Catlin Gabel: what education can be
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Are you concerned about your teen’s weight? Are you hitting a brick wall when trying to discuss weight, fitness and health issues with your son or daughter? You’re not alone. Many parents report that this is a particularly tough, and often emotional, subject for parents and teens to discuss. So we’ve asked the experts for tips on broaching this important subject with your child.
Teens are certainly not alone in their less-than-desirable reactions to the topic of weight, says Steven Crawford, M.D., associate medical director of The Center for Eating Disorders at Sheppard Pratt in Baltimore, Maryland.
“Consider how you, even as an adult, might react if someone — maybe even your own child — commented on your recent weight gain or pointed out that your exercise and eating habits were really unhealthy,” says Crawford. It’s a sensitive topic for a lot of reasons, but more and more because of the intensity with which our culture, and the media, has placed a focus on weight and connected it to individual self-worth and social status, he adds. “These are, developmentally, very sensitive topics for teens, so some resistance is to be expected.”
Weight is often a tricky subject for moms and daughters, especially, because moms tend to bring their “body baggage” to the conversation, says Dara Chadwick, a journalist and author of “You’d Be So Pretty If…: Teaching Our Daughters to Love Their Bodies – Even When We Don’t Love Our Own” (Da Capo Lifelong Books) “For example, if a mom was heavy as a child and found that to be a painful experience, she may want to ‘spare’ her daughter from going through what she went through and may take a heavy-handed or critical approach to talking with her daughter about weight or eating,” says Chadwick.
“Or, if the mom works very hard to stay slim, she may feel that an overweight daughter is somehow a reflection on her as a mother,” Chadwick says. “Daughters tend to shut down when they feel they’re being lectured, or when it’s a ‘do I as I say, not as I do’ situation. In other words, Mom or Dad tells the daughter to go out and play, or get some exercise, from his or her perch on the couch.”
“Stay alert for natural opportunities to discuss healthy living,” says Chadwick. “While you’re in the kitchen together preparing dinner, while you’re taking a walk after dinner, while you’re watching a television show that makes fun of weight or features an actor who’s incredibly thin. Using moments like this helps take the focus off the daughter herself. Instead, it’s a more global discussion, which tends to feel safer.”
Watch the humor. “I’ll admit I’ve made jokes about my size in the past. But those jokes can hurt just as much as criticism,” says Chadwick. “Don’t make your butt the ‘butt’ of every joke. And think twice before joking about your teen’s body or appearance in any way.” Teens are notoriously sensitive and an off-hand joke about clothes, hair or weight can sting more than adults may realize.
“Never yell, bribe, threaten or punish your child about weight, food or physical activity. If you turn these issues into parent-child battlegrounds, the results can be disastrous,” says Dayle Hayes, MS, RD, a registered dietitian in Billings, Montana. “Shame, blame and anger are set-ups for failure. The worse children feel about weight, the more likely they are to overeat or develop an eating disorder.”
“Make sure you set a good example for health, balanced eating and body image,” says Crawford. “This means not ‘dieting,’ fitting in family meals whenever possible, no excessive exercising and no criticism of your own or other people’s bodies.” If you don’t want your kids to shut down when the topic of weight comes up, let go of a focus on the weight, or the number on the scale, and focus on general health, he says.
Instead of saying, “I’m concerned because you have lost so much weight over the past month,” say “I’m really worried about you because it seems like you don’t have as much energy lately. Are you feeling OK?” Likewise, instead of saying, “You seem to be gaining weight. You’d better start watching what you’re eating,” it might be better to say “I know you’ve been grabbing a lot of meals on the run lately. Let’s try to make some more time to have family meals together,” and then follow through by planning and preparing meals that incorporate a variety of foods.
“Keep in mind that everything in moderation — as opposed to completely banning fast food or desserts — is the key to balanced eating,” says Crawford.
“It is vital for teens to have breakfast,” says registered dietitian Joan O’Keefe, RD, a frequent speaker on nutrition at schools and the creator of the “Nutrition 101” video series (available at www.foreveryoungdiet.com). “Their biological clocks say ‘sleep in,’ but the reality is that they have to get up and they have to have breakfast and it must include protein.”
Protein in the morning will keep kids satisfied and will help eliminate junk-food cravings, says O’Keefe. “Protein sources can be fast,” she adds. “Leftover protein from dinner (chicken breast, etc.), yogurt with berries, peanut butter and an apple or whey protein (mix it and go out the door with it) are all quick and easy options.
“As with any other important issue, make sure that both parents and important relatives are all on the same page,” suggests Hayes. “Sending mixed messages about weight can also have unhealthy consequences.”
If you’re concerned about other family members having potentially negative discussions with your teen about weight, you may want to share this article with them and talk a bit about the approach you want to use.
Teens naturally go through a normal and necessary weight gain at the start of puberty, which allows their body to proceed with maturation, says Crawford. As time goes on, with normal eating behavior, their weight will level off at the body’s unique set point. Parents who draw negative attention to this period of weight gain could trigger body-image concerns and dieting behavior.
Has your daughter started her period yet? If not, did you expect her to start earlier? There may be a possibility that low body weight has delayed the onset of menstruation. If she did start menstruating, is she still getting her period, or has it stopped or been irregular? If you have concerns about this, talk with your daughter’s doctor.
“Introduce your teen to some helpful websites that focus on teen health, such as www.nflrush.com/play60 and www.kidshealth.org (which also has a teen section),” suggests Dallas, Texas registered dietitian Paragi Mehta, RD.
“Together, visit sites such as www.americanheart.org and www.diabetes.org,” suggests Mehta. “This is not to scare your teen, but to create an awareness that if we get healthy now, we can reduce our risk of having lifelong disease or health conditions. Explain to your child that diabetes and heart disease are serious, and talk about how making healthy lifestyle choices now can help protect her health in the future.
While these sites offer positive examples for teens, the same can’t be said of all media, of course. “Have open conversations with your kids about the distorted messages their magazines, and media in general, send to us about weight,” says Crawford. “Remind them that models in advertisements have been Photoshopped and retouched and that they don’t represent what the majority of people actually look like.”
“Diets can further complicate an already stressful relationship with food and could trigger continued problems with eating for your child,” says Crawford. “Diets are the number-one risk factor for developing eating disorders. Instead of putting your child on a diet, the goal would be to work toward normalizing eating behavior, ensuring that they are getting most or all of the necessary nutrients they need in a day, and getting in touch with the body’s natural hunger and fullness cues.”
“Always keep the focus on health, rather than weight,” says Hayes. “Losing weight is incredibly difficult and it is not the only measure of success. If your family starts eating better and moving more, your children may ‘grow into their weight’ as their height increases,” she says.
“Try to make healthy food choices whenever possible, such as a baked sweet potato instead of fries, water instead of soda, etc.,” suggests Chadwick. “But don’t point out your choice or make a big deal out of how you’re choosing the healthy version. Kids will tune that out quickly.”
Remember to show that all foods can be enjoyed in moderation. “Have a treat and enjoy it,” suggests Chadwick. “Show kids that everything – pizza, cheeseburgers, hot fudge sundaes – has a place in a balanced approach to healthy living. When you choose to have a treat, do it mindfully and let your child see you enjoy it. Proclaim it ‘treat night’ and don’t say one word about how it’s going to your thighs or how you shouldn’t be eating it. Just enjoy!”
Getting your teen involved in meal planning and physical activities can be a big help, and you can do it without a lot of talking about “the problem.” Get your teen involved with meal planning, creating healthy grocery lists and the grocery shopping, suggests Mehta.
“Get involved in exercise activities with your teen, i.e., kickboxing, martial arts, biking, walking, jogging, tennis, rock climbing or dance aerobics,” suggests Mehta. “Join a health club together or do dance/exercise DVDs together. This can help with bonding and is a win-win situation, she says. “You get to spend quality time together, get exercise together, and show how you really care about your health and your family’s health.”
If you want to be as informed as possible before you talk to your child or her doctor about your concerns, it can be helpful to call an eating- disorder specialist first, suggests Crawford. Inform him or her of your child’s weight gain/loss, current symptoms, health problems or any other concerns you might have.
It’s always best to have an open line of communication with your child if possible. “If you do express these concerns to your child, indicate that your primary concern is for her health instead of focusing on the weight or the food she may or may not be eating. Be prepared for her to be defensive,” says Crawford.
Your child’s primary care doctor can be a great first step because 1) your child is already familiar with this person, and 2) an appointment can be scheduled without too much resistance from your child generally, especially if it’s incorporated into an annual check-up or well-visit.
Make the doctor aware of your concerns in advance of the appointment so that he or she can plan to ask your child the necessary questions, run the appropriate blood and lab tests and make a referral for recommended treatment.
But don’t put all your eggs in one basket, Crawford stresses. It’s common for parents to take their concerns to a pediatrician who may not be familiar with eating disorders and, thus, may not take the appropriate steps. If your pediatrician dismisses symptoms and you still have concerns, follow up with an evaluation by an eating-disorder specialist, he suggests.
Also, make sure your pediatrician knows that you endorse a non-diet approach and that you do not want them to focus on the number on the scale or discuss a need for weight gain/loss in front of your child, Crawford advises.
Don’t hesitate to ask for help. Don’t be offended if someone else is able to get through to your child more easily than you are. “Often a teenager that continually shuts down when confronted by a parent will respond more openly to the concerns when they are expressed by a doctor, school counselor or even a friend,” says Crawford.
Kathy Sena is a freelance journalist who frequently covers health issues and teens. Visit her website at Kathy@kathysena.com.
Catlin Gabel: what education can be
Hear more from people who know it best.
We are now accepting applications.