From Obesity to Anorexia
Recapturing the lost art of Healthy Eating offers
Simple Solutions to Complex Questions

By Abigail Natenshon, MA, LCSW, GCFP

At the recent conference of the International Congress on Obesity, childhood obesity was described as being "as big a threat as global warming and bird flu." At the same time, with girls as young as age five becoming increasingly sensitive about their weight and body image, the average age of onset of anorexia has dropped precipitously from 13 to nine. In a recent survey, young girls indicated that they would rather have cancer, lose both parents, or live through a nuclear holocaust than be fat. The fact is that children who diet and restrict food are as much at risk, medically and psychologically, as children who overeat and become obese; both conditions foster anxiety, depression, poor self-esteem, body image concerns and in some instances, eating disorders. Overeating and under eating, though they may appear to be polarities, are in fact, flip sides of the same coin, opposite ends of the same continuum; the common thread they share is the lost art of healthy eating.

At any age, dieting as a weight management technique is draconian. It is an approach to food management and self management that indicates a basic misunderstanding about how the body works and what it needs, about how food works and what it does. By feeling compelled to rely on external controls rather than on internal ones, dieting children lose a sense of centeredness, trust, safety and control within themselves. Dieting numbs hunger and satiety cues, damages the functioning of the metabolism and so sabotages the quality of one's relationship with food that dieting children today tend to become tomorrow's overweight adults. Any behavioral extreme is unhealthy; self-starvation ultimately leads to gorging, the benign diet can ultimately lead to anorexia or bulimia in the genetically susceptible child. A child's fear of eating a single cookie is as dangerous a sign of unhealthy eating as binging on an entire bag. By the time girls have reached the first grade, 50 percent have been on diets; by the eighth grade, 80 percent have dieted. On any given day, 45 percent of women and 25 percent of men are on diets. Dieting parents run the risk of instilling the belief in their child that food is fattening, food is "the enemy." Parents have their jobs cut out for them.

Seven tips for raising healthy eaters:

• Parents must first know themselves and be certain that the lessons they teach their children are what they intend. Parents need to model healthy eating and exercise in their own home.
• Parents need to learn what truly healthy eating is; healthy eating includes three meals a day consisting of all the food groups…healthy meals are varied, balanced, and most importantly, eaten fearlessly. There are no bad foods. Healthy eating is the ability to eat everything, as long as it is in moderation.
• As teachers, parents need to refute commonly held myths such as… food is fattening, nobody eats breakfast; fat-free eating is healthy eating; it's okay to skip meals when not hungry; a Power Bar and a Diet Coke is lunch.
• Parents need to cook and serve meals, feeding their family, nutritionally and emotionally. Family meals provide the perfect opportunity to emotionally connect to and converse with loved ones at the end of the day, while providing parents a bird eye view of their child's eating habits and concerns.
• Parents need to listen actively to their child in such a way that the child becomes capable of listening to herself. "Mom, am I fat?" demands an intelligent and purposeful response. A problem cannot be resolved unless it is recognized and defined.
• If your child is overweight, help her learn to eat differently, not less, and to engage in activities that will get her blood flowing.
• Never lose sight of the fact that body shape and size are partially genetically determined, the result of nature as well as nurture. The child of two obese parents stands an 80 percent chance of being obese; the child of one obese parent holds a 40% chance, and the child with no obesity in his family has a 15 percent chance of becoming obese. Eating disorders too are genetically predetermined, which accounts for the fact that only one sibling in a family may develop a disorder.

Enlightened parents who become empowered teachers, role models and communicators have the potential to virtually immunize their children from the ravages of disordered eating and eating disorders. Their influence supersedes the pernicious effects of the media and peer pressure. The healthfully eating child is a child who is self-aware, self-responsive, self-determining and self-regulatory. The child who eats well knows how to nurture and care for herself… in life spheres that extend far beyond eating and weight management. How we eat is how we live.

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.