Encouraging Healthy Eating
The first week in February (Feb 1-7 2020) was Eating Disorder Awareness Week (EDAW) in Canada. This is an educational initiative designed to bring more understanding towards eating problems, and to promote insight regarding the factors that contribute to the onset, severity, and maintenance of these problems. In honour of EDAW, we have prepared a short post with some suggestions on how to promote non-disordered eating (or “healthy” eating) in children and youth, which focus on creating an environment conducive to balanced eating thoughts and behaviours.
Before we dive into some suggested “Do’s” and “Don’ts”, here are some helpful definitions:
- Eating Disorder: A defined, diagnosable condition characterized by cognitions and eating behaviours that are disturbed, and may lead to a change in weight/shape. The DSM-5 contains the diagnostic criteria that define and categorize the eating disorders according to thoughts (e.g., obsession with thinness), behaviours (e.g., bingeing, purging, laxative use, exercise), and physiological indicators (e.g., weight, BMI). Examples include: Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.
- Disordered Eating: Eating behaviours that are considerable “abnormal” and problematic, such as cutting out entire food groups when not medically unnecessary (e.g., refusing to eat carbohydrates), bingeing, purging (vomiting on purpose), obsessive calorie-counting, dietary restriction, rigid thinking or rigid control around food. When disordered eating behaviours become severe, they may warrant an eating disorder diagnosis. Ultimately, these are behaviours that interfere with “normal” behaviour around food, for example, fear and panic around Thanksgiving, avoiding food-related events, etc.
- Diet: An individual’s typical daily intake.
- Dieting: Deliberate attempts to control one’s weight or shape by controlling one’s dietary intake and exercise. “Extreme” or “Fad” diets often require the participant to eliminate entire food groups (e.g., raw food, paleo/keto, cabbage soup diet, etc.) or consume a concerningly low amount of calories (e.g., 1200 kcals for a young active woman, when the recommended amount is around 2200 kcal).
In order to encourage balanced nourishing eating behaviours, DO:
- Model balanced eating and a positive attitude around food.
- Children and youth learn how to behave with food by doing what they see, i.e., acting how their parents act. From a young age, parents are by far the most influential source of information about food, eating, and exercise.
- Some specific ideas to try include:
- Encourage variety. Eating a variety of fruits, vegetables, grains, and proteins will help combat restrictive or restrained eating, and has the added benefit on enhancing the variety of vitamins and minerals consumed through the diet.
- Model the relaxed use of “fun foods”. There is absolutely a place, in any diet, for fun foods such as chocolate, chips, ice cream, etc. If children and youth observe parents enjoying it with moderation, they will learn this, and potentially avoid an “all-or-nothing” mindset with food, which can lead to bingeing in adulthood.
- Model pleasure. Food is inherently enjoyable, and a healthy mindset with food acknowledges that foods must be delicious to be satisfying. Modeling pleasure may prevent children and youth from developing a rigid mindset (e.g., “food is just fuel”), which often leads to rigid eating behaviours, and shame around wanting or “craving” delicious foods.
- Use “Gentle Nutrition”. Gentle Nutrition is a concept developed by the authors of Intuitive Eating (Tribole & Resch, 1995) which emphasizes that nutrition is not an all-or-nothing behaviour, i.e., you will not become nutrient-deficient if you happen to eat fewer vegetables than the recommended amount one day, or if you eat cake one day for your snack rather than yogurt – your weight also will not be drastically affected by this either. It is our collective behaviours overtime that matter. This can help to further combat rigid thinking around the nutritional value of foods.
- Model intuitive and mindful eating. Intuitive eating refers to our ability to notice and respond to our hunger, fullness, and satisfaction cues, and use this internal information to drive our eating behaviour rather than external factors (e.g., time of day, calorie count, “allowed foods” from a diet, etc.). Mindful eating refers to the ability to be fully engaged in eating, and eating without distraction or avoidance. It can involve commenting on the interesting colours, smells, sounds (hello Rice Krispies!), tastes, and mouth feel of various foods, without judgment.
- Model healthy body image, and body acceptance.
- Just as with #1, children and youth learn how to treat their bodies by seeing how parents treat their own bodies. It is an unfortunate reality that most women have dieted or will diet, and many of them engage in self-deprecating talk around food and body image. A common example is: around Christmas, commenting on how treats will go “straight to my thighs” and discussing New Years resolutions around dieting. Often, children and youth take that as an indication that they should also try to change their weight and shape, and punish themselves for enjoying food. There is an overwhelming amount of research that shows that dieting does not work long term (and in fact leads to weight gain overtime) and promotes disordered eating behaviours. One of the most effective ways to prevent eating disorders is to discourage dieting in youth, and promote body acceptance.
- Model joyful movement.
- Exercise is most healthful when it focuses on joyful movement and fun, rather than regimented activities designed to burn as many calories as possible. In order for children and youth to remain active in adulthood, it is important for them to find activities that promote movement and pleasure. A great place to start are team sports, but activities like swimming, walking in nature, yoga, etc. are other good examples. Engaging in active movement as a family is another way to promote a healthy mindset around activity.
- Model Help-Seeking.
- If you are struggling with a mental illness or disordered eating, consider seeking help for it. Children and youth do what they see, and seeing a parent acknowledge a struggle without shame and seek help for it, is very powerful.
In order to prevent disordered eating behaviours, DROP (or Don’t engage in):
- Diet talk. Diet talk refers to negative and distorted talk about food. It includes “moralizing” food into “good” and “bad”, calling yourself “naughty” for having eaten something (e.g., having a second piece of cake), and planning ways to “compensate” for this transgression, e.g., “Now I have to workout for twice as long”. Avoiding these may allow children to develop a more balance, neutral mindset around food and exercise, which may help prevent the emergence of a restricted or rigid mindset.
- Body talk. Negative body talk is similar, and refers to critical or negative comments about self or others. Generally, when parents comment on their own weight or the weight of their children, it can lead to the emergence of body dissatisfaction in youth and the onset of dieting and disordered eating behaviours. Some parents may be concerned that their child is “overweight” or “obese”, and believe that criticizing their weight may “inspire” them to lose weight. Remember: there is no evidence that dieting works long term, and most people regain the weight they lost and more. Thus, diet/body talk mostly make children and youth feel bad about themselves with no effective way to “solve” the perceived “problem”. Encouraging children to diet often leads to lifetime struggle with food and weight. Furthermore, people can enhance their health by focusing on health-promoting behaviours (variety in diet, movement), irrespective of weight. If you are concerned for your child’s health, consider consulting with a weight-inclusive professional, such as a Health at Every Size (HAES) dietitian. Promoting body acceptance and neutrality around food is the most effective strategy to try.
- Dieting behaviours. Again, children and youth do what they see. If they see their parents avoiding bread, or having a different meal than the rest of the family, they may internalize this and develop similar behaviours. An important thing to reflect on as a parent is whether or not you have a problem with food or eating that may need treatment. There is no shame in acknowledging this, and in fact, modeling help-seeking when needed is one of the greatest gifts you can give your child.
The above recommendations are suggested in order to create an environment for your children most conducive to healthy, balanced eating and body acceptance. They are just a place to start. If you are concerned that you or someone you know may be struggling with an eating disorder of disordered eating, please consult the resources below. We also have a number of clinicians at Insight Psychology who work with individuals with eating disorders, and many take a family approach. Please contact our admin today.