Thursday, March 22, 2012

Body Image and Teenagers

Q. My daughter is getting ready to go on her first spring break trip with her friends. In preparing for this trip, we have made a couple of trips to the store for bathing suits. They have all ended in an emotional breakdown on her part in which she cries and cries about how fat she is. Now, my daughter is at a very healthy weight. So, I am wondering how I can encourage healthy body image in her, and how do I know if my daughter has a real problem with body image that would require professional help?

A. Today's question will be answered by Christine Baker who works in our Birmingham Office. Christine has worked in residential treatment for eating disorders before coming on staff as an intern at Pathways Professional Counseling.

First, I would like to point out that you are not alone in your struggles with your daughter and her body image. A study (Nichter, 2000) indicates that 90% of teenage girls frequently think about their body image, and that 86% of teenage girls are dieting, or think they should be. This results in approximately 10 million females in the U.S. having eating disorders. So, what is causing this body image epidemic? According to the Mayo Clinic (2010), factors that may harm a girl’s body image are the following: having a mother who is overly concerned about her own weight or her daughter’s weight or appearance, natural weight gain and other changes caused by puberty, peer pressure to look a certain way, media images that promote the ideal female body as thin, and being teased about her weight. These girls who are struggling with negative body image are at higher risk of developing mental health problems, including low self-esteem, depression, and eating disorders.

So, now for your question: What can I, as a parent, do about it? My first thought would be to look inward. As cheesy as that sounds, many mothers have their own, unresolved issues about their weight and body image that are inadvertently holding their daughters back from creating that healthy sense of self. Some questions that you may ask yourself could be: Do I like my own body? Do I keep negative feelings about my body to myself, rather than voicing them to my daughter? Am I satisfied with the way I look in clothes? Do I diet frequently, and/or does my weight “yo-yo” up and down? This can be a difficult and embarrassing process, but it is extremely important because the way that you think about your body or weight will be communicated to your daughter and impact the way she thinks about her own body or weight.

Not only should we examine our own lives, but we should also look at what we are talking about with our daughters. The Mayo Clinic (2010) claims that the best way to encourage healthy body image in our daughters is to talk about body image with them. Some topics they suggest are:
  • Explaining the effects of puberty and genetics. Make sure your daughter understands that weight gain is a normal part of her development, especially during puberty. Also, explain that body shape is largely influenced by genetic factors.
  • Discussing media messages. Television, movies, websites, magazines, and even some of your child’s favorite toys may send your daughter the message that only a certain body type is acceptable. Examine what your daughter is watching and reading and encourage her to discuss those messages with you.
  • Discussing self-image. Discuss with your daughter about her self-image. Ask her what she likes about herself and explain what you like about her, too. Your acceptance and respect can help build self-esteem and resilience.
  • Using positive language. Stop using the words “fat” or “thin” as a part of your everyday vocabulary. Encourage your family and friends to refrain from using hurtful nicknames or joking around about people who are overweight or have a large body frame.
Some other helpful strategies that require changes in behavior rather than conversation are as follows:
  • Team up with your family doctor. Your family doctor can help your daughter set realistic goals for body mass index and weight based on her personal weight history and overall health.
  • Help establish healthy eating habits. Make sure that your household pantry and kitchen is stocked with healthy choices. If your daughter only has bad food to choose from, she is not going to have the opportunity to establish a very healthy diet.
  • Counter negative media messages. You will probably not be able to shield your daughter from all the negative media messages out there regarding body image. However, you can provide her with books, magazines, movies, etc. that applaud women for their achievements rather than their appearance. (Example: You could give your daughter a subscription to a news magazine instead of a fashion magazine).
  • Praise achievement. Help your daughter value what she does instead of what she looks like.
  • Encourage physical activity. Participating in sports and/or other physical activity helps to promote good self-esteem and a healthy body image.
If you have started implementing some of these changes into your family’s life, and your daughter is still really struggling with body image, here are some questions to ask yourself: Is my daughter isolating herself from friends and family? Is my daughter making excuses for missing meals and/or snacks? Is my daughter wearing baggy clothing to hide weight loss? Is my daughter spending a lot of time in the bathroom, or is my daughter exercising more than normal? If you are answering “Yes” to some of these questions, there is a possibility that your daughter’s poor body image has gone beyond the point of most teenagers'.

The first thing I would suggest you do would be to talk to your daughter about your concerns. When you confront her with your concerns, make sure that you are focusing on the behaviors that are worrying you (i.e. missing meals, excessive exercise, etc.) rather than the weight loss itself. You do not want to inadvertently encourage her bad behaviors. If things don’t get better, you might need to contact your family doctor, a psychiatrist, and/or a professional counselor to have your daughter assessed for an eating disorder. Another assessment scale available is the Eating Attitudes Test (EAT-26). This assessment is considered to be the most widely used screening measure to help identify the symptoms and concerns characteristic of eating disorders. You can use the EAT-26 to help you determine if you need to speak to a mental health professional or physician and get help for an eating disorder. It will take you about two minutes to complete. The EAT-26 is not designed to make a diagnosis of an eating disorder or to take the place of a professional diagnosis or consultation, so speaking to a therapist would still be the best way to assess the severity of the problem.

I hope you find this information on how to encourage a healthy body image in our daughters helpful, and remember, the most important thing you can do is to communicate, communicate, and then communicate some more!

Mayo Clinic Staff. (2010, June 5). Healthy body image: Tips for guiding girls. In The Mayo Clinic. Retrieved December 14, 2011
Nichter, M. (2000). Fat talk: what girls and their parents say about dieting. Cambridge, MA: Harvard University Press

Thursday, March 8, 2012

Importance of Family Time

Q. As the weather warms up outside, our family is getting ready for a busy spring. I want to make sure, though, that we are spending time as a family. We would love some ideas of how to spend quality time together as a family.

A. Family time is very important, and I am glad that you want to make it a priority. Many families struggle to know how to spend time with one another in today's technological age. With cell phones, Facebook, computers, televisions and game consoles, there are so many ways we can distract ourselves and keep from spending time together. Covenant Eyes recently ran an article that said "Since 2007, there has been a sharp drop-off in the amount of face-to-face time families spend together in Internet-connected households. In the first half of the decade, family face time has dropped from 26 hours per week to 18 hours in 2010."1 Because of this sharp decline, families need to be very intentional about spending time together and actually face to face. The article goes on to say that "up to 47% of people have felt ignored by a family member due to internet usage."2 That is a staggering number.

Don't just think it is kids or teenagers spending too much time online either. As counselors, we often hear of kids who feel their parents are online too often or spending too much time on Facebook or other social media sites. We are all responsible for this decline in face-to-face time, which means we all have a part in making it better.

Recently, there has been a great deal of research on family dinners and how they help kids and teenagers feel connected. "Archives of Pediatrics and Adolescent Medicine" found that "frequent family meals are associated with a lower risk of smoking, drinking and using drugs; with a lower incidence of depressive symptoms and suicidal thoughts; and with better grades in 11-to 18-year olds."3 If a simple family dinner can do all of that for your children, imagine what more face to face interaction might do for them.

Now that we have established the importance of time together, let's talk about some things you can do to have fun as a family:
  1. Grab some outdoor games such as cornhole, a ball and glove or bocce ball and play an outdoor game together. You can go to a park or simply do this in your back yard.
  2. Make sure to have at least three family meals a week together. Sit around the table and talk. Make sure you are not using this time to be on the phone or watching TV.
  3. Have a board game night. There is nothing more fun than getting out the Monopoly game or a deck of cards. This kind of interaction can lead to not only fun, but also some great conversations.
  4. Go for a hike. You mentioned the weather warming up. Look for places close to your area where you can get outside and be active with one another.
  5. Ride bikes together as a family. Dust off those old wheels and get to peddling. Being physically active together and going on an adventure with your kids is always a good idea.
There are many other things you can do together as a family too. Just make sure to unplug and spend quality time together. It may take some time to get used to not being plugged into technology, and it may be hard for your kids at first, but after a while, all will get use to the family's new way of functioning. Try it out and let us know how it goes.

*This column is not intended to substitute for an actual session with a licensed counselor.

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