Many of us have heard about the growing rate of obesity in America. What’s to be done about it? Perhaps we need to go on a diet so we can get thinner. Not so, says Kathy Kater, LCSW, Ph.D.,
Twin Cities therapist who specializes in body image, eating, fitness, and weight issues. Dieting often backfires, and being thinner does not necessarily mean being healthier.
Kater and Dr. Katja Rowell, a Twin Cities family physician specializing in the behavioral dynamics of feeding children, presented several workshops for health professionals, educators, and parents October 5 and 6 in Grand Marais, and they offered a new way of looking at eating, weight, and their affect on health.
“When weight is seen as the problem and weight control is seen as the solution,” Kater said, “we are really contributing to the problem.” In a set of articles on body image, eating, fitness, and weight Kater distributed at the workshop, she wrote, “Advertisers spend tons of money on strategies to make you feel there is something wrong with you. …Undue emphasis on appearance is a formula for unhappiness, chronic stress, and poorer overall health.”
Bias against body fat
America’s standard for beauty is not necessarily healthy, and it doesn’t reflect the diversity of shapes in which people are made. The stigma over carrying body fat, however, is like wearing a report card across one’s forehead, Kater said.
A focus on weight, body size and fat ratio – even by health professionals – can steer people in the wrong direction. Eating disorders, once seen mostly among teens and young adults, are now becoming more prevalent among menopausal women.
“…If the ‘Ugly Duckling’ had continued to compare herself to the ducks, she’d still
be miserable, no matter how beautifully she developed,” Kater wrote. “…Clearly, worrying about weight is not effective on the road to health; indeed, it is detrimental. …Instead, weight bias increases vulnerability to depression, low self-esteem, body dissatisfaction, maladaptive eating behaviors, exercise avoidance, and future weight gain.
“Healthy, well fed, active bodies are diverse in size and shape, from fat to thin and everything in between,” Kater wrote. “Don’t let anyone tell you otherwise, not even your doctor, who may be caught in unhealthy cultural myths about weight.” Being thin is not the same as being healthy, and thin people who are not fit are at greater risk of health problems than heavier people who are
fit.
“Well fed, fit people will always fall along a natural distribution ranging from very thin to very fat – even obese,” Kater wrote.
The dangers of dieting
An emphasis on dieting can backfire, Kater said. “…Eighty-five to 95 percent of weight lost through any type of dieting is regained. …Over time, your body will fight to maintain or resume the shape it was born to be. You may force your body into sizes and shapes that you prefer, but you can’t beat Mother Nature without a tremendous cost.”
Ignoring hunger when dieting is usually counterproductive. “Hunger is an internally regulated drive and demands to be satisfied,” Kater wrote. “If you limit the food needed to satiate hunger, it will backfire, triggering preoccupation with food and ultimately an overeating or compulsive eating response.…Dieters who go off their diets only to binge are not ‘weak willed.’ They are mammals whose built-in starvation response has kicked in – both physically and psychologically – going after what has been restricted.”
Feeding children
Dr. Katja Rowell treats children with eating problems and with parents who are worried – unnecessarily — that their children have eating problems. The most natural thing for a child to do is to eat enough to grow at a healthy pace. Problems will occur, Rowel said, if parents don’t trust that a child’s body will regulate itself.
Rowell sometimes sees parents and babies in power struggles, with parents trying to either restrict food or push it on their children. She tells parents their job is to decide what will be served at snacks and meals. The child’s job is to decide if and how much he or she will eat from what is served.
Some parents quit offering a food if a child refuses to eat it, assuming the child doesn’t like it. She encourages parents to keep offering that food anyway, because he or she may grow to like it if they are introduced to it enough – sometimes up to 40 times before trying it and liking it.
Parents sometimes expect children to eat the same amount from day to day, Rowell said. Some kids might eat two cups of macaroni and cheese at one meal and merely lick a blueberry at the next, however, and this is normal. She encourages parents to look at how much nutrition a child is getting over the course of a week rather than worrying if they get enough of all the food groups each day.
Kids who graze all day tend not to eat as much food at meals or as much variety. Rowell recommended feeding children regular meals and snacks and sitting down to a family meal – which means eating with as few as one “loving adult” – at least four times a week. Babies, however, should be fed as much as they want whenever they want it. Sometimes they need a rest in the middle of a feeding. Rowell recommended finding out what a baby wants or needs when he or she fusses rather than just offering food to pacify him or her.
Parents worried about their children eating too much often have children who binge when given the chance after their eating has been restricted, Rowell said, although that behavior tends to level off as eating becomes less of a family issue. She also said studies have not shown that switching to skim milk has an effect on children’s weight. In fact, “low-fat diets are dangerous for small kids,” she said.
Rowell encouraged parents not to jump to conclusions about food allergies such as lactose intolerance. Suspected allergies should be confirmed by a complete medical workup, she said.
Rowell does not support a trend for schools to assess body mass index (BMI) and report that to parents. The cutoff between “normal” and “obese” is arbitrary, and BMI is not a measure of health. Studies have been conducted on thousands of children in hundreds of schools that have tried to lower body mass index among their students with initiatives in school lunches, gym class, and educational programs, Rowell said, and they have made no difference.
“It’s a lot more complicated than ‘calories in, calories out,’” Rowell said. “We are not merely facing a ‘childhood obesity crisis.’ We are facing a crisis in feeding our children.”
Dr. Rowell’s website can be accessed at www.familyfeedingdynamics.com.
Kater’s website can be accessed at www.BodyImageHealth.org.
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