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Before it's too late...
September 27, 2011
Children instinctively know how much to eat. However, many children’s eating patterns may derail over time. Given the right temperament, environment and genetics these patterns may escalate into eating disorders. The following are 3 common scenarios that are important to watch for.
The Picky Eater: Jacob is an 8 year boy whose mother describes him as picky since age 2, but over the past year, has become increasingly difficult to fee. Jacob is sensitive to texture and smells. He will eat kid foods such as fries, chicken nuggets and pizza but he won’t touch fruits, veggies, and most animal protein. In addition Jacob eats excruciatingly slow, taking 8-9 bites before finishing a chicken nugget. Dinner lasts 45 minutes and mom prompts him to finish. Jacob has always had a slight build but has fallen from the 5th percentile for weight to less than the 3rd percentile.
What to Do:
Family meals are a priority for picky eaters. Family meals foster warmth, security, love and offer opportunities to model healthy attitudes towards food. Keep the mood light and relaxed. Avoid nagging or using meal time to discuss subjects that may cause tension.
Serve new foods in a kid-friendly way. This means cook the broccoli with cheese sauce or serve carrots with ranch. Put butter on vegetables or peanut butter on apples. Sure, its added fat however your child will certainly have more success with tastier vegetables and with time, will begin to accept “naked” vegetables. Be patient with food acceptance. It takes at least 10 exposures to new foods to be accepted and a picky child will require more exposures. Even if the food is not accepted for months, continue to place a bite on the child’s plate. Resist encouraging your child to take a bite. Studies support that the more a child feels forced to eat the more likely food will become a control issue. Also be careful to not applaud your child for trying a new food. The less attention that a picky eater receives about eating the less likely the child will spiral into disordered eating.
So what if your child will not eat the main course. Should you make him a peanut butter sandwich or bowl of cereal. NO! Unless you want to be a short order cook until your child moves out of the house refrain from offering alternatives. Instead offer milk and have sides that your child will eat, even if its fruit or bread.
The Vegetarian: Sarah is 13 and wanting to be vegetarian after watching an animal rights documentary. She has begun avoiding red meat but will still eat grilled chicken. She is continuing to eat dairy products, eggs and fish.
What to Do:
Imagine Sarah’s mom telling Sarah “you can’t eliminate meat, how would you get protein? You don’t even like beans or nuts and those are the main protein sources that vegetarians eat. I do not support you eliminating meat!” How do you think Sarah would react? Most likely Sarah will become even more convinced to be vegetarian. Now picture Sarah’s mom saying “ok, you can give it a try if you like.” If the elimination is not made into an ordeal and Sarah’s mom continues to cook foods she knows Sarah will eat (ie, grilled chicken) than the novelty of being vegetarian may disappear. Only 2% of teens are vegetarian so chances are good that this phase will be short. Equally important is to monitor that your child does not begin to restrict other foods, for example progressing to vegan, gluten free or eliminating starchy carbohydrates.
The Dieter: Alley is a 15 year old teen who wants to lose a few pounds because she feels her stomach, legs and face are big. She weighs herself daily. She uses an app to monitor her food intake. She avoids all starchy carbohydrates and desserts.
What to Do:
Make time to eat with your dieting teen. Teens who eat alone are more likely to under or overeat. Dieting teens frequently say they’ve eaten when they haven’t. Even if the whole family cannot eat together try to ensure that the dieting teen eats with at least one parent. At a minimum sit with your dieting daughter while she eats.
Avoid power struggles. If you demand that your child eat, she may make up for later by restricting, exercising, or self inducing vomiting.
Limit special foods that she may request. If you buy 35 calorie bread, pounds of fruits and veggies, spray butter, nonfat everything, your child may have a difficult time reintroducing regular foods. Make it a family rule for everyone to eat the same dinner. Once your child starts eating her own diet foods it is very difficult to reintroduce mom’s spaghetti and meat sauce.
Adolescent girls who diet have a 20% chance of developing an eating disorder within one year. Signs that signal that your child may require intervention include an increasingly restrictive intake, rigid and obsessive thoughts about food and a significant weight loss. Enlist the help of a treatment team before its too late.
How Much Should I Weigh?
July 10, 2010
One of the most frequent questions I am asked is “how much should I weigh?” There is no one formula, graph or chart to answer this question. Instead a number of factors are used to determine a healthy weight range for every individual. Listed below are some of these factors:
- No symptoms of malnutrition or being underweight. Some of the main symptoms of being underweight include fatigue, inability to concentrate, insomnia, constipation, cold intolerance and irritability. Consequences that should be addressed by a physician include cessation of menstruation, anemia, osteopenia or osteoporosis, low pulse, low blood pressure and heart problems.
- Normal body composition. Bodies require a minimum of body fat in order to maintain life and reproduction. Research shows that a minimum of 16% body fat is necessary for menarche. Most authorities agree that lean women have body fat percentages of 18 to 24% and average weight women have 25 to 31% body fat. Lean men have body fat percentages of 6 to 17% and average weight men have 18 to 24% body fat. Body composition is a vital measurement for determining healthy weight. This is because a person can weigh what is considered a healthy weight but have too little body fat to begin menstruation and protect bone health.
- Body Mass Index (BMI). BMI is a measurement of weight in relation to height. A BMI of less than 18.5 is underweight and indicative of under nutrition. A BMI between 19 to 24 is considered healthy. BMI, however, does not take into account muscle mass and since muscles are heavier than fat, BMI is not an accurate indicator of healthfulness for athletes and fit individuals.
- Maintained with “normal” eating. A healthy weight is a weight that a person can maintain with normal eating. In brief normal eating is having regular meals and snacks, eating adequate amounts of food and having a wide variety of foods. A normal eater trusts their internal hunger and fullness signals and is able to be flexible with variety and scheduling. A normal eater has a peaceful relationship with food.
- Consideration of weight history and ethnicity Just as skin color, hair color and height vary among ethnicity weight also varies. For example American Indians tend to have bigger frames than Asians Thus a lean American Indian would probably weigh more than a lean Asian person. Additionally if a person has struggled with obesity in the past, she is more likely to have a higher healthy weight range than someone who has never gained excessive weight.
- Maintained without excessive or compulsive exercise. Sedentary people tend to maintain higher than recommended body weights and people who engage in excessive or compulsive exercise typically maintain artificially low body weights.
- Increases with age. As height increases so does weight. Each inch in height is equivalent to 3-6 pounds of increased bone mass, blood volume, and organs. Even after peak height is reached bodies continue to physically mature thus a person may continue to gain and /or redistribute weight. Ideally, from at least the mid 20’s to mid 40’s weight is maintained within 5 to10 pounds. Perimenopause and menopause is also a time where weight gain and redistribution may occur due to lower estrogen levels. The average weight gain during menopause is 5 to 10 pounds.
- Weight range rather than a single number. Weight fluctuates within the day and from day to day due to fluid fluctuation, hormones, elimination, sodium intake and a number of other factors. At least 3 pounds during the day and even more from day to day can be attributed to normal fluctuation which is why a range instead of a single number, is imperative.
In summary just as no two dogs, even within the same breed, are likely to weigh and look the same, no two people are likely to weigh and look alike. We each have our own unique features which are mostly determined by factors that we cannot control. People become dissatisfied and unhappy trying to achieve and maintain a weight that is unnatural for them.
Rate Your Eating Style
June 15, 2010
Do you eat with enjoyment, find satisfaction with food and radiate positive vibes about your body? Or are you tortured with food, endlessly trying to limit your intake, only to be seduced by a Sprinkles cupcake? Take this quiz to find out how healthy your relationship with food and body image is.
When you look in the mirror do you:
A. Examine closely for new bulges, dimples or folds
B. Promise to limit desserts and wine
C. Think, “Hey! I’m looking pretty good!”
Someone compliments your appearance. You reply:
A. Thanks, but I’d look better if I lost 10 pounds
B. So, do you! Have you lost weight?
C. Thanks!
Your pantry consists of
A. Sandwich thins, fat free dressing, fat free yogurt and 100 calorie packs
B. Mostly fruits, vegetables and lean protein
C. A variety of all foods, including treats
Your 20 year high school reunion is approaching. Do you:
A. Promise to go to the 30th reunion when you lose weight
B. Choose the healthiest option and increase exercising
C. Pull out your yearbook to reacquaint yourself with names and faces
In the bookstore you gravitate to:
A. The latest book on weight loss
B. Cooking Light
C. Your favorite fiction
How You Score
For every “a” answer, give yourself 1 point. For every “b” answer, 2 points. For every “c” answer, 3 points. Add up your points and match your total score to one of the three following categories.
1-6 points:
You may be struggling with low body image. This is characterized by persistent negative thoughts about your body and weight. Regardless of your weight, whether low, normal or high, you are never satisfied and always seeking to improve. There’s always some area that needs toning or firming. Your eating habits tend to be all or none. Either you’re eating low calorie, low fat foods or gulping chips and queso, enchiladas, rice and beans. Mondays begin with new vows to diet.
This pattern of dieting and overeating is detrimental not only to your metabolism but just as importantly, your sense of well being. If you’re not eating “good” you tell yourself you’re a loser and lack will power. If you’re eating “good” you’re on top of the world. In truth being “good” or “bad” has nothing to do with food intake! Additionally categorizing foods only further perpetuates the cycle of dieting and overeating.
Learning to eat a balance of all foods without judgment and guilt is the first step to breaking this pattern. Once “bad” foods are incorporated into your diet, overeating tends to subside. As eating becomes normalized, weight loss may actually occur.
7-10 points:
You value health and it shows! You eat a balance of foods and practice moderation. Be careful, however, to not label foods. An occasional burger or cookie helps to prevents deprivation which prevents overeating. Nothing is fattening or unhealthy unless eaten in excess consistently! Also be careful when complimenting someone about weight loss. If that person regains, she may feel awkward and self conscious when she sees you again. Weight comments, even weight loss, places emphasis on appearance and isn’t a person more than their appearance?
11-15 points:
You have a positive body image and a peaceful relationship with food. You recognize your body is your vehicle for life and appreciate all that it does for you. You’re able to accept the natural changes your body undergoes as it ages. Your food intake consists of a variety of foods, all of which you enjoy without guilt. You listen to your body signals about when to eat and when to stop.
Eating out is fun because you order what you like and are able to stop eating when comfortably full. You feel good about yourself and for who you are. Congratulations on modeling normal eating!
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Raising Your Child’s Body Esteem
April 11, 2010
“I’m thinking about getting a boob job for graduation,” announced 17 year old Lindsay* in our session last month.
Yes, you heard right. Lindsay is only 17 and graduating from high school next month. She is smart, outgoing and beautiful , both inside and out. She however, sees flaws when she looks in the mirror. She sees a crooked nose, a pudgy stomach, bulky thighs, and a flat chest. Lindsay is recovering from an eating disorder. She is weight restored and able to nourish her body adequately yet her negative view of herself and her body persists.
Unfortunately, body dissatisfaction is common and not just with people with eating disorders. Studies have found that 40% of 9 and 10 year old girls have tried to lose weight and 53% of 13 year olds are unhappy with their bodies. This increases to 78% by the time girls reach 17. This is not surprising considering our children are inundated with constant media messages about beauty and perfection.
How can you help your child love her body? Here are five points to remember.
1. Avoid criticizing your own body. If you talk negatively about your body, whether complaining about a flabby tummy or crows feet, you are sending a message that your body is not good enough. Model a healthy, positive body image even if it doesn’t come naturally. Say words like “my body feels strong today because I was able to work, garden and be mom today.” Focus on what your body can do rather than appearance and your child will also.
2. Avoid talking about others people’s bodies. Many times conversations about other people’s bodies and weights can cause everyone within listening distance to question their body. Imagine a 12 year old overhearing “Wow, have you seen Sarah? She’s gained so much weight!” Likewise, imagine a 12 year old overhearing “Ann has lost so much weight, she looks fabulous!” Both of these comments, even the compliment, send messages that gaining weight is negative, losing is positive, and bodies need to look a certain way. Become adept at steering conversation away from appearance and instead on attributes.
3. Remember that a girl’s body continues to change until they reach early 20’s. During this time girls will experience linear growth and a corresponding weight gain. Hormones cause necessary fat deposition in the pelvis, breasts, upper back and arms and lean body mass decreases from 80% of body weight in early puberty to 75% at maturity. It is not abnormal for a girl to gain 40 pounds over this time.
Because everyone experiences growth at varying rates, your 12 year old may be in class with girls who weigh 70 pounds and girls who weigh 115 pounds. Assure her that everyone eventually catches up and by the time her peers are high school seniors there will be less discrepancy in body weight.
4. Watch what you watch. Many parents screen media for sex and violence but neglect screening for “eating disorder porn.” Eating disorder porn are images that depict unrealistic thinness and body shapes. Obviously these images are ubiquitous! Limit buying magazines and watching TV shows to those who depict realistic bodies. Educate your child about the numerous techniques used to retouch photos. Encourage your child to think critically about the messages unrealistic body shapes and sizes send.
5. Love your child for who she is rather than what she looks like. Be sure to tell her what you personality characteristics you appreciate about her. For example say “I admire how you handled that sticky situation” or “You have been a good friend to Julie.” These comments help to develop her character and deemphasize appearance.
Are You Over Exercising?
1. Do you experience stress and anxiety if you miss working out?
2. Do you adjust your exercise according to how much you ate?
3. Are you afraid of gaining weight if you do not exercise?
4. Do you think about burning calories as you exercise?
5. Do you cancel plans with friends so you can exercise?
6. Do you exercise when you are sick, hurt, or too tired?
7. Do you have trouble sitting or relaxing because you’re not burning calories?
8. Do you have difficulty taking rest and recovery days?
9. Are you preoccupied with being toned and/or having a low body fat?
10. Do you experience self-disgust with your health habits?
11. Do you feel virtuous when restricting or exercising?
12. Do others tell you that you exercise too much?
If you answered half of these questions with a yes, you are exercising too much
or you are feel driven to exercise beyond what is healthy.
Signs & Symptoms of Excessive Exercise
• Muscle Soreness Or Tenderness
• Feeling Unmotivated & Lacking Energy
• Inability To Complete Workouts
• Decrease In Performance
• Depression
• Irritability
• Exhaustion
• Prolonged Recovery
• Exclusion Of Other Activities
Copyright © 2010 Pam Chin-Lai. All rights reserved. Material from this web site may not be reproduced, in whole or in part, in any form, without written permission. For reprint information, please contact Pam Chin-Lai. This website created by chinlai-hom.com.
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