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Shrinking Women

The Therapeutic Moment today is a tough one and there is so much going on in this poem: Siblings and how our experiences in our families can be very different; how we see what our parents do more than we hear what they say; the parental legacy of dieting. It’s a nice piece of work and there are lots of ways to read it.

You need to eat more ice cream

icecreambar-insideDo you remember this post? It was going around about a month ago. The mom found a note written by her 7-year old daughter listing all of the ways her daughter was going to lose weight. The mom was understandably upset and she was also flabbergasted because, “Our attitudes are reasonable and balanced. Weight has never been an issue in our home – it is, for the most part, irrelevant.” Later the mom finds out that her daughter learned about dieting from another little girl.

I’m glad the writer shared this story with us because it’s a reminder that our kids talk to other kids. And even if weight seems irrelevant in our homes, it is relevant out there in the rest of the world so we need to talk about it — explicitly and often. You want to be the boss of this conversation, right? Certainly you don’t want the media to dictate how your child feels about herself. And you don’t want other kids in charge of whether or not your daughter feels pretty. That’s why you have to talk about it.

Help your kids be critical

Point out the lack of body diversity in the media and explain why we see only one kind of body on TV. Make a point of celebrating all kinds of bodies, definitely. But you also need to talk about how not everyone thinks all kinds of bodies are just right. Explain that this is a prejudice that your family doesn’t participate in. (And you don’t, right? You don’t talk about your weight or your friends’ weight or how fat your favorite actor has gotten, do you? Because that’s gotta stop.)

Talk before their friends do

Head off the diet talk your child will inevitably hear from friends by talking about it right now. Tell them that sooner or later someone they love will call themselves fat or compare their size to someone else. Sooner or later someone will tell your child that she is too fat or too skinny; it’s inevitable. I tell kids that children — especially in the tween/teen ages when they’re trying to figure out what the heck is going on with their bodies — do a lot of comparing and they talk about these comparisons. They say, “Why do your thighs touch? Why do you have an outie instead of an innie? Gosh, your arms are so bony!” It’s going to happen but you can limit some of the harm by talking about it now. That way when another little kid on the soccer team says, “You’re eating fries?!? Don’t you care about getting fat?” your child will have an answer ready. I know this is hard for a lot of parents because they hope if they don’t bring it up their child won’t have to deal with it. Trust me, they’re dealing with it. This is the soup we’re all swimming in and as Don Draper says, “If you don’t like what is being said, then change the conversation.” I know the guy’s a louse but he has a point here.

Diet really is a four letter word

Diets are bad for kids and other living things. Food deprivation — not eating when we’re hungry, not eating until we’re full — screws up our metabolisms and there are a slew of studies that show they are especially bad for children. Calorie restriction (says the research) actually makes children fatter. Really. And it also messes with their natural ability to read their bodies’ satiety signals.

Eat more ice cream

This is why you have to eat regular old “junk” food now and then. Now I’m not telling you to hit the golden arches every time you have your child buckled into the car seat but you do need to teach them how to be competent eaters. That means not avoiding a whole class of delicious food because it doesn’t meet high nutritional standards. Denying is tatamount to dieting and remember we need to avoid that. Our children need to see us eating food for fun and for celebration and because it’s delicious. They need to see us model enjoying our food and not feeling guilty about it. They need to see us push our plates away when we’re full and dive in full of enthusiasm when we’re hungry. We need to learn to be competent eaters, too.

Don’t demonize food

I know this is hard, especially when we’re having such intense discussions about organic and go local and factory farming. These are important discussions to have but when our kids are young they need to figure out how to listen to their bodies first and foremost. I worry when I hear about parents showing their young children Fast Food Nation or Forks Over Knives. These documentaries can get in the way of a child’s natural ability to understand appetite. You can live out your values in ways that help our kids instead of harm them. By all means, go to your local farmer’s market and get everything you need to make a big, beautiful salad but don’t beat yourself up (and definitely don’t do it in front of your child) if you end up at the local Big Box supermarket picking up non-organic lettuce some weekend. Likewise you can help your child talk about how he feels after he eats a box of sour gummy worms without shaming him. Kids are going to eat too much sometimes. Eating is opportunity to learn, which means sometimes eating too much or too little or not what our bodies want. Making mistakes is part of the process.

On eating well

intuitive eatingAs we wind down to the end of January, many of us are contemplating where we are regarding our New Year’s resolutions around eating well and some of us are feeling pretty grouchy about our progress. Changing our diets is hard — it takes new planning, new habits, new skills and sometimes new tastebuds.

There’s no such thing as failure

Most of us, especially when it comes to the food we put in our bodies, view failure as a big, shameful black mark. We carry a lot of other things in our plans to eat better like negative attitudes towards our bodies, fear-fueled concerns for our health, and values we learned at our childhood dinner tables. Suddenly a stalk of broccoli or a bite of white bread gets awfully mixed up with a bunch of other emotionally-charged ideas. This is why we need to learn how to be kind and patient with ourselves.

Here’s the good news about missing our New Year’s resolutions: Not reaching a goal is an opportunity to get a better understanding of what works for us and what doesn’t. When we’re talking about how we fuel our bodies, we need to look beyond our physical well-being and look towards our spiritual and emotional well-being. Changing how we eat confronts essential ways we nurture our bodies and souls and sometimes restriction confronts the ways we need to do a better job of covering ourselves with kindness.

There is no one way to “eat right”

We are all carrying different bodies. We are not physically, culturally or spiritually identical to any other person. How our bodies respond to different foods and ways of eating is unique. Some of us do better with a greater variety of foods or less of a certain kind of food and that’s just fine. If your plan was to eat less carbs or more greens and you’ve found yourself heading back to your 2012 ways of eating, it may be that you do better with a menu that’s different than what you envisioned when you were making your new year’s resolutions. Choking down a food you don’t like or depriving yourself of one that you love isn’t the best way to long-term physical or emotional health. Think of yourself as an explorer lovingly discovering what suits your life best and honor the fact that you are an ever-changing human being. What works for you today may not work tomorrow; be flexible.

Going beyond dieting

If you have missed your goal perhaps it’s time to write a new one and use the information you gleaned over the past few weeks as an impetus for loving change. Perhaps you can look back and tune into what your Self (not just your body, but your heart and mind) were trying to say. Did you feel nurtured, nourished and cherished? Or deprived, afraid and resentful? Were you hungrier than was comfortable? What did work? Even if you didn’t succeed in all of your goals, did you discover a new food that’s delicious and makes you feel good? Or a new routine that makes you feel more energized? Celebrate that new information and give yourself permission to incorporate those “imperfect” successes.

You can also take The Fat Nutritionist‘s tagline to heart: “Eat food. Stuff you like. As much as you want.” When you give yourself permission to eat “too much” or “too little” and do it in a mindful, present way you can learn an awful lot about what works best for you. Instead of cutting out whole swaths of food on someone else’s say-so, you may want to give yourself the time, space and attention to eat those “offending” foods and see if they actually are a problem for you. I know that leaning on a plan can feel very comforting but you may find that someone else’s “perfect” diet only works for you when you let go of the rigidity that defines them. Paleo, primal, raw or vegan can be guides to what makes sense for your body in general instead of inflexible how-tos that set you up for failure.

Stay in it for the long-term

Being healthy goes beyond fueling our bodies a certain way; we also need to take care of every other part of ourselves. For some of us, the spiritual or emotional costs of giving up a certain food may be greater than the physical costs of eating it. By all means, add a green smoothie to your morning routine if it makes you feel great but don’t beat yourself up if you find that it’s not a habit that makes long-term sense for you. It’s ok to have one when you can but skip them on the days you’re over-scheduled or just don’t feel like cleaning out the blender. After all, adding green smoothies to your routine is supposed to make you feel better not worse and if it’s not improving your life, feel free to chuck it and try something else.

Remember, none of us will ever be perfect so instead aim for good enough and know that with every new thing you learn about yourself, you’re also getting better.


Dr. Katja Rowell: Obesity fear-mongering

Love Me, Feed Me!This is the second entry of a 5-part interview series with Dr. Katja Rowell whose consulting service, The Feeding Doctor, focuses on helping families learn about healthy, happy eating. Finding non-alarmist nutrition information for kids is a challenge and her commonsense, respectful approach has been a huge boon to me. Be sure to become a The Feeding Doctor fan on facebook and check out her new book, Love Me, Feed Me! now available at Amazon.

Can you talk some about kids and the emphasis on obesity in nutrition education? The good and the bad of it?

This is so tough. We know there is a problem with how we feed our kids as a society. Many kids are getting bigger than is healthy for them, and many are also not getting enough food (food insecurity) many are malnourished, many teens are practicing dangerous dieting behaviors, are gaining weight and bingeing as well and eating disorders are being diagnosed in more and younger children. I see it more as a crisis in feeding all our kids. A crisis in our relationship with food. I really have a problem with nutrition education that is aimed at fat kids, or aimed at “preventing fat kids.” There are many normal or healthy weight kids who have terrible nutrition and we are ignoring them. If you know that most fat adults were not fat kids, then we have to help all children. There are many larger kids who are healthy and we are misdiagnosing them. Our emphasis on weight and weight loss is not healthy for anyone. We know that teens who diet, even “healthy” dieting like “watching what you eat,” or trying to eat more fruits and veggies are heavier than their peers who do not diet. I think we have to be really careful with nutrition education, not to scare kids or focus on avoidance or restriction. Nutrition education should be age-appropriate (meaning we should NOT have six year olds reading labels for fat grams) and should focus on joy, structure, providing, good taste and permission. There are no “bad” foods. There is room in a healthy diet for all foods.

I also get particularly angry that the language of addiction is used in nutrition education with kids. We need to get the “crazy” out of our relationship with food and not introduce kids to the idea that food is somehow forbidden, or that you have a “snack attack” or “can’t stop” or that you have a “craving” for a food. Commercials for kids use this language really well as they are trying to pique a child’s interest in a food and make it desirable- to tap in to that formidable “pester power” so the kid begs for Cocoa Puffs or Cheetos. And why does every movie or TV show (Disney too) show tweens and women eating ice-cream out of the carton when they are upset? What are we teaching girls by showing them that cliched coping model? We need to reframe how we talk about food. The fact that nutrition education co-opts this language and reinforces the message of desire, lack of control and pathology is harmful. Nutrition education should normalize food as a delicious, joyful part of life, not something that controls us.

Is the “healthy at any size” credo something that makes sense for children? Why or why not?

sodasip-insideI do think it makes sense. I think we need to focus on behaviors. Is the kid eating breakfast, are they given the opportunity to move their bodies in enjoyable ways? I think of my brother who is tall and lean now but had a puffy phase right before his pubertal growth spurt. (This is a very common pattern.) If he had been told to worry about that, or put on a diet, he would have been robbed of the opportunity to grow into the body he was meant to have. I cannot tell you how many women share that history of being started on a diet around that time and starting a lifetime of dieting, shame and consequently weight gain. Again, if we as parents can provide a variety of foods in a structured setting and avoid the notion that all kids have to grow at the 50th % we would all be better off. Now, I want to be clear that if someone is gaining weight rapidly in a way that is not consistent with their healthy growth curve (big or small) that person needs help. Rather than ask “what is that kid eating?” we need to ask “What is happening in that child’s life that is messing up their normal growth?” Are they getting enough food? Structure? Sleep? Is there chaos or stress in the home? Are they getting a variety of foods? It is more about behaviors and taking care of yourself than the number on the scale.

How can parents promote healthy eating and exercise without focusing too much on body shape or losing weight?

I remember being at the park with my daughter on the swings and a little girl ran up and started swinging. Her dad, a lean man, came jogging over and yelled, “Sally! Get off the swings! That’s lazy exercise! We didn’t come here to sit around, get off and run around.” Her smile faded pretty quick. I can tell you that’s NOT the way to instill in her a life-long love of movement and her body. We can’t be food cops or personal trainers.

Ignore weight. Focus on behaviors that you can control. Be a good role model. When I do intake analyses with my clients, they are shocked when I usually start with “feed your child more” and stop restricting. The urge again to do “something” and follow the advice in magazines might mean you give your child a piece of fruit for snack and that’s it. The reality is kids need substantial meals and snacks so they can have energy and then not be allowed to graze in between. Be a good role model. Enjoy eating a variety of foods yourself. Swing by the park on the way home from day-care for half an hour. Play some Wii Games (watch out for wii fit!) FInd a community pool, provide opportunities to be active. I saw something from the pediatrician’s office the other day that exemplified to me how out of touch and ridiculous current public health initiatives can be. It said, “Outside of school, have your child participate in sixty minutes of vigorous aerobic activity for an uninterrupted sixty minutes.” and, “Don’t let your child be sedentary for more than thirty minutes at a time.” Really? Then you turn into that personal trainer dad. Do you have a timer when your kid plays Legos or draws and make them do laps around the house if they’re doing homework for thirty minutes? How can your kids do an hour of uninterrupted activity? It’s too much and sets every one up to feel like a failure which leads to apathy and a lost opportunity to encourage small, real changes that are intrinsically rewarding. So much of the advice is also not backed by any scientific evidence that the recommendation will improve health or outcomes.

(Stay Tuned for Part 3 next week!)

Introducing Dr. Katja Rowell: A 5-part series

Love Me, Feed Me!This is the start of a 5-part interview series with Dr. Katja Rowell whose consulting service, The Feeding Doctor, focuses on helping families learn about healthy, happy eating. Finding non-alarmist nutrition information for kids is a challenge and her commonsense, respectful approach has been a huge boon to me.  I asked her if she’d let me interview her and not only did she say yes but she gave me SO MUCH information back that I have enough to share across the next five weeks. Be sure to become a The Feeding Doctor fan on facebook and check out her new book, Love Me, Feed Me! now available at Amazon.

Katja Rowell, M.D. is a graduate of the University of Michigan medical school and served as a family physician in urban and rural clinics and at a university student health service. She was struck by the prevalence of disordered eating and feeding and related health problems. Rowell believes establishing a healthy feeding relationship– in essence– the HOW children are fed is the missing piece in addressing disordered eating, childhood overweight and damaging dieting behaviors.

Without further ado, here’s the first part of the 5-part series speaking with a nutritionist who has no desire to scare the heck out of you, demonize food or force-feed you guilt in the guise of education.

Your blog was originally called Family Feeding Dynamics. Can you talk more about how you came up with this name and what it means?

Feeding dynamics is the name of Ellyn Satter‘s feeding model with children. It transformed first my own family’s experience around food, and then was the major impetus for my career shift from traditional family doctor to a childhood feeding specialist.

I wanted to celebrate that link with Satter’s feeding model, but also stress the family aspect. To stress that families teach kids how to eat. Family meals matter. The word dynamic also recognizes that feeding our families is a dynamic process, meaning it is flexible and changes with your family. For example, I had a hard time cooking the kinds of meals I thought I “should” during stressful times, whether we were moving, health reasons, or just being overwhelmed with the needs of an active infant and an over-worked partner. I relied more on take-out or pre-prepped meals at the time, but I “forgave” myself, meaning I let go of the guilt. I think that positive attitude helped me get back to feeling good about cooking more regularly again. So much changes with kids – their tastes, different feeding challenges depending in your child’s temperament and developmental stage, or your home situation with jobs, schedules etc. So you might eat dinner at 5:30 when your child is younger, but change to a seven p.m. dinner when your child starts after-school activities. It’s about being flexible, forgiving, fluid, and dynamic with your approach to doing your job with feeding.

What are the most significant barriers you see in the way of parents helping kids learn healthy eating?

popsicle-insideTime is probably a major factor for most families I work with. Money and access to a variety of foods is an issue for too many Americans as well. I read somewhere that for a families in the “lower middle class” range, that eating the way the food pyramid recommends would take about 70% of their income. So, for many families, food insecurity, and money is an issue.

Another barrier I commonly see is picky eating and the power struggles around that issue- which in most cases is a result of feeding decisions in the past or feeding patterns. Fundamentally most parents (and health care providers) also don’t understand normal growth and normal eating habits. Parents of big kids worry that their children will be fat, parents of small kids feel judged or worry that their child is not healthy or will grow up to be small. Out of this concern and misunderstanding comes this urgent sense of “We have to do something!” and unfortunately that “something” usually means feeding with pressure-feeding to try to control size and that often backfires. That kid who gets pushed to eat more will eat less, that kid who is being restricted often then gets obsessed with food and you might start to see weight increase more rapidly. We have lost a sense of trusting that kids can and will grow to a body that is right for them if we do our job with feeding. Another barrier is that lots of parents I work with don’t know how to cook basic food and feel overwhelmed by shopping, meal planning and cooking. It’s part of why my blog focuses on meal-planning and recipes as well as research and topical subjects.

What do you mean by “jobs with feeding?”

It boils down to what is called the Division of Responsibility with feeding which is Satter’s main notion and recognized by the American Dietetic Association as “perhaps the best way to feed children.” The person feeding the child decides what, when and where the kid eats, the child decides if and how much. It sounds easy, but it is not the norm in how we feed kids as a culture. Think about the kid who is forced to eat two bites of meat before he earns dessert, or the child who has to finish a serving of vegetables before he can have more meat, or the child who is cut off after one serving of pasta. This is typical, and to many the badge of good parenting and feeding, but it is doing the child’s job-which is letting them tune in to their bodies and to decide how much of something to eat. As a mom, I plan the meals and snacks and I provide a variety of foods from the basic food groups, and I provide a pleasant setting, Then my job is done. My child’s job is to show up, be pleasant and decide how much or if she eats. It is hard work planning and providing snacks and meals with fat, protein and carb. It is not sexy, it is not easily sold or taught in a sound-bite format. But, it is pleasant. I don’t have fights or negotiations at my table, and the families I work with tell me things like, “I can look forward to dinner again,” or “I get to be a mom, not a food cop” and you know what? Their kids eat a better variety and get better nutrition too. It’s one thing to see the research on feeding, but it’s another to see it work in my home and with my clients. I love what I do. To me this is very powerful preventive medicine. If a kid can grow up with a healthy relationship to food and her body-what a gift, what a head start in terms of health.

(Stay Tuned for Part 2 next week!)

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