ABC Health & Wellbeing
By Dr Jocelyn Lowinger, 29 Jul 2016.
Meal times can be a source of frustration and conflict in many families.
In a scenario that is familiar to many parents, you go out of your way to provide healthy meals and encourage your kids to eat their leafy greens. But all they want to eat is pie, chips or pizza.
Of course you want to encourage your children to eat well. It sets them up for a lifetime of good health and helps them avoid obesity, which we know is a big issue in Australia.
Eating disorder facts
- Eating disorders don’t just include anorexia nervosa and bulimia nervosa, There are a range of other related disorders.
- They can be serious and life threatening mental illnesses.
- Anorexia has one of the highest rates of death of any mental illness.
- Eating disorders affect about one in every 11 Australians, of all ages.
- Research suggests around one in three girls as young as five engage in disordered eating behaviours, such as restricting food intake.
Recent data shows one in four Australian children aged between two and 17 is overweight or obese. However, it is less well known that children who are overweight or obese are at higher of developing disordered eating and binge-eating behaviours.
And these bring with them their own health risks.
Disordered eating is broad term used to describe restrictive dieting, compulsive eating or skipping meals. It can be an early warning sign of an eating disorder, such as anorexia nervosa and bulimia nervosa, and has also been linked to a range of other health issues, such as obesity, depression and anxiety.
So how do we encourage healthy eating in our kids, without inadvertently triggering disordered eating that may result in an actual eating disorder?
While people who are dieting are at increased risk of developing an eating disorder, Butterfly Foundation CEO Christine Morgan said it was too simplistic to say that dieting causes eating disorders.
The danger of dieting is that it results in weight loss and nutritional deprivation, which can trigger an eating disorder in people who have a genetic vulnerability.
“The problem is we don’t know who has the vulnerability. We know it runs in families, but it could be anybody,” Ms Morgan said.
Other risk factors for eating disorders include low self-esteem, weight and body shape concerns, dieting, the internalisation of the thin ideal and perfectionism.
And it is important as parents or carers that we are aware of these risk factors, so we can do what we can to minimise their impact.
Susan Paxton is a professor in the School of Psychology and Public Health at La Trobe University and her research focuses on the prevention of eating disorders.
She has helped develop an evidence-based resource, Confident Body, Confident Child, designed to help parents adopt behaviour that can help promote body satisfaction and healthy eating in children, between the ages of two and six.
She said there were four key things parents can do to help prevent disordered eating in their children:
1. Promote a healthy relationship with food
How parents feel about themselves, how they talk about food, and whether they themselves are on diets can affect their children. This is why it is so important that we role model healthy eating behaviours and attitudes to food, weight and health.
“If parents are restricting food, and their mood is determined by a number on the scale then, we risk children developing unhealthy beliefs,” Ms Morgan said.
Professor Paxton agreed parents needed to be good role models.
“We need to make nutritious food available, but it’s important we don’t speak about food in a guilty way,” she said.
“So many adults are on diets themselves, which can be a problem, because diets can lead to eating disorders as well as weight gain.”
She pointed out that when children see important people in their lives dieting, it can foster the belief that their body can easily be changed by restricting what they eat.
“A lot of sensitivity about food and eating comes from people’s concerns about weight loss,” Professor Paxton said.
“It has become so ingrained in popular psyche that you can lose weight, and that you should lose weight, but for many people that is not true.”
Believing that diet and exercise can easily control weight and body shape can create feelings of ineffectiveness, which in turn can promote ever more extreme forms of dieting, exercise and other weight control behaviours.
“Food is not something to be at war with. We need to have a positive relationship with food,” Professor Paxton said.
So what are some of the things you can do to promote a healthy relationship with food?
- Make nutritious food options readily available at home.
- Explain the difference between “everyday” foods and “sometimes” foods and avoid labels such as good/bad, toxic/clean, junk/healthy food.
- Allow children to eat “sometimes” foods in moderation, banning is more likely to lead to over-eating these foods (and drinks) when they are available.
- Be a good role model — eat a balanced variety and amount of nutritious foods and drinks, eat breakfast and do not skip meals
- Model eating “sometimes” foods in moderation, without talking about being bad or feeling guilty.
2. Prioritise family meals
Regular family meals can help kids develop a healthy attitude towards food, and it also gives you a chance to role model healthy eating patterns.
Family traditions based around meals, such as a Sunday roast, can help children develop positive memories with food.
“Bringing people together in social connectedness means meals become more than just about eating the food. When meals are eaten together there is a social connection. The focus on food is dissipated and the focus becomes talking together,” Ms Morgan said.
However, family meals are not always easy to organise. So parents are encouraged to get the whole family to figure out ways to make it work.
You are more likely to get the most out of family meals if you focus on connecting with your child rather than on what or how much they are eating.
It is also helpful to turn off the TV and other devices and involve your children in work associated with the family meal, where you can.
3. Don’t use food as a reward
Many parents have been known to soothe an upset child with a sweet or treat.
But Ms Morgan said it was important we do not use foods to calm, soothe or reward good behaviour, as it can set up an association between food and managing emotions.
“It’s important to deal with your kids’ emotional reality when they are sad, angry or tired,” she said.
“Acknowledge the emotion and help your kids find a way out of the emotion. Don’t teach them the habit of turning to food to fill emotional gaps.”
There is a difference between hunger and emotional needs. It is important to provide the right type of nutrient for different types of needs.
“From a young age it is extremely important to teach kids about valuing themselves and others for their worth as a person not for their size and shape or what they eat,” Ms Morgan said.
Here are some ways you can avoid emotional feeding and using food as a reward:
- Find non-food ways to praise and reward children, for instance create a sticker chart or spend time together.
- Praise children for their character rather than their weight or what they eat.
- Show love through giving hugs or telling your children you love them rather than by using food.
- Help your child explore a range of ways to calm down.
4. Eat when you’re hungry
Accredited practising dietician Fiona Sutherland has worked extensively with people with eating disorders; she said the best approach to take was “parents provide, children decide”.
Have a variety of food available, but encourage your children to take the responsibility for their eating choices, by taking food and drink from that selection.
Importantly, you do not need to have all types of food in every meal — children will absorb the nutrients they need over time so look at their dietary intake over a week or two.
“We need to help children to trust their bodies so they can grow up and feed themselves. Helping them become self-regulated in eating is giving them an enormous gift,” Ms Sutherland said.
Here are some ways we can help our children eat only when they are hungry:
- Help your child to identify feelings of hunger and fullness.
- Avoid telling them to eat everything on their plate.
- Avoid strict rules around the foods your child eats.
- Allow your child to eat “sometimes” foods in moderation, banning can encourage over-eating when they are available.