Site Contents
/ 
Excerpts
Children
and Teens Afraid to Eat
Helping
Youth in Today's Weight-Obsessed World
Part I: Children
and teens in weight crisis
Part II: Helping
youth in a weight-obsessed world
Today's crisis consists of six major eating and weight problems:
1. Dysfunctional eating. Disturbed, chaotic, disordered eating has become the norm for kids. They are dieting, fasting, bingeing, skipping meals, undereating and overeating.
2. Undernourishment of teenage girls. Teen girls have the poorest nutrition of any group in America. Yet their widespread undernourishment and malnourishment go largely unnoticed, ignored by the policy makers who should care the most.
3. Hazardous weight loss. The methods kids use to lose weight can be very dangerous ó vomiting, smoking, fasting, and taking laxatives, diuretics, diet pills. They can have lasting harmful effects, and even kill.
4. Eating disorders. Extremely difficult to treat, eating disorders devastate families and claim many lives, a significant number from suicide. But their prevention and treatment is largely ignored in U.S. health policy. "The public is silent when young women die," charges Naomi Wolf, author of The Beauty Myth.
5. Size prejudice. Large kids are easy targets for cruel and isolating taunts from their peers and others. Yet the harassment and stigma of size prejudice hurts youth of all sizes ó in today's milieu no one is thin enough or perfectly shaped enough to feel safe. And some, especially boys, are stigmatized because of small stature or thinness.
6. Overweight. More kids are overweight today than ever before, yet we seemingly have no means to help them. Prevention efforts other than scare tactics have not moved forward, perhaps because most people still believe weight loss is fairly easy and safe. Research proves otherwise.
These six problems are interrelated and are intensifying. What affects one, affects others. For 16 years, I've been editing Healthy Weight Journal reviewing the latest worldwide research on these issues, and have seen all six problems growing worse year by year, yet little is being done to solve these problems in an integrated way.
Appearance and, above all, thinness are the criteria by which girls are being judged. Magazines for teenage girls give training in lookism where the emphasis is on makeup, fashion, weight and how to attract boys, with almost no space given to sports, hobbies, careers or healthy body image attitudes. Young readers are being sold to advertisers through articles and editorial copy linked to the ads. Boys, too, are being taught body dissatisfaction through advertising and the many new "muscle" magazines. . . .
The increasing pressures to be thin are vividly illustrated by a survey of Miss America winners from 1922 to 1999. These cultural icons dropped weight steadily from the 1920s, when it was in the range considered normal -- to as low as a body mass index of 16.9. Nearly all winners since the mid 1960s have had a body mass index below 18.5, defined as undernourished by the World Health Organization. Worse, it is likely that every local and state pageant up through the national contest promotes this same ideal of female gauntness and hunger.
You may recognize the eating patterns. The fourth grader who eats only a small amount of each food on her plate, never feeling really satisfied, because she's afraid of getting fat. The 12-year-old who comes home to an empty house and eats continuously on snack foods, crackers, cookies and chips. The teenager who skips breakfast and lunch, grabs a candy bar and Diet Coke after school, finds a way to skip the evening meal with her family ó and then goes on an eating binge in the evening. The wrestler who fasts and spits for two days before his match to make weight, then binges a day or two before restricting again.
Dysfunctional eating describes these types of disordered and disturbed eating behaviors which disrupt normal life, sometimes up to the level of clinical eating disorders. Dysfunctional eating hasn't been investigated in much detail. Today there's such concern, almost an obsession, with what to eat, that how and when to eat are being largely ignored. Yet, when kids eat in normal ways, good nutrition is likely to take care of itself.
The appalling truth is that over half of teenage girls do not eat enough for health, energy and strength. They do not eat enough to feel or look their best. But it is the lower 25 percent of girls ó the hungry one-fourth ó who are at most risk. . . .
Looking at iron intake, girls at the 25th percentile get less than half the iron they need, and at the 10th only one-third . . . In London, investigators recently found that one in four girls age 11 to 18 may be damaging their intelligence by dieting and depriving themselves of iron. "We were surprised that a very small drop in iron levels caused a fall in IQ," said Michael Nelson, PhD, study author and senior lecturer in nutrition at King's College, London. "We conclude that poor iron status is common among British adolescent girls and that diet and iron status play an important role in determining IQ.". . . Iron is not easily absorbed by the body. In fact, experts say 80 to 98 percent of iron may be wasted unless some heme iron from animal products is consumed. . . .
The calcium situation is even worse. Girls at the 25th percentile, are getting only about one-third of what they need . . .
The effects can be physical, mental, emotional, social and spiritual. And they can be long- lasting.
Worse, many of today's quick fixes are outright dangerous, causing serious injury and sometimes death. Yet kids and adults are trying them all, often with a terrible sense of desperation that if they only try hard enough, they'll hit on the miracle cure.
But is the cure for obesity worse than the condition? This is the question asked by the distinguished editors of the New England Journal of Medicine in their 1998 New Year's Day editorial. The editorial said flatly that weight loss is not effective, that it involves serious health risks, and that it is untrue that the risks of obesity are so high this kind of treatment is justified. It was a breath of fresh air, indeed.
The answer is, yes, in many cases the cure is worse.
Americans spend $30 to $50 billion annually on weight loss schemes. And this figure doesn't even include smoking for weight control, that unacknowledged and highly lucrative windfall for tobacco companies.
If this industry made cars, no one would buy them, and if they did, consumer groups would force a recall. If the diet industry promised any other health service, it would be required to prove safety and effectiveness. It would be held accountable for the harm it does. Instead, the weight loss industry's unproven experiments are prescribed to millions of unsuspecting consumers ó as were both the disastrous very low calorie diets and the fen-phen and dexfen diet pills in the last decade.
 |
|
While eating disorders may carry a certain aura of glamour for some, highlighted by the veil of "heroin chic," in truth they offer not sophistication, but the deadening opposite. They expose the raw state of advanced starvation, a human being at her lowest survival level, losing even her sense of humanity, compassion and love. How can this be called attractive or desirable?
. . . "I have many regrets. I lost a number of friends, hurt a lot of people I care about," laments one young woman.
Echoes from his youth, writes Dan D, are the shouts: "I don't want you on my team. You're too fat to run." "Look at the fat tub." "Your belly looks like a watermelon." Today he says, "My stomach still knots when I remember . . . I'll carry the scars to my grave ó [but] today's kids have it worse."
For some children, fat oppression, teasing and ridicule comes from inside the family circle, so there is no escape from tormentors. . . . Pat, 34, describes her father's disdain of her size in Real Women Don't Diet. "My experience of prejudice for being fat started at a very young age. The sadness and teasing I went through then was not from individuals outside my family; it was from within my family, by the people who are supposed to most love you."
Poor family communication can also contribute to overweight. If children are isolated in a disinterested or disengaged family, they may be at a higher risk of overweight, reports Laurel Mellin, MA, RD, San Francisco. Her study of 254 obese adolescents found that four factors accounted for most of the weight differences: family cohesion, adolescent communication, age of obesity onset and the mother's weight . . .
Lowering fat intake by itself has not been a successful weight loss method. For instance, women lost weight the first year when reducing their fat intake from 38 percent to an extremely low 20 percent in the Women's Health Trial, a treatment study of women with breast cancer. However, by the end of the second year, they had regained it all and weighed about the same as the control group, even though they had carefully followed the low-fat diet.
What's missing? All of the other four food groups ó fruits, vegetables, milk and meat. Teens are coming up short in four out of five. . . .
Young children are the most active and physically fit of all Americans, averaging one to two hours of moderate or vigorous physical activity each day. But they're less active than their parents were as children ó and are developing habits that could turn them into inactive, unhealthy, overweight adults. And the less active they are, even at age 3 or 4, the less active they will be later on. Most kids become less active each year . . .
At the other extreme from sedentary living are young people who exercise obsessively, and develop an activity disorder that takes over their lives.
Part II: Helping youth in a weight-obsessed
world
Health at Any Size affirms that beauty, health and strength come in all sizes, that good health is not defined by body weight, but by a state of physical, mental, and social well-being, by wellness and wholeness. It recognizes that people are healthiest at the weight that results from a healthy lifestyle . . .
This new approach asks: How can we gradually shift to healthier habits that will last a lifetime? How can we prevent the onset of eating and weight problems?
Following these three principles will help us make this shift:
1. Eat well. Think of food as a friend ó celebrate, enjoy, taste, savor . . .
2. Live actively. Help children celebrate activity as a natural and joyful part of their lives. . . .
3. Feel good about yourself and others. Celebrate and enjoy every child's special traits and talents . . .
Instead of struggling against a child's natural weight, parents and health professionals need to recognize and work with it.
| $19.95, softcover |
$27.95, hardcover |
It's important that families talk to each other ó the small talk, the praise and reassurances . . . Talking about feelings is not always easy, but it helps if moms and dads will ask, "How do you feel about that?" and then listen, without offering advice. Helpful parents will listen quietly when kids want to talk, giving their undivided attention. Acknowledge their feelings in a noncommittal way, "Oh . . . Hmmm . . . I see . . ." Give the feeling a name, "That sounds frustrating." Encourage and trust the child to explore solutions, without taking over.
. . . Restoring normal eating is a priority for those who have restricted their eating, or who habitually overeat. Unfortunately, today many parents are so confused and fearful of their own eating, weight and health, that their fears are multiplied in their children. They need to stop dieting, stop talking about hips and stomachs and thighs, and realize that their own attitudes and behaviors may contribute to their children's eating and weight problems. Giving oneself a year to normalize eating will make a great difference . . .
Satter is adamant about family meals. "Meals are as essential for nurturing as they are for nutrition . . . Without meals, a home is just a place to stay." . . . It is when parents don't live up to their feeding responsibilities or intrude on the child's prerogatives that feeding difficulties and disturbances of food regulation occur. Parents may fail to get a meal on the table, then try to control what and how much their child eats . . .
The large child needs lots of love and attention, as do all children, and to be reassured of parental love regardless of weight. Diets and weight loss programs are not an option, since they disrupt normal eating, will likely fail, and may set up a lifelong pattern of excessive weight gain following weight loss.
Many schools are well on their way to shifting physical education emphasis toward keeping all youngsters active in ways that last a lifetime. These schools focus on getting all kids involved, less on winning games, grooming star athletes, and showcasing spectator sports. They don't excuse youngsters with special needs from PE, but broaden programs to include them. . . .
Schools reflect society's obsession with thinness and scorn for large people. The pressure, the harassment is all there ó between students, between teachers, between students and teachers, in the classrooms and in the halls. . . .
There is a great need to support teen girls by increasing social support and mentoring, reducing environmental stressors like sexual harassment and teasing, transforming girls' lives by reducing the importance of appearance, and changing institutions such as the mass media that disempower them.
Preventive programs are most promising when they have first assessed the need and timing for prevention, then deliver the program about one year before the age when the behavior starts. . . . Levine and Piran advocate prevention programs that include these components:
l Media literacy and ways of analyzing the culture
l Student discussion of the impact of culture
l Nutrition education that promotes healthy eating and challenges dieting
l Techniques for developing personal competencies
So how do we create an atmosphere that makes healthy choices for youngsters easy and fun, and show them it's the natural way to live? It involves families, teachers, schools, health professionals and communities.
"Feeling good about yourself starts by accepting who you are and how you look," the Canadian Vitality program reminds us. "Think positive thoughts. Laugh a lot. Spend some time with people who have a positive attitude ó the type who look at the cup as being half full, not half empty. Positive vibes are contagious. Enjoy eating well and being active. Feel good about yourself. Have fun with family and friends, and you'll feel on top of the world!"
Letters, phone calls, faxes, email and Internet campaigns are effective in combating these destructive images. . . . On a more impulsive note, vigilantes are striking at offensive displays on billboards and buses by scrawling graffiti over thin women's bodies. "I'm So Hungry," lamented the caption on one gaunt model. "Please Give Me a Cheeseburger," another pleaded. . . .
Official recognition of eating disorders is, I believe, the key to bringing about needed change in federal policy. In the U.S. we have about 16 million girls between the ages of 13 and 20, according to the last census. If 10 percent of these girls have clinical eating disorders, and one-fourth are severely undernourished, what are the numbers here? Are they enough to gain a politician's attention?
When eating disorders and related problems get the attention they need, policy makers will be forced to change their approach to obesity, so as not to exacerbate eating problems. A health-centered approach is the most logical when one looks at the big picture.
The time has come to move forward. . . . If we work together, it will happen.
Encouraging health at any size challenges us to make changes in these five areas: attitude, lifestyle, prevention, health care and knowledge.
APPENDIX INCLUDES:
Body mass index chart
Median daily intake
Eating disorders test
Vegetarian self-test
How to help a friend with eating issues
Letter of protest to Red Robin
A doctor's weight loss education
Teens & Diets: No Weigh
Child-centered resources (7 pages)
References
Index
Biography
A personal note
For reviews and commentary, click here
For information on FREE Health at Any Size magnet, click
here
320 pages
6 x 9
Softcover, $17.95, ISBN: 0-918532-52-3
Hardcover, $24.95, ISBN: 0-918532-53-1
