I came of age in a house of fat-free cookies, Weight Watchers’ meetings and Denise Austin’s eight-minute abs. There was plenty of pasta and ice cream but also a focus on being skinny. In the decades since, I’ve counted points, intermittently fasted and completed fitness challenges to make my body smaller.
So it was no surprise that I was concerned when I spotted a doctor’s note in my electronic health portal that described me as “overweight but alert.”
Though I knew body mass index, better known as BMI, was a questionable barometer of health, I was alarmed that mine had crept beyond the so-called healthy range. Amid studies citing obesity as a risk factor for severe Covid-19 and endless suggestions of how to lose those “pandemic pounds,” I felt determined to fix myself in a hurry.
I chose a sensible nutrition plan, one touted as a “lifestyle change,” not a diet. Still, I worried about how it might affect my kids (ages 7, 12 and 15) to watch me tracking my food intake, following rules such as “water first, veggies most” and skipping carbohydrates at dinner.
The pandemic has caused a dramatic global spike in mental health issues and disordered eating for teens, according to the US Centers for Disease Control and Prevention data. After reviewing 11 worldwide peer-reviewed studies, the University of Calgary’s Hotchkiss Brain Institute identified an 83% increase in pediatric hospital admissions for eating disorders during the pandemic.
I couldn’t block the dangerous messages of diet culture from reaching my family, but I didn’t want to cause additional harm with my own behavior. I found a book I wished I’d read as a teen, “No Weigh: A Teen’s Guide to Positive Body Image, Food, and Emotional Wisdom,” coauthored by three teen experts: adolescent medicine physician Dr. Shelley Aggarwal, eating disorder therapist Signe Darpinian and registered dietitian Wendy Sterling. Though intended for teens, the book resonated with me both individually and as a parent.
In March, this trio collaborated on a down-to-earth guide for parents. “Raising Body Positive Teens: A Parent’s Guide to Diet-Free Living, Exercise and Body Image” has changed the narrative in my head and household, as I support my teen, tween and 7-year-old to cultivate a balanced relationship with food and body.
Here’s what I learned from the authors about the science of raising truly healthy kids.
Do parents’ eating and dieting habits influence how their children eat?
Yes, these experts say. It’s well-established that “how a parent is eating, how they are buying, how they are preparing, how they are plating and how they are offering food influences the experience of the child in reference to food and body,” Aggarwal said.
Though I’m quick to blame my mom for modeling dieting behavior during my childhood, I recognize she likely internalized the diet culture norms of her day.
Aggarwal urged parents to reflect on their own complicated experiences with body image and try to develop a personal practice of well-being. “You can only give what you have,” she told me kindly.
What’s wrong with working on weight loss?
In our culture, and especially in medicine, “weight has been overvalued as a marker of health,” Aggarwal said. Chief among the faulty messages of diet culture that parents inadvertently pass onto kids is using the word “health” as “code for thin.”
“Thin does not equal health,” Aggarwal said, so we need to shift away from using weight to indicate whether anyone is healthy, attractive or worthy. Parents should make clear to kids that no person’s worth rests on their appearance, their weight or how or what they eat.
It’s critical for parents to understand the “biological, psychosocial and cognitive needs of their changing young person,” Aggarwal said. Gaining weight and changing shape are normal and expected parts of puberty. Fat aids body function, she noted, even in the brain, of which 60% is made up of adipose (fat) tissue.
How can focusing on eating ‘healthy’ become problematic for families?
The pressure parents feel to raise “healthy” kids of a particular weight can lead them to adopt rigid approaches to meals and snacks, including rules such as saying “no dessert until you finish dinner,” obsessing over nutritional information and categorizing foods as “good ” or “bad.”
These restrictions often backfire, according to Sterling. Restrictive feeding disrupts a child’s innate ability to listen to their internal hunger and fullness cues and has been shown to be a risk factor for disordered eating and eating disorders.
Further, parental encouragement of dieting in kids was a significant predictor of a higher risk of overweight or obesity, dieting, binge eating, engaging in unhealthy weight control behaviors and lower body satisfaction, according to a 2018 study.
The experts recommend checking whether a teen’s or your own relationship with food or exercise seems imbalanced. Parents commonly reported overlooking signs of disordered eating because they thought their teen was just “trying to eat healthier and exercise more,” according to Darpinian.
What should parents do instead to promote wellness?
“Food is so much more than protein, starch, and vitamins and minerals, yet many people struggle to have fun with food,” Aggarwal said. She encouraged families to remember that food is at the “heart of the human experience” and an important source of connection through cultural traditions, holidays and special events.
To promote a body-positive household, stop talking about diet, weight and shape and be judgment-free about other people’s bodies, Sterling said. Learn about intuitive eating, which dietitians have recommended for decades. For kids whose eating seems out of balance, Sterling suggested teaching them to use a “hunger meter” to determine their level of hunger before making food choices.
Families must look beyond appearance toward a broader view of the core things that allow us to experience wellness, such as mental health, sleep, and eating and moving in ways that are fulfilling and joyful.
Comments such as “I’ll need to run tomorrow to work off this dessert” troublingly link exercise with food intake. Instead, the authors said in their chapter on sleep, parents can “focus on the many practical benefits of exercise, including improved mood, energy and sleep, stress relief and metabolic fitness.”
How can we help teens manage stress, sleep and social media?
Parents can guide teens toward choices that have been shown to be scientifically critical to wellness. For example, the authors pointed to studies that show the ways sufficient and consistent sleep improves sports and academic performance.
Similarly, technology use should be intentional and regulated. Parents should proactively monitor — and teach kids to build awareness of — time spent online and the impact social media has on their sleep and self-esteem.
What if a parent or child is starting from a place of hating their larger body?
If “body positivity” sounds unattainable for parents and teens unhappy with their bodies, Darpinian recommended using micro-goals that have been proven to help us reach our goals more effectively. To improve body image, practice reducing body checking behaviors such as obsessively looking in the mirror or at photos or comparing yourself with others.
Instead of focusing exclusively on trying to reach an ideal weight or size, the experts suggest encouraging wellness behaviors that promote overall intuitive self-care.
“We know that if you improve your health behaviors and you’re doing a good job of getting yourself to bed on time, you’re handling stress effectively, you’re eating in an intuitive way and in the habit of moving in ways that are joyful to you, the result is going to be your body’s natural body weight,” Darpinian said. A therapist can help if there is grief or disappointment involved in accepting where one’s body naturally ends up.
How do we discuss body stigma with teens and set boundaries with family members?
The authors included wisdom from diet culture dismantler Virginia Sole-Smith, such as how to respond when your teen asks, “Am I fat?” or talks about dieting, and how to discuss fat phobia.
The book also provides helpful scripts for challenging boundary-setting situations. I never could pinpoint what bothered me about comments (even positive ones) on my appearance until the authors supplied the perfect response: “When you comment on my body without my consent, I feel angry, and hear in my mind that you are scrutinizing my body.”
Giving up dieting doesn’t mean I’ve given up on my family’s health. Instead, I’m honing a holistic, non-diet approach to our nutrition, fitness and well-being.