Fostering Healthy Body Image And Weight In Your Pre-Teen Or Teen

Contributed Article by Dr. Wendy Oliver-Pyatt – Founder, Oliver-Pyatt Centers

Puberty is a tumultuous time in a child’s life: the first giant step into the unknown world of adulthood, with its excitement and fears. And no area of puberty and adolescence is more fraught with both promise and worry than a child’s changing body image.

Suddenly, after growing slowly and steadily for years, a child approaching puberty rapidly begins to shoot up and round out. In addition, sexual characteristics make their appearance, as hormones trigger breast development, pubic hair growth, and a host of other changes including that hallmark of the teenage years: radical mood swings.

To help your teenager through this exhilarating but also frightening time, it’s important to begin by understanding normal pubertal changes.

As children’s bodies undergo these changes, they also develop a new image of their own sexuality and attractiveness. In addition, as they add weight and round out, their casual relationship with food and eating becomes more complex.

Children who navigate these changes successfully can mature into confident, healthy individuals who value their own bodies and are in control of their eating. Those who fall prey to societal pressures or destructive dieting during their teen years, however, are targets for eating disorders or lifelong obesity. That’s why parents need play an active role in understanding their children’s changing bodies and feelings during puberty and adolescence, and promoting a positive body image and a healthy relationship with food and eating.

Why Puberty Changes Can Trigger Body Issues

The onset of normal puberty changes often leads to insecurity and negative body image in formerly confident, self-assured children. Consider these three typical examples:

Fourteen-year-old Katie weighed 110 a year earlier before her periods started, but quickly shot up to 145. She became terrified about getting fat and weighed herself every day, because her P.E. teacher said she was getting “a little too hefty” for the gymnastics activities she loved.

Latisha, a 9-year-old, was a happy child who loved life and made friends easily. She was sturdy and athletic like her dad, and already nearly as tall as her mom. When she started at a new school in the fall, the other kids started calling her “Jumbo” and “Whale.” She began to feel insecure, and when she came home from school she would ask her mom worriedly, “Why am I so big?”

Thirteen-year-old Miguel was a whiz at computers and a genius at video games. But the boys at his school didn’t care about his brain; all they noticed was that he was 15 pounds heavier than most of them. At lunch, they called him the Pillsbury Dough boy, and poked him in the belly. The girls laughed, and Miguel wanted to crawl in a hole and die.

Just like their children, parents too may react to normal pubertal changes with concern, thus “pathologizing” these changes. For example, the parents of the children described above reacted in the typical way: by putting them on diets. All three sets of parents followed diet plans recommended by their children’s doctors. Latisha’s mother also hired a personal trainer and purchased low-calorie frozen dinners for her, and Miguel’s mom paid him $5 for each pound he lost. Katie’s stepmom spent hours in the kitchen trying to create low-fat, low-calorie versions of Katie’s favorite foods.

One year later, Katie was in the early stages of bulimia. Latisha was self-conscious and was starting to sneak food into her room, and Miguel continued to gain weight with each passing month and ate compulsively while playing video games.

What happened to these children? The answer to this question involves two modern-day culprits: fat phobia, and the harmful dieting that it generates. Understanding the toxic effects of both fat phobia and dieting can help you give your child the tools she needs to traverse normal development safely while maintaining a healthy self-esteem and relationship with her body.

The Toxic Effects of “Fat Phobia” and Dieting on Normal Human Development

Spend an afternoon watching your child’s favorite shows, or looking through fashion magazines for teens. Do you see anyone who looks like your child? Probably not, because the “ideal body” of today’s TV star or fashion model is generally a product of dangerous starvation diets and plastic surgery.

Statistically, only 3 in every 100 women has a fashion-model figure — meaning that 97 in 100 girls think their bodies are “abnormal” compared to the artificial ideal promoted by the media. This dissatisfaction rises as children enter their teen years and become more interested in looks and aware of their own appearance.

In other cultures, a child’s first steps into manhood or womanhood are celebrated. For instance, women in some African tribes receive special tattoos when they reach puberty and begin developing womanly curves, and Judaism honors both boys and girls who reach the age of 14 with a special ceremony. But for most American girls (and a growing number of boys), there is no celebration or ceremony. Instead, there’s a growing realization that their bodies are growing thicker, plumper or curvier in a culture that despises a healthy body as “fat,” “weak,” and “gross.”

As a result, more than half of 13-year-old girls, and more than three-quarters of 17-year old girls, are unhappy with their bodies. By the time they hit college, nearly all will be dieting and more than 10 percent will have life-threatening eating disorders. Boys, too, are now becoming victims of the unrealistic images they see in the media. As a result, eating disorders now affect around 3 percent of boys, and at least one-third of male teens engage in extreme dieting or binge eating.

Ironically, the media’s promotion of dangerous thinness as an ideal leads millions of children to begin dangerous dieting when they aren’t actually overweight — an ordeal they frequently undertake with the blessing of parents and doctors who focus on weight tables instead of factoring in children’s genes and development. For instance, consider the three children I described at the beginning of this article:

The first girl, Katie, was actually at an appropriate and healthy weight for her height and age. She just “felt” big because she wasn’t as slim as a fashion model, and because she was being pressured by a coach to maintain an unnaturally child-like figure. By accepting the idea that her weight was a problem, and aiding her efforts to go below her natural weight, her parents played a strong role in pushing her into an eating disorder.

The second child, Latisha, inherited her father’s genes, and is biologically designed to be taller and somewhat larger than her more slender peers and her mother. Moreover, her body was preparing to reach puberty at 10 years of age, which is a common phenomenon for African American girls (who often begin menstruating a year or so earlier than other girls). But because she was bigger than her mother, both her parents and her doctor bought into the idea that she was “fat.” She also started to feel ashamed about her size — and when her parents fostered her anxiety about her body by supporting her dieting, it reinforced her sense of shame about her body and who she is.

As for Miguel, he was initially only a few pounds overweight — most likely the result of his transition from childhood to adolescence, as well as his lack of physical activity. His parents’ decision to put him on a diet and pay him to lose weight backfired by driving him to “retaliatory grazing.”

If dieting actually worked, or at least did no harm, then it wouldn’t really matter if these children had spent a few weeks counting calories or carbs — even though they didn’t need to. But in reality, a child’s first diet is often the initial step toward a dangerous eating disorder or obesity. In fact, parents need to be aware that dieting often creates lifetime food, body image, and weight problems.

Here’s how the vicious cycle works. Fewer than 5 percent of dieters successfully keep off the pounds they lose, and more than one-third of them gain back more weight than they lost. That’s because dieting triggers excessive hunger and causes our bodies to store fat more efficiently.

As a result, the child who initially diets to get rid of a few pounds of “baby fat” is likely to gain weight instead, causing feelings of shame and distress — feelings that in turn can lead to secretive eating and bingeing. That’s the first step in a cycle of failed diets, out-of-control eating, and weight gain — a cycle that often lasts a lifetime. Worse yet, failed diets lead many children to ever-more-restrictive diets, eventually culminating in full-blown bulimia or anorexia. More than one in three dieters progresses to extreme dieting, and a quarter of those people will develop eating disorders.

In addition to setting children up for obesity or eating disorders, dieting is dangerous in other ways. For example, 45% of skeletal mass develops during the teen years, and strict dieting can dramatically reduce bone mass. Dieting also impairs thinking and memory and mood, making it more difficult for children to succeed at school and enjoy their lives. In addition, extreme dieting can damage the kidneys, heart, and immune system.

In short dieting creates weight problems and eating disorders in children who aren’t overweight to begin with, and it doesn’t help children who are overweight to lose their excess pounds.

Dealing with “Fat Phobia”, Weight Concerns, and Human Development in a Productive Way

To raise children who are free from weight problems, or to help children who actually are overweight, parents need to focus on two objectives — neither of which involves dieting. The first is to counter the toxic effects of the “culture of thinness” by teaching their children (whether they have weight issues or not) to have realistic ideas about their own bodies, and to offer knowledge and reassurance about human development. The second is to create lifestyle changes that foster a relaxed relationship with food, free of bingeing, restricting, and emotional eating.

The most important step in this process is to immunize your child against unhealthy cultural messages. For instance, share stories about models and actors with eating disorders so your child will understand the ugly truth behind the size-zero fairytale. Also, keep an eye out for good role models — for instance, many of the contestants on American Idol — who aren’t unnaturally slender and who have confidence in their own beauty. In addition, see if you can steer your child toward programming where he’ll see real-life people in all shapes and sizes who lead successful and interesting lives.

The next step is to address your own fears and misconceptions about weight — both your own weight and your child’s. Start by examining your own relationship with food and your body. A child who grows up hearing, “Ugh, I look disgusting in this dress — I can’t go to the party” or “I hate myself for eating that cake!” learns to think of food as an enemy and his or her own body as an object of shame or disgust. A child who grows up watching a parent’s unsuccessful diets and witnessing the resulting anxiety over weight gain will feel a lack of control over her own eating and weight. Avoid these issues by expressing positive thoughts about your own body and about your relationship with food — and, even more important, by avoiding fad dieting — and you’ll pass healthy attitudes on to your child.

Also, examine how you feel about your child’s size and weight. This is especially important if you have a strong case of “fat phobia” yourself, or if your child is larger than you (particularly if you have a daughter). Often, today’s children are taller and heavier than their parents. If you have a mental picture of your child as a “little you,” it’s important to realize that it’s just fine if she’s 3 inches taller or 20 pounds heavier than you by the time she’s a teen. Also, if you’ve battled weight issues all of your life, it’s important not to start your child on the same path by panicking when she gains a few pounds in puberty. Expecting a child to be a size 6 like you when her body’s blueprint dictates otherwise is a prescription for eating disorders.

It’s also crucial to be aware of the normal pattern of weight and height gain in children as they near or pass the turning point of puberty. Here are some guidelines, although children’s weight and height will vary according to their genes and environment:

It’s normal for a child to gain 30 to 40 pounds between the ages of 11 and 14. It is normal for your child to gain 20 pounds (or more) in a year.

In girls, puberty-related weight gain generally appears first as a layer of fat all over the body and then gradually appears more around the breasts, thighs, and hips. Thus, some girls will appear “fat” for a time before their curves appear. Others, however, will develop a curvaceous body well before their peers — and still others will remain very thin and un-curvy. Girls in any of these groups need assurance that they are perfectly normal. Boys, too, may go through a “baby fat” stage before growing into their weight gain, and need to know that this is healthy and normal.

Boys tend to be shorter than girls until they reach puberty. At that stage, both girls and boys often “shoot up.” This means that your child may be much shorter or taller than her classmates, and she needs to know that this is normal. It’s also normal for a child’s feet or arms to grow quickly (hence the cliche about “gangly teens). Boys may also develop a temporary swelling of the breast, and need reassurance that this is normal.

Children proceed through puberty in different ways according to their own genetic blueprint. Help children recognize and prepare for this by discussing the facts about differences in body size and shape that are inherent in all living creatures.

When Should I Talk to My Child About His or Her Development?

When you see your child’s body starting to change, talk about what’s happening! Don’t wait until your child starts to receive misinformation from others. When you and your child recognize these changes as normal and healthy — even as exciting — you can set the stage for emotional and physical health. In particular, make sure your child knows that weight gain is a normal, healthy part of becoming a young woman or man. (Are children embarrassed when you bring up these topics? Yes. But they’ll appreciate the information, because you’ll be addressing their own unspoken fears and concerns.)

In addition, take active steps to teach your children healthy ideas about food and eating. Here are effective strategies for giving children the gift of a healthy relationship with food and their bodies:

Never portray any food as an enemy. Help your child to develop a natural, healthy relationship with food and eating. Educate your child about the health benefits of high-nutrition foods, but don’t place junk food completely off-limits. We crave what we can’t have, so a child who occasionally eats a cupcake or candy bar is much less likely to become overweight than a child who thinks that all tempting foods are taboo and thus obsesses about them.

Treat all family members equally with regard to food. Never single out a child based on his or her weight. Do not make different rules for different family members (e.g.; Johnny can have all the dessert he wants, but Sarah really should eat fruit instead).

Teach your child to recognize hunger and satiation. Ask a young child things like, “How does your tummy feel right now? Is it hungry?” After a meal, ask, “Is your tummy really full?” Also, don’t make your child clean her plate — a habit that train people to overeat. Instead, let her decide when she’s eaten enough. A good rule of thumb: You decide what, when and where your child eats, while your child decides whether or not to eat, and how much to eat. Trying to control how much your child eats will backfire!

Encourage “mindful eating.” Often, both kids and adults eat on autopilot. One way to increase your child’s awareness of her own hunger and how much she’s eating is to serve snacks in bowls rather than letting family members grab an entire bag of chips or box of cookies. This helps a child recognize when she’s full, instead of zoning out and eating the entire box or bag of food. Also, encourage your children to eat in the kitchen or the dining room. Another good rule of thumb: your entire family should make it a habit to avoid eating while watching television.

Beware of pressures from coaches. Kids involved in sports often experience pressure to lose weight, especially in activities like gymnastics, ballet, track, and wrestling. This puts your child at greatly heightened risk for an eating disorder. If you sense that a coach or instructor is pressuring your child to diet, meet with the coach and explain that this is unacceptable to you.

If your child truly is overweight, and you’re quite sure that it’s not a temporary weight gain due to puberty or an emotional upset such as a divorce or death in the family, realize that “quick fixes” don’t work. Instead, make gradual and positive life changes (not just for your child affected by weight gain, but for your entire family) that will pay off over time. Here are the most important steps you can take to promote a healthy and adaptive relationship with food and body image, through normal development and for a lifetime.

Increase your child’s activity. If your child isn’t routinely physically active, plan regular family activities that involve movement; for instance, put up a basketball hoop or go on family bike rides. (But don’t present these activities as a way for your child to lose weight. Instead, offer them as something fun to do.) Also, reduce the amount of time your family spends watching TV — one of the biggest culprits in weight gain. Put away the video games for the weekend, too.

Avoid tasteless, artificial diet foods. Instead, teach your child to enjoy and appreciate natural, well prepared and tasty foods — whether they’re low in calories or carbohydrates or not. Your child will respond with satiety and stop eating on her own, when given the opportunity to eat delicious and nourishing foods in a setting which promotes mindfulness.

Find a knowledgeable pediatrician. If your current pediatrician pushes a diet for your child, seek out a doctor who understands the impact of dieting and food restriction. Also, be sure this doctor rules out physical problems that can contribute to weight gain, such as sleep apnea (a surprisingly common problem in children) and thyroid conditions.

Teach your child that his weight and his body size and shape aren’t the most important things about him. Involve your child in esteem-building activities that make him feel competent and proud of his abilities. (For example, foster an artistic talent by signing your child up for sculpture classes, or encourage his musical abilities by buying him a guitar.) Getting a teenager involved with a volunteer organization such as Special Olympics can also increase her activity level while helping her realize that there are more important things in life than how much a person weighs. It may seem strange, but taking your child’s mind off her weight is one of the best ways to help her become fit!

Love your child unconditionally. Never bribe your child to lose weight, or say “You’d look so pretty in that dress if you lost a few pounds,” or say, “Look how good Kathy looks now that she’s thinner — you could do the same thing.” Let your child know that you love her just as she is now — absolutely and unconditionally. Don’t make critical comments about her current weight, and don’t lavish her with praise and presents if she loses weight. A child who realizes that her parents’ love doesn’t hinge on her weight is far less likely to sneak food and eat secretly — a major contributor to obesity and emotional problems.

Buy clothes that your child enjoys wearing, and that fit well. It’s important that your child have access to attractive, well-fitting clothing that matches who she is. Make sure she has an adequate supply of clothes that fit. Try L.L. Bean and Land’s End for plus sizes. Don’t expose your child to a shopping trip to a store that doesn’t supply the clothing she needs. Remember that your developing child will be growing quickly, and you may need to invest more in clothing than you expected during developmental changes.

None of these fixes will work overnight — but unlike dieting, they almost always will work in the long run. More importantly, they will give your child self-confidence and the secure feeling that she’s loved and valued — no matter what the scale says, and no matter how different she looks from the anorexic model on the cover of this month’s Vogue. That sense of self-esteem will do more to make her happy in life, and more to give her control over her weight and her health, than any diet could ever do.

If you or a loved one are suffering from negative body image, talk to a professional eating disorder therapist.


Published Date: October 1, 2008
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on
May 30, 2014
Published on, Resources on Eating Disorders