Estimated read time: 5-6 minutes
ATLANTA — Oona Hanson's child came home from school one day with a desire to eat healthier, which she thought was a positive development.
But six months later, her child was in the hospital with an eating disorder, said Hanson, who didn't want to reveal her child's name and age to protect their privacy.
Hanson, based in Los Angeles, worked for years teaching children, and with a background in educational psychology, she thought she knew everything she needed to in order to avoid eating disorders in her children. But she said her experience showed just how much families need to learn.
Now, Hanson privately coaches parents and caregivers on how to help their children develop a healthy relationship with food and their body. She is also a family mentor for Equip, an eating disorder treatment online service.
Eating disorders impact people of every age, gender and background, experts say, and a study published Aug. 1 in JAMA Pediatrics shows that up to 5% of children ages 9 and 10 show disordered eating behaviors.
Where these disorders come from is a complicated question, said Tom Quinn, director of external affairs of the United Kingdom-based charity Beat, formerly known as the Eating Disorders Association. Eating disorders can have roots in trauma, genetics, body image, societal pressure, disruptions in eating or a combination of all of them, Quinn said.
But what the adult world says can have a definite impact. A study published in July in the journal BMJ looked at how students reacted when schools weighed kids and notified families, letting them know if the child was considered in a healthy weight range. The students — even those who were told they were in a normal weight range — were more likely to try to lose weight after families got the letters, the study showed.
Clearly, negative talk about weight can be harmful, but the study suggested that positive comments can backfire as well. Having a healthy relationship with their food, body and weight can set kids up for a happier life, and there are ways adults can shape the conversation to help, experts said.
Focus on balance
Cookies, broccoli, grilled fish, ice cream, french fries and almonds: Chances are, you can immediately look at the list and distinguish which you think are good for you and which are bad.
Labeling food like that can actually contribute to a poor relationship with food and body, though, Hanson said.
"Many of these messages about food and body come through these Trojan horses," she said. "A lot of behaviors get described as healthy behavior when they're actually very similar to eating disorder behaviors."
Instead of talking about foods as good or bad, healthy or unhealthy, it can be helpful to focus on balance, said Lisa Damour, an Ohio-based clinical psychologist specializing in the development of teenage girls.
What their bodies need will include lots of fruits and vegetables, lots of healthy proteins, it can and should absolutely include foods that are treats just because they're fun to eat.
–Lisa Damour, clinical psychologist
That can mean placing the emphasis on caring for themselves in well-rounded ways, with lots of enjoyable activity, good rest, attention to the body's cues and varied foods, she said.
"What their bodies need will include lots of fruits and vegetables, lots of healthy proteins, it can and should absolutely include foods that are treats just because they're fun to eat," Damour said.
"There are lots of conversations that adults can have with their kids that can address concerns adults may have ... that has nothing to do with talking to children about what they weigh," she added.
Look at what you are modeling
It's important to be mindful of not just what you say to your children about their weight, but also what they hear you say about yourself and others.
Maybe it's admiring the small body of someone on TV, complimenting the weight loss of a friend, or vocally bemoaning your own insecurities: Whatever way you frame weight, your kids will likely start to shape their view based on what they hear, Hanson said.
And much of what they hear tells them that smaller bodies are better and gaining weight is bad.
"A lot of how children learn to navigate the world is by watching," Damour said. "A good place to start would be to examine the patterns within the home."
Changing how you talk about body around your kids is a powerful place to start, but it can be difficult to unravel the shame and stigma from your own vocabulary. In those cases when a critical comment or praise of someone's weight loss slips out, Hanson recommends talking to your child about what happened — even if it's after the fact.
"Go back afterward and say, 'You know what, we were packing for the trip, and I was pulling out last year's shorts and they didn't fit, and I said some really mean things about my body. That comes from an old way of thinking, and I'm really trying to think about myself in a different way," Hanson said.
Change the ratio
We know that criticizing weight and bodies can have a negative effect, but how about positive body comments, such as "you are so beautiful" or "you are in such great shape"?
That's complicated, too, experts said.
"I'm not going to tell somebody that they can't tell their child that they're beautiful," Damour said. But "what we want to do is make sure we are really keeping an eye on how much of the time we are commenting on a child's container, and how much we are commenting on our child's content."
There are ways to talk about a child's body in ways that don't focus on appearance, like complimenting their strength or grace and emphasizing all the great things their body allows them to do, she added.
But in many ways, their body and appearance are "luck of the draw," Damour said.
There is a time and a place to tell your child how special and adorable you find them — just be sure that most of the time you spend is talking about character rather than appearance, she said.
"There are a lot of downsides to commenting on someone's weight, no matter what you're saying," she said. "If you have the option of just not doing it, I think that is a wonderful option to exercise."