What to Say and Do If Your Child Thinks They’re Fat

The first time it happens, you may be caught off-guard, but it’s a common situation for many parents: Your child expresses concern about their body size. If this has happened to you, you’re certainly not alone.

“According to the National Eating Disorders Association, 81% of 10-year-olds are afraid of becoming fat,” says Nicole Siegfried, a licensed clinical psychologist, certified eating disorder specialist and chief clinical officer at Lightfully Behavioral Health based in Thousand Oaks, California.

They’re not coming by this fear in a vacuum either, she notes. “According to the most recent Gallup Poll, 55% of Americans want to lose weight.”

Dr. James Greenblatt, a functional psychiatrist, chief medical officer at Walden Behavioral Care in Waltham, Massachusetts, and founder of Psychiatry Redefined, an educational platform dedicated to the transformation of psychiatry, says that it’s a cultural issue. “Unfortunately, ours is a society wherein prevailing cultural aesthetics and aesthetic preferences place ‘thin’ near the very tops of the list of idealized physical attributes.”

Fear of being fat outstrips fear of other medical concerns. Greenblatt points to a 2014 study that surveyed more than 7,000 adolescents about their beliefs and attitudes toward health and wellness. It found that 63% of girls reported being afraid of gaining weight or “getting fat,” while just 26% of girls reported a fear of having or eventually developing breast cancer.

[Read: Body Image Issues Affect Kids, Too.]

Why Fear of Being Fat Is So Common

Body image issues among children have long been a problem, but many cases have gotten supercharged in the age of social media.

Social media platforms have become the battle-ground for the modern war on the body,” Siegfried says. “Unrealistic, filtered, photoshopped and posed images are plastered throughout social media feeds. Hashtags such as ‘what I eat in a day‘ promote restrictive eating and, at times, dangerous weight loss fads.”

The constant input of such messaging takes a toll, she continues. “Because 95% of adolescents have a smart phone and 45% of teens report that they’re online on a ‘near constant’ basis” — a situation the coronavirus pandemic has only exacerbated — “they’re inundated with messages about weight loss and anti-fat propaganda. For these reasons our young people are programmed to think that ‘fat; is bad, and that they are ‘fat’ and need to fix it.”

It can be shocking for some parents to see how early some kids start paying attention to their weight. “Negative body image develops early,” Siegfried notes, with 40% to 50% of 6- and 7-year-olds reporting they want to change their bodies.

[READ: Popular and Dangerous Social Media Diet Trends.]

How to Respond to Your Child

If your child expresses a fear of being fat or dismayed about their body, you’ll likely feel compelled to try to dissuade your child from thinking they’re overweight. Many parents respond by saying something along the lines of “you’re not fat, you’re beautiful! Or “Don’t be silly — you’re slim and trim!”

But this knee-jerk reaction isn’t always the best way to handle the situation, Siegfried says. “Unfortunately, these comments come from a place of well-meaning, but they actually perpetuate fear of fat and contribute to the narrative that fat is bad.”

Barreto agrees that while the impulse to assuage these fears is one based in love, “it’s important for parents to take a moment to pause and consider that fat is not a feeling.”

By this she means that you can open a dialogue with your child about what’s underlying the questions or concerns they’re expressing about their body.

For example, ask your child what’s making them feel this way. Or ask an open-ended question such as: I can see you’re having a difficult feeling; can you tell me more about what’s on your mind?

“The first few times your child may not be able to answer this, but over time they might express their concerns or worries,” Barreto says.

Opening that dialogue, rather than making a snap response, is critical, Greenblatt says. “Your child, especially if a pre-teen or teen, may shut down instantly in the face of blank parental contradiction or anger, which may close channels of communication that are critically essential to navigating future personal or familial issues.”

Quite simply, if you invalidate their feelings, “which, remember they are choosing to share with you openly, they may look elsewhere for validation and an open ear,” he says. And that “elsewhere” may perpetuate the problem.

In addition, Siegfried encourages changing the focus of the conversation. For example, emphasize a special talent they have that has nothing to do with how their body looks. Focus on how the body functions rather than how it looks to redirect your child’s attention to what amazing things their body can do completely apart from what it looks like.

Barreto adds that when it comes to compliments, choose carefully what you focus on. Instead of praising a child’s beauty, praise characteristics that can help them “build resilience and good self-esteem,” such as “you were a good friend today” or “you handled your frustration well.”

[Read: 8 Strategies for Maintaining a Healthy Relationship With Food.]

Warning Signs of an Eating Disorder

Because so many young people feel such intense pressure to look a certain way, some may pick up disordered eating habits. Monica Barreto, a pediatric psychologist with Orlando Health Arnold Palmer Hospital for Children in Florida, says “research has shown that among the most frightening and dangerous mental health issues teens struggle with are eating disorders. While most prevalent at the age of 12 to 25, children younger than 12 are also at risk, especially due to health issues related to picky eating and food refusal at an early age.”

She also notes that 15% of female teens have disordered eating, and 9% of 9-year-olds have vomited to lose weight.

This is especially dangerous the younger the child is. Greenblatt notes that “biologically and psychologically, the teenage mind is very much ‘still under construction.'”

Adolescence and puberty is a time of enormous change in a child’s body, and if your child isn’t getting adequate nutrition because they’ve started restricting their eating as a means of countering a self-image of being fat, essential nutrient deficiencies can develop. “These deficiencies may lead to the entrenchment of some of the symptoms of anorexia nervosa (or another eating disorder),” he explains.

If you notice any of the following signs, talk with your pediatrician right away.

Altered eating habits. If your child suddenly changes how much, how often or what they eat, that should prompt you to ask some questions. “A great deal of scientific research has shown that a change in diet often precedes the onset of an eating disorder,” Greenblatt says. “Suddenly restricting foods or entire food groups, such as suddenly adopting a vegan or vegetarian diet” can all be signs of a developing eating disorder. Because veganism and vegetarianism are often seen as virtuous, “becoming vegetarian may be an attractive option for teenagers trying to conceal disordered eating behaviors.”

New behaviors around food. A sudden habit of hoarding food or eating or preparing food in private or otherwise “developing ritualistic behaviors around food” can all signal trouble, Greenblatt says.

A preoccupation with food. “A child or teen struggling with an eating disorder is constantly thinking about their body, weight and what they’re eating,” Barreto says. “It becomes an around-the-clock obsession, which greatly impairs their normal functioning and quality of life.”

Additional warning signs may include:

Anxiety or panic attacks.

— Sudden or new weight loss.

— Constant weighing of oneself or tracking calories.

— Depressed mood, despondency, irritability or anger.

— Dizzy spells or fainting.

— Frequent visits to dieting or pro-anorexia websites.

— Changes in engagement level with family or friends.

— Changes in school performance.

— Sudden increase in exercise duration or frequency.

— A new affinity for baggy clothes, which may be used to conceal rapid weight loss.

If you notice these behaviors, don’t delay in seeking help, Siegfried says.

“I recommend that parents seek help immediately if they have any concerns related to their child’s body image or eating behaviors. Unfortunately, individuals with eating disorders and their family members often delay getting help, with 20% of teens with eating disorders seeking treatment and most individuals waiting six years to get help.”

But early intervention is key, she notes. “Research shows that getting help sooner for eating disorder symptoms improves recovery rates.”

Greenblatt adds that if you’re concerned about your child’s well-being, “it’s never the wrong call to contact a health professional, even if just to ask a few questions, get some information or cultivate reassurances.”

In addition to speaking with your pediatrician and/or a mental health professional, you may also want to connect with a registered dietitian, he says. “An experienced nutritionist will be able to assist with dietary planning and also help to ensure that your child’s meals provide all the essential nutrients required for a growing body and brain.”

Barreto adds that “the most important thing for a parent is to be aware of their child’s thinking and behavior surrounding food and body image and to get them help if there is any concern.”

How to Encourage a Healthy Weight

There are plenty of ways parents can support their kids in developing healthy eating habits.

— Encourage intuitive eating.

— Banish fat-phobic language.

— Make peace with your own body.

— Build media literacy early on.

— Encourage movement for fun.

— Increase intake of healthy foods.

— Refocus on overall health.

Encourage intuitive eating.

Siegfried recommends following an intuitive eating model with kids and to forget some of the rules you may have been taught as a child yourself. “Labeling, outlawing or judging foods contributes to a negative relationship with food. Alternatively, an all-foods-fit approach lays a foundation for a lifelong healthy relationship with food.”

Banish fat-phobic language.

Don’t permit the word fat to be used as an insult, and don’t talk about foods as being “good” or “bad.” Encourage your child to speak up if they hear another child bullying anyone about their body weight.

Make peace with your own body.

“Children are listening when parents berate their own bodies or when they forbid foods for themselves,” Siegfried says. “The way we talk to ourselves is a model for how our children talk to themselves.”

Build media literacy early on.

“The media can be a powerful thing, shaping the way children, teens and even adults feel about themselves and their bodies,” Barreto says, and she notes that “60% of teens with eating disorders have reported that bullying contributes to the development of their disordered eating.”

Social and other types of media that present distorted body imagery are here to stay, so help your child learn how to handle it smartly.

“Educate your children on inaccuracies, distortions and mis-portrayals in social media” and limit their time with social and other forms of media that may promote body image distortions.

Encourage movement for fun.

“It’s important to encourage children and teens to move their bodies to release stress and increase natural feel-good endorphins,” Barreto says. “Refocusing physical activity from weight-loss to overall health and fun can play a significant role in teaching youth that moving their bodies is a ‘get-to'” not a ‘have-to’ activity.”

Increase intake of healthy foods.

“When it comes to healthy eating habits, increasing your family’s intake of fruits and vegetable is a great way to start,” Barreto says. “Trying different protein foods, whole grains and making sure everyone has a good breakfast before starting their day,” are all good ways to encourage your child to develop a healthy relationship with food.

Refocus on overall health.

Barreto says that “refocusing on overall health versus the number on the scale can help any child and family take one step closer to a healthy mind and body.

Lastly, Greenblatt notes that “health is about balance. Health adheres to the ‘Goldilocks Principle;’ too much or too little of nearly anything — be it food, a certain nutrient, exercise, TV watching, social media exposure, etc. — is almost always harmful. What we should be pursuing is that sweet spot in the middle, the ‘just right’ balance that’s optimum for physical and mental health.”

More from U.S. News

Food Swaps to Lose Weight and Eat Healthier

Questions Doctors Wish Their Patients Would Ask

Ways to Shift Your Mindset for Better Weight Loss

What to Say and Do If Your Child Thinks They’re Fat originally appeared on usnews.com

Update 03/16/22: This story was previously published at an earlier date and has been updated with new information.

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