In today’s society, there is a large focus on body image and body “ideals” which are greatly influenced by the barrage of image-focused media messages that we receive daily. Often, ad messages focus on losing weight, looks and “fat-shaming,” rather than on health. The reality is that the number on a scale or one’s clothing size does not determine an individual’s health. Health is a function of genetics, lifestyle, activity level and dietary choices. There is no single way to define what it means to be beautiful.

The media’s push towards a specific “ideal image” can become a dangerous and sometimes life-threatening one, especially for children and teens who are more susceptible to internalizing negative messages. Eating disorders are one way that kids and teens manifest the pressure towards the “thin ideal,” although media and social pressures are not the only contributing factors.

Guiding principles to keep in mind when talking to your child about nutrition and health:

  • Weight is not always a sign of health status. Health is independent from size or weight. Each individual has a natural set point that varies over time, which is their body’s ideal weight range for optimal health. Excessive weight loss can lead to significant physical complications and can be very damaging to the heart, brain, kidneys, muscles, etc. In addition, maladaptive weight techniques, such as fasting, skipping meals, or using weight-loss drugs or supplements can lead to life-threatening conditions.
  • If you have concerns about your child’s eating behaviors or weight, raise them to your child’s doctor. Parental concern can be a strong predictor of the presence or development of an eating disorder. It is important to recognize that doctors are people too, and are subject to the same media messages that other people see. If you feel that your child’s doctor is not taking your concerns seriously enough, or that your child’s doctor is overly focused on encouraging weight loss in your otherwise healthy child, be sure to voice your concerns and raise the conversation about societal pressures and the risks of eating disorders. Remember, you are your child’s best advocate!
  • Model the behaviors and beliefs you want your child to develop. As a parent, your relationship with your body image will influence your child’s own body image beliefs. Be cognizant of the messages you are sending. Criticizing yourself (or others) based on things like body shape, weight and clothing size may lead your child to do the same. Likewise, praising and rewarding oneself (or others) for weight loss also can reinforce the message that weight alone determines one’s value. Send your child the message that people are defined by much more than their physique. Healthy people come in different shapes and sizes, and what really matters is their compassion, creativity, kindness and spirit.
  • Involve your whole family in meal planning and healthy eating.Growing children and teens need nourishment. Develop a culture in your home of eating regularly and healthily with a variety of food groups, rather than focusing on the latest no-fat, no-sugar food trends that often have poor nutritional value.

A few warnings that may signal a developing eating disorder:

  • Sudden weight loss or gain
  • A hyper-focus on calories and the fat content of food
  • Avoiding foods that the child liked to eat in the past
  • Refusing to eat with the family and/or in public
  • Excessive exercise
  • Change in how the teen dresses, including wearing baggy clothes to hide their body
  • Mood changes including more anxiety, irritability or sadness and withdrawal.


Rebecca BegtrupRebecca Begtrup, D.O., M.P.H., is an attending psychiatrist on the outpatient psychiatry team at Children’s National and co-founded the Behavioral Health Feeding and Eating Disorders Program.

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Posts from Rebecca Begtrup, DO, MPH

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