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Family Meals Focus

The Ellyn Satter Institute Newsletter

Are we teaching our children conflict and anxiety about food?

 by Jennifer Harris, RDN, LD, CEDRD

Provide, don’t deprive, and trust your child to eat well and grow up to have the body she is meant to have. Your child is entitled to be free from worry about eating, moving and weight. You are entitled to feel comfortable about doing your feeding jobs and relaxed about trusting your child to do her eating jobs. You do not have to get caught up in the weight and health hysteria that frightens your child about her eating and weight and undermines you in doing a good job of parenting with food. 

Consider these scenarios:

  • My niece asked her mother if she could have a piece of bread pointing out that she had eaten all of her fruits and vegetables. She is not allowed to eat bread unless she eats all her other foods.

  • A fellow parent shared her concern about her daughter’s intake of desserts. As a result, she instructed her daughter to exercise more to compensate. I cautioned her about the potential for harmful messaging to her daughter, such as: you are gaining too much weight, or desserts will make you fat. Parents don’t set out to hurt their children intentionally. But it didn’t matter, this child knew her mother was commenting on her weight.

  • Not long ago my college aged daughter sent me a panicked text. “Is cheese bad for me?” A well-intentioned friend, a student in a health care discipline, noted her love for cheese and told her it was bad for her. I never taught my daughter about cheese, I just fed it to her. This one comment shook her confidence level with regard to her eating routine.

How things used to be

When I tell these stories to my own mother, she looks bewildered and says she never had these types of concerns when feeding her family. She served the meal, we showed up hungry, we ate what we wanted from the offerings placed before us, and we asked to be excused — usually eager to get back to our friends for more play time. My mother certainly didn’t worry about whether I was getting the right number of minutes of physical activity a day, and there was no discussion about calories or “balancing the energy equation”.

It’s different now

Children are worried.1,2 Parents are confused. And within this fright and confusion lies the irony of obesity “treatment.” Despite our current health initiatives to address overweight in ourselves and our children, we are getting heavier. So we must ask the question:  Are we treating the cause? Or are we causing what we are trying to treat? And are we tempting disorder in the process?

Pediatric and adult obesity3 rates are increasing and for adolescents eating disorders are on the rise as well. In fact, the median age of onset may be as low as 12-13 years.4  It’s easy to blame technology, safety, busy families and more food choices. Instead, we need to think about our reaction to weight and childhood obesity. In our fight against obesity, have we sent the wrong messages to children?

  • Emphasized weight rather than health?5,6
  • Fed our children for disease prevention instead of normal growth and development?
  • A study involving girls ages 3-6 reported that half worried about being fat and a third reported they would change their appearance. This is despite the fact that nearly all reported that they liked how they looked.7

Parenting with food: more doing; less talking

How do you talk to your kids about food, health, exercise, and weight? Prior to late adolescence it isn’t about talking at all, it’s about doing. Parenting includes many, many things, including parenting around food. Maintaining the Satter Division of Responsibility in Feeding (sDOR) demands commitment, consistency and trust. Stick with it and your child will grow up to feel good about food and eating, have the body s/he was meant to have, have a more stable adult body weight, eat a more varied diet, and experience improved health. The fruition of proper childhood feeding results in all of those things and it even has a name: Eating Competence, as in the Satter Eating Competence Model. How can you support eating competence in your child? Feed well and expose your child to movement in a manner that is enjoyable and pleasant.

Parent in the best way around food

  • Maintain a Division of Responsibility with Feeding. As far as meals and snacks are concerned: Parents are responsible for: what, when and where.
  • Children are responsible for: how much and whether.
  • Maintain structure and routine with meals and snacks. Set times and places to eat. Even on weekends. It means planning ahead for you, but it’s worth it. It means no food or beverages between meal and snack times (except water). Children are more curious and willing to try new foods when they come to the table hungry. Children do better regulating their intake when they know they will be fed, and are allowed to get enough to eat.  
  • Keep food neutral and avoid restraint. Children who do not get enough to eat, who do not get to eat the foods they like, or who are encouraged to follow food rules tend to overeat if given the opportunity, and may have higher body weight as a result.8 Restraint can look like: not having enough food, never offering desserts or high fat foods, or encouraging “eat this, before that” strategies. Restraint can also be about food insecurity: Not having enough money to buy food or meals’ being so erratic that children can’t count on being fed.    
  • Within the structure of sDOR, balance the offerings with foods they readily accept, foods that are new to them and, include “forbidden foods”. When parents provide in this way, without pressure, it complements a child’s natural curiosity as it relates to food.  As a result, children will get enough to eat, are better able to work at internal regulation, and will learn to eat the foods their parents eat. Children do better with taking care of themselves through eating that way.9

Parent in the best way around activity

  • Maintain a Division of Responsibility with activity.
  • Parents are responsible for: structure, safety and opportunities for movement
  • Children are responsible for: how much and whether.
  • Set limits on screen time but not reading, writing or other sedentary activities.
  • Tolerate a normal level of commotion in the home.

The take-home message

Provide, don’t deprive, and trust your child to grow and develop into the body they are meant to have. They will be healthy. 

References

  1. Wertheim EH, Paxton SJ, Blaney S. Body image in girls. In: Smolak L, Thompson JK, eds. Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment, 47-76. Second Edition: APA; 2009.
  2. Cash TF, Smolak L. Body Image, Second Edition: A Handbook of Science, Practice, and Prevention. 67-75. New York: Guilford; 2012.
  3. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311:806-814.
  4. Smink FR, van Hoeken D, Hoek HW. Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep. 2012;14:406-414.
  5. Gaesser GA, Angadi SS, Sawyer BJ. Exercise and diet, independent of weight loss, improve cardiometabolic risk profile in overweight and obese individuals. Phys Sportsmed. 2011;39:87-97.
  6. Loprinzi P, Smit E, Lee H, Crespo C, Andersen R, Blair SN. The “fit but fat” paradigm addressed using accelerometer-determined physical activity data. N Am J Med Sci. 2014;6:295-301.
  7. Hayes S, Tantleff-Dunn S. Am I too fat to be a princess? Examining the effects of popular children’s media on young girls’ body image. Br J Dev Psychol. 2010;28(Pt 2):413-426.
  8. Lumeng JC, Ozbeki TN, Appugliese DP, Kaciroti N, Corwyn RF, Bradley RH. Observed assertive and intrusive maternal feeding behaviors increase child adiposity. Am J Clin Nutr. 2012;95:640-647.
  9. Loth KA, MacLehose RF, Fulkerson JA, Crow S, Neumark-Sztainer D. Are food restriction and pressure-to-eat parenting practices associated with adolescent disordered eating behaviors? Int J Eat Disord. 2014;47:310-314.

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