The 4 letter word that can impact your child’s health
Co-Authored by: Grace Bell, MSACN and Tami Butterfield, BScN, MScN, CN
Over the past decades, the topics of ‘obesity’ and the ‘childhood obesity epidemic’ have expanded into family homes, schools, and media. Through this expansion, the introduction of a four-letter word into our children's vocabulary has brought about challenges to our children’s health. This word, if used inappropriately, increases the risk of children developing an unhealthy relationship with food and their body. This word is “diet”.
Historically, the word “diet” was defined as a ‘way of life’.(1) Over time it became a word to describe restrictive eating in order to maintain or lose weight. Weight became the focus, which took away the ability for people to establish a healthy relationship with not only their food but also with their bodies. In the attempt to be health-minded parents, to support their child’s health, many have read parenting articles on foods and feeding, connected with other parents, and followed advice from health professionals or influencers on how to feed their children through diets to lose weight and be “healthy”. But, how does this affect our children?
Diet-culture, body-shame and our children
Diet culture and body-shame (fatphobia, or body size bias), has misinformed parents into believing if they do not encourage children to eat ’healthy’,(2) and/or lose weight, they will be part of a generation of children that will have a shorter lifespan compared to their parents. These beliefs are influenced by reports on the childhood obesity epidemic. These reports focus on a type of calculation, Body Mass Index (BMI), which misrepresents physical health. Childhood obesity reports do not take into account the individual and unique nature of each child’s ancestral and genetic makeup, nor do they consider the connection between food relationships to overall health.
The ‘childhood obesity epidemic’ has provided opportunities for diet and weight-focused organizations and businesses to develop and promote services, programs, and apps that are marketed to parents. Although their marketing content indicates they want to support parents with helping their children with what to eat, when to eat, and how much to eat, the core of these programs, services, and apps lies in diet culture and body-shaming.(3,2)
As much as we would like to think diet culture and body shaming don’t impact our kids, there are signs that they do. Even if our kids are not “dieting”, they may be rehearsing diet culture and body shaming by way of using the words and behaviors they hear from those around them (this includes what they see on social media and tv).(4)
Things children may say or do:
9-year-old “my friend is on a diet”
10-year-old concerned about the size and shape of their belly
7-year-old is worried they will eat the “wrong” or “bad food”
A child expresses worry about eating food because they are afraid of being judged, or shamed because of the food itself or their body size
A child may comment on another person’s food intake or body size/shape
These are a few of the signs and symptoms of diet culture and body shame.
Diet-culture and body-shame byproducts are manifesting in our children in their perception of:
health as ‘ Diets’ and ‘dieting’
being fat or large equates to being a bad person
establishing food as either good or bad, implying food is a moral choice
In addition, children engage in self-shaming and self-judgment as well as shaming and judging others. When parents and adults focus on weight, this encourages children to engage in fear, stigmas, bullying,(5) weight cycling, disordered eating,(6,7) eating disorders, body shame, and developing distorted perceptions of their body.(8) All of which are opposing factors to health.
Many adults experience and struggle with diet culture and body shaming, and may not be aware that their language and behavior in relation to food and body size/shape is affecting the children around them, including their own children. Since children learn behaviors and beliefs from the world around them, what we say and do will influence their relationship with food and their body. Thankfully, people are becoming more aware of their diet and body size misunderstandings and are now utilizing body-positive words and behaviors. These changes support an anti-diet stance, which will help in overturning the misinformation around health by taking weight out of language related to health and size.
How to help your child have a healthy relationship with food and their body
Recognizing that questions and advice, in relation to health, which include how to eat to stay thin, how to lose weight, or what foods are good or bad, are considered pro-diet culture and body shaming.
More supportive health questions and advice include:(9)
How do I create an environment where my child feels safe to be in their shape and size?
What foods does my child enjoy and why?
What foods does my child not enjoy, and why?
How can I help my child listen to their body to know what it needs when it needs it, and how much it needs?
How do I establish positive food relationships that are without moral judgment?
How are my personal beliefs around food and body influencing my child?
There are many ways to incorporate language and behavior that are food and body-positive. The needs of every family are dynamic, therefore choosing options that meet each family member’s needs and the family as a whole will create an environment where everyone will benefit.
A few ideas include:
Having as many meal times as a family as possible
Create a fun social environment that includes food.
Avoid associating food with body size
Avoid labeling food as good or bad, right or wrong, red light or green light.
Celebrate body diversity
Avoid using food as a reward or punishment
Avoid negative statements about food and body (i.e. “I ate too much, I am going to have to run this off!”, “5 minutes on your lips, 5 years on your hips”, “I am not eating carbs because I want to lose weight”, etc.)
Be weight neutral
Avoid shaming personal preferences (“you're going to eat it like that? Ew, gross!” or “That’s weird”)
Acknowledge hunger and satiation cues
Have patience
Advocating For Children: How To Approach Health Professionals Who Engage In Diet Culture And Body Shaming
Many well-meaning pediatricians still practice from a weight-centric and sometimes fat-phobic paradigm.(10) Although Pediatricians have the education and experience in childhood health, many are not educated in Health at Every Size® (HAES) and food relationship dynamics.
Parents can establish boundaries with health care providers by discussing when it is okay to discuss weight and their view of weight as it relates to their child’s health. In addition, parents may provide a simple letter stating their wishes on when and how weight will be discussed during their child’s medical visits.
Sunnysideupnutrition.com provides a healthcare provider letter in PDF format that can be downloaded and given to your child’s healthcare providers.
The letter, along with other insights on how to talk to healthcare providers can be found here: https://sunnysideupnutrition.com/a-letter-to-your-childs-doctor/
Final WORD To Support Parents
As noted here, DIET is a 4-letter word that can do more harm than good when it comes to the health of our children. Parents and caretakers are responsible for the well-being of their children, which can be confusing, frustrating, and stressful. Therefore, parents need a 4-letter word to help them as well, this word is CALM. Being calm, versus being stressed by participating in; diet culture, body shaming, and food shaming, supports the health of not only parents but also children.
References
1. Graber NT Cynthia. The Ancient Origins of Dieting. The Atlantic. Published January 30, 2018. Accessed November 18, 2021. https://www.theatlantic.com/health/archive/2018/01/the-ancient-origins-of-dieting/551828/
2. Bratman S. Orthorexia vs. theories of healthy eating. Eat Weight Disord - Stud Anorex Bulim Obes. 2017;22(3):381-385. doi:10.1007/s40519-017-0417-6
3. Forget WW! How to Protect Your Children from Food & Body Shame. Marci R.D. Published August 27, 2019. Accessed November 18, 2021. https://marcird.com/forget-ww-how-to-protect-your-children-from-food-body-shame/
4. Jendrzyca A, Warschburger P. Weight stigma and eating behaviours in elementary school children: A prospective population-based study. Appetite. 2016;102:51-59. doi:10.1016/j.appet.2016.02.005
5. Alimoradi Z, Golboni F, Griffiths MD, Broström A, Lin CY, Pakpour AH. Weight-related stigma and psychological distress: A systematic review and meta-analysis. Clin Nutr Edinb Scotl. 2020;39(7):2001-2013. doi:10.1016/j.clnu.2019.10.016
6. Hunter JD, Crudo DF. Unintended Consequences of Restrictive Diets: Two Case Reports and a Review of Orthorexia. Clin Pediatr (Phila). 2018;57(14):1693-1695. doi:10.1177/0009922818795905
7. P02.168. Safety issues and orthorexia in paediatrics | BMC Complementary Medicine and Therapies | Full Text. Accessed November 19, 2021. https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/1472-6882-12-S1-P224
8. Bidstrup H, Brennan L, Kaufmann L, de la Piedad Garcia X. Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review. Int J Obes 2005. Published online October 9, 2021:1-9. doi:10.1038/s41366-021-00982-4
9. How Parents Can Help Kids Develop a Positive Relationship With Food. Center For Discovery. Published October 16, 2019. Accessed November 18, 2021. https://centerfordiscovery.com/blog/how-parents-can-help-kids-develop-a-positive-relationship-with-food/
10. Palad CJ, Yarlagadda S, Stanford FC. Weight stigma and its impact on paediatric care. Curr Opin Endocrinol Diabetes Obes. 2019;26(1):19-24. doi:10.1097/MED.0000000000000453