a child witnesses her mother expressing disgust at her image in the mirror, the child may begin to mimic that behavior.
According to the National Eating Disorders Association (NEDA), 40 to 60 percent of elementary school girls (ages 6 to 12) are concerned about becoming too fat or gaining wait. It's troubling when girls as young as 6 are worrying about the fat content in their lunch boxes. So where are these children picking up their ideas about food, fat, and body image? Their home environment, other kids at school, and commercials and magazines all influence them. Kids start to perceive what fat means just by hearing about it from other peers and adults or by watching TV. They learn that fat is "bad for you" and will make you gain weight. As a result, they don't want to eat. A majority of my patients have also said that their mothers were very tough on them about how their bodies looked or that their mothers had personal body issues. Generally, later on in life, these young women become binge eaters to rebel against the ideas that were set forth by restrictive mothers. Mothers, then, are the first and most significant female models in their developing daughters' lives. They are faced with the difficult challenge of modeling positive feelings toward food, eating, and body image. Here are steps that mothers can take to help their school-age girls and to prevent early eating and image problems.
Model a Positive Body Image. Women may have internalized cultural values, such as the importance of thinness, and have difficulty trusting their own needs, desires, and wants. It is key that mothers be aware when they feel bad about their own bodies and when they are modeling a negative body image. Be careful not to use words such as "fat" and "diet" around the home. Young kids, especially girls, are impressionable and susceptible, so teach them to be comfortable with their developing bodies. Convey this with phrases such as, "Honey, that dress really flatters your body" and "You are my beautiful child, inside and out." Although mothers who struggle with their own negative body image may find this difficult, it's key to remain cognizant of the language and phrases said in front of daughters. It's essential that every mother find the strength within to avoid making bad comments about her own body.
Discuss "Sometimes" vs. "Always" Foods. When it comes to discussing food choices, avoid categorizing foods as "good" vs. "bad" (which can make kids feel as though they've been good or bad) or "healthy" vs. "unhealthy." Instead, talk about "sometimes" foods and "always" foods; this can help your kids understand that some foods are better eaten in smaller quantities and less often. Vegetables, fruits, whole grains, proteins, and dairy products can all be explained as "always" foods that are useful and necessary for growth and development. Sweets and fried foods can be seen as "sometimes" foods that taste good but are not healthy or necessary to help us grow. When kids do desire "sometimes" foods, they should eat just a small portion and stop when satisfied. Because feeling full and satisfied may have a different meaning for every child, be attuned to your child's unique nature of fullness. Let your child be the one to say when she is finished eating; don't make the decision for her.
Practice "Self-Attuned Eating." The "self-attuned eating" model, a process of learning to pay attention to and trust feelings of hunger and fullness, can help with making certain food choices. In my own practice, I rely on this model; while it may not work for everyone, I believe it is the best way to prevent eating disorders if it's taught and practiced with children early on in their lives. This model teaches that feeling satisfied is important, so no food is off-limits and it's okay to eat all types, whether carrots or candy. This helps them feel safe, comfortable, and open around all foods and promotes a healthy, normalizing attitude toward eating.
Talk About Empty vs. Full Stomachs. Discuss how food affects the digestive system and the body by sharing how to eat only when hungry and how to stop when full. Talk to your kids about how their bodies feel at the present moment. Try asking if their stomach feels empty and "growly" or if their stomach feels full and "heavy." Re-enforce this on a regular basis to help kids feel connected to their bodies. In Preventing Childhood Eating Problems, psychotherapists Jane Hirschmann and Lela Zaphiropoulos stress that allowing children to decide when, what, and how much to eat helps strengthen their self-confidence, self-esteem, and sense of dignity. This also helps kids avoid the kinds of eating difficulties that have plagued many adults for life.
Involve Children in the Lunch-Making Process. Get creative by having your kids prepare their own lunches. Allow them to choose what they like and also teach the basic food groups. Offer enough options so that kids can choose chocolate milk one day and regular milk another day. Include them when grocery shopping so they are further involved in picking the foods they would like to have in the house. Talk about how their bodies need certain nutrients and vitamins to grow strong; this makes them feel that they have some control over what is eaten. As they consume a variety of foods, explain the purpose each one serves and the positive effects. For example, "We eat carrots because they have vitamins and help with our eyesight." Although getting vital nutrients is crucial to development, enjoying the eating experience can have a long-lasting effect on the mind and body.
Aviva Braun is a licensed clinical social worker who offers both individual and group therapy to adolescent and adult women who have eating and body image problems. She has presented on the topic of eating disorders and healthy body image to schools, college counseling centers, and parent associations. Visit her site at avivabraunlcsw.com.
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