Children and Adolescents with Eating Disorders and Body Image Concerns

LeafBy Natalie Gornstein, LICSW

How do I help my child feel better about his/her body?

Why isn’t she happy with the way she looks?

Why is he comparing his body to that of his friends?

These are all common questions that come up in my work with children and adolescents with eating disorders and body image concerns. Parents are often at a loss for what they can do to change their child’s perception of his or herself. This can be a challenging point in development as kids’ bodies change through the years.

Body image, or how you see yourself when you look in the mirror or picture yourself in your mind, develops at a very young age. It encompasses how we feel about our bodies in terms of weight, height and shape what we believe about our own appearance, and how we sense our body as we move.

According to National Eating Disorders Association, negative body image is characterized by a distorted perception of your shape, feeling ashamed, anxious and self conscious about your body, and feeling uncomfortable or awkward in your body.  It is also defined by a belief that only others are attractive and that your body size and shape are a sign of personal failure.

Positive body image is defined as a clear perception of your shape, or seeing your body parts as they really are. Someone with positive body image is able to celebrate and appreciate his/her natural body shape and understands that a person’s physical appearance says very little about one’s character and wellness as a person.  If you have positive body image, you feel proud of your body and refuse to spend an unreasonable amount of time worrying about food, weight and calories, and you are comfortable in your body.

People with negative body image have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self esteem and obsessions with weight loss. Although we may all feel uncomfortable or awkward in our bodies at times, the critical piece in developing positive body image is to recognize and respect our natural shape.

As parents, we have an incredible impact on our childrens’ lives and developing sense of self. Healthy eating and an active lifestyle help build self confidence and healthy attitudes toward food and activity. It’s important to examine your own beliefs and behavior related to body image and weight and consider how your children might interpret the messages they get from you. Body dissatisfaction is not a “normal” part of development and it’s important to not normalize dieting. Doing so is the beginning of struggling with food and the idea that if we control our bodies or food intake then everything else will be easier. Here are some guidelines to encourage your child to develop a healthy relationship with his or her body.

  • Be a positive role model. Children learn best through actions instead of words.  If you refrain from engaging in unhealthy eating and exercise patterns its less likely your child will engage in them as well
  • Make your home a safe place to communicate
  • Accept your child’s body size
  • Make clear rules in your home about “body teasing”
  • Promote diversity in size. Remind your child that people come in different shapes and sizes.  Not only one shape is acceptable.
  • Promote positive self esteem in your child. Tell your child that you love him/her on for who he/she is on the inside.
  • Value character over appearance.
  • Encourage assertiveness (not aggressiveness) in your child
  • Model healthy eating and exercise. Eat a variety of foods and exercise for fun, refrain from value judgements (labeling food as “good” or “bad”).
  • Talk to your child about what he/she sees in the media. The advertising images we see are usually altered us ing computer imaging to achieve “perfection.” Become a critical viewer of the media and encourage your child to do the same.
  • Talk to your child about how genetics  contribute to diversity in body types. Our genes can have a greater impact on our size and shape than eating and exercise habits.
  • Have family meals as often as possible. Meals can be simple; just having shared time around food is what is important.

Here are some things to avoid:

  • Don’t diet in your house. Dieting is not a normal part of life.
  • Avoid categorizing foods as “good” or “bad.” Your child will learn to equate what he or she eats with who s/he is morally.
  • Don’t use food as a punishment or reward and steer clear of withholding food because of behavior problems
  • Don’t comment on your child’s body weight or shape. Try to avoid giving the impression that one size or shape is more acceptable than others. Avoid comparing your child’s body to that of peers
  • Don’t comment on the weight or shape of others.
  • Avoid using meal times to discuss stressful topics.  Conversation during meals should be kept relaxing as much as possible.

While these tips can help prevent your child developing a negative body image, a some children and adolescents will develop a clinical or subclinical eating disorder. Moreover, an even larger percentage will struggle with body image or their relationship with food. If your child expresses feeling uncomfortable in his or her body, ask more about it. Don’t take it at face value because there are often other things that are troublesome. It’s important to open up a dialog about how he or she is feeling.

If your child is displaying or reporting significant anxiety and increased time worrying about food and body that is affecting his or her quality of life it may be time to seek professional help. If he or she over values weight and shape or struggles to see him or herself in positive ways, it may be helpful to seek consultation from an eating disorder or body image specialist.