Mom, Am I Fat?
By Abigail Natenshon, MA, LCSW, GCFP
Your child's room is strewn with clothing as she searches desperately for something that "looks decent" on her. As the piles become heaps, still nothing looks good enough. She peers into the mirror, and sees nothing but that her physical appearance does not measure up to the standards she has set for herself. Her eyes see "fat" everywhere she looks, her belly, her thighs, her face, her hips. She turns to you and the dreaded question emerges. "Mom, am I fat?" You look at your daughter in wonderment. To you, she is the picture of health, trim and fit. Now comes the challenge...how to respond.
If you point out how thin she is and question her judgment and/or sanity in asking such a question ( "Are you kidding/crazy? Of course you're not fat! You are just right!") she is liable to think that you are either biased in her favor, or just plain dishonest with her and not to be trusted. She may also assume that you just don't understand what looks good and how important it is to be thin, deciding to leave you out of the loop in the future, as you clearly can't be of help to her. If you respond, "Yes, you do look a little rounder around the middle," you can be assured she will plunge further into the depth of despair and anxiety, experiencing an ever increasing preoccupation with her body image distortions. It is no wonder that parents feel they are in a no-win situation with their pre-adolescent and adolescent daughters.
Parents who understand that such a preoccupation could possibly be the first and earliest warning sign of an eating disorder, see this question as a tip-off that their child may be struggling with a shaky sense of self esteem and self-image, a precarious sense of judgment and a faulty self-perception, and may be on the verge of descending the slippery slope that could lead to the onset of a clinical eating disorder. On the other hand, the question may simply be a benign request for a little reassurance. Whatever it means, it is the responsibility of the parent to investigate with open ears and an open mind, to tread softly by assuredly, prepared to nip potential problems in the bud.
What parents need to know
First, you might as well feel good about the fact that your child has chosen to confide in you, bringing you into her inner world by sharing her concerns along these lines. As a parent, it is up to you to decipher what, in fact, your child is really asking of you. On first "listen," the question sounds like an innocent request for a status report on her body size and appearance. Upon more careful (active) listening, parents can begin to discern and seek to reveal the layer upon layer of more significant meaning, concerns, and interests for that child. Whether this "cigar is just a cigar" or not, this child's question and dilemma must be approached as the tip of a proverbial iceberg. Chipping away at its possible significance for the child, the parent begins the critical discovery process.
Active listening is the empowered parent's most pivotal parenting tool. When used with skill, it provides the basis of the connection between parent and child that allows parents to remain parental while remaining loved, to teach important life lessons while imparting self-actualizing life values. Through active listening,
- A parent is able to hear what is unspoken, what lies beneath the surface, bypassing the obvious to reveal what is truly at the heart of the question.
- The parent hears the feelings underlying the content of the question posed.
- The child is invited to listen to herself, to begin the process of self-discovery.
- The child is offered the opportunity to find a meaningful solution to a problem revealed.
The nuts and bolts of active listening
The actively listening parent must hear and address the question that the child is really asking. This question has less to do with size or appearance, and more to do with the child's fears... about being fat, about dealing with her self-hate, about whether or not she may, in fact, be going a little crazy with her obsessive preoccupation with her body.
The following are some appropriate responses...probing, gentle, and caring responses... that facilitate and nurture a trusting parent/child connection and that speak so clearly to your child's real needs.
"Mom, am I fat?"
Active listening responses often take the form of questions.
- "I wonder what makes you ask such a question. Do you doubt your own capacity to tell?"
- "What are your own thoughts about this?"
- "Why this concern now? Has long have you been thinking about this?"
- "What might have led to it?"
- "Does your concern make you alter the way you eat?" ..Dress?"
- "Did you eat three meals today?" "If not, why not?"
- "Are you actively trying to lose weight now?"
- "If so, how have you decided to go about this?"
- "Are you aware that...
- Dieting is the worst way to lose weight?"
- When kids diet, they increase their odds of their becoming overweight adults?"
- The best way to manage weight if you feel you are overweight is to eat differently (more regularly, more nutritiously) not less."
- 20 percent of the weight girls gain in puberty is supposed to be gained in fat."
Eating disorders kill and maim. Eating disorder prevention saves lives and protects the child from unnecessary suffering. It starts with a parent's willingness to listen and the effective parent/child connection that comes of it. The nature of this connection will change through the years and through life experience to accommodate the growing child's changing needs and increasing autonomy.
Parent/child connections take diverse forms; listening to the feelings underlying the spoken word is only the beginning. Beyond that, parents in search of a healthy connection need to:
- Encourage discussion about feelings, which are guideposts in defining and resolving problems as they arise.
- Educate their child, dispelling myths and misconceptions about eating and nutrition, about eating disorders and the parent/child relationship.
- Role model a healthy relationship with food and exercise.
- Provide regular, nutritious meals for the entire family, which parents sit down to enjoy with everyone together. The dinner table provides a perfect context to know your child better, how she relates to food, and how she thinks and feels about herself and life.
- Build self-esteem in the child, along with teaching importance of making a meaningful contribution to the greater world, which lies beyond the child's own personal borders.
It is critical that parents appreciate the power of their input in their child's life, throughout the child's stages of development, from childhood through adolescence, young adulthood, and beyond.
Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 31years. She is the author of When Your Child Has An Eating Disorder, A Step-by-Step Workbook For Parents And Other Caregivers, Jossey-Bass, 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at www.empoweredparents.com and www.empoweredkidZ.com, www.treatingeatingdisorders.com.