Talking to Your Teen About Weight: by Katharine Rogers, PsyD and Stephanie Hosford, PsyD
Today’s blog is another insightful article written by therapists Katharine Rogers and Stephanie Hosford of BASE Cognitive Behavioral Therapy. Stephanie Hosford’s teen group “The Body Project” has openings for their next session, which is a 4-week series beginning on October 2 in Charlotte. Please visit the BASE website for more information or you may reach out to Dr. Hosford directly. Enjoy!
Whether it’s during your teen’s annual physical, in response to a comment your teen has made, or you start to feel concerned about behaviors you are seeing at home, talking to your teen about weight can be a tricky topic to navigate. As eating disorder therapists, we often hear parents express deep care and concern for their children, while also feeling stuck with how to go about communicating these concerns.
First, let’s talk about decoding growth curves and weight changes that might come up in the pediatrician’s office. The more you know, the better equipped you can be to determine what your child needs.
What is a growth curve?
A growth curve measures changes in height and weight over time as it relates to age and sex for your teen.
What is a percentile?
You will see percentiles along your child’s growth curve from the time they are born until age 19. A high or low percentile does not always mean your teen is not healthy. There is no ideal percentile. As long as your teen is following their curve they’ve been on since they were little, their body is growing as expected.
When should I be concerned about weight change?
Significant drops in weight, significant increases in weight (i.e., jumping to different curves), or a plateau in weight gain over time are all causes to check in with your pediatrician. Note: significant weight loss in teens that takes them off their growth curve but still might fall on a “healthy” curve according to BMI charts can still be associated with the same medical complications as an extremely low body weight.
What if they have gained or lost a few pounds?
Teens will have an expected body weight for their height and age, based on their growth curve. This may fluctuate around 5 pounds depending on many factors. A single weight reading does not give us the full picture. That’s why we always want to look at trends over time. It is normal and healthy for teens to gain weight into their mid 20s as they go through puberty.
If your teen has made a negative comment about their body weight or shape, and you find yourself wondering how to respond, let’s talk through a few scenarios.
It is normal for teens to bring up concerns about their weight! We have identified common statements we have heard parents use when a teen brings up body image or weight-related concerns. These responses are all normal and often come from a place of care and concern for your child. We have provided alternative responses and a few notes from the perspective of a therapist.
Responding to Weight-Related Talk:
Common Parent Responses and Alternative Suggestions
Parent: “Oh stop saying that! You are already so skinny! Just look at me and all my belly fat…”(or any area on the body the parent tends to criticize about themselves).
“Therapist Tip: This response may minimize what the teen is feeling, reinforce the value we place on appearance and weight, as well as highlight the parent’s own negative body talk while drawing an unhelpful comparison. ”
Try this instead: “How are you feeling today? Sometimes when I have a really tough day or I’m feeling stressed out, I’m extra critical of my body and appearance. I’m here if you want to talk about it.”
“Therapist Tip: Instead, focus on qualities your teen has beyond appearance while also acknowledging their emotional pain. ”
Parent: “You need to exercise more. Why don’t you start going for runs or going to the gym?”
“Therapist Tip: This may also reinforce that there is something about their body that needs to be changed. It also doesn’t provide much opportunity for the teen to consider the multitude of ways we can engage with exercise. ”
Try this instead: “Let’s move our bodies in a way that we enjoy today as an act of self-care. I typically feel more energized and strong when I prioritize this. What would you like to do together?”
“Therapist Tip: Instead, focus on “life enhancing movement” through social activities that involve body movement, movement just for fun, or finding movement that supports mental health. ”
Parent: “We could try cutting out sweets together.”
“Therapist Tip: Try to take out any judgment in food, such as labeling certain foods as “good” or “bad.” Dieting and restriction is unsustainable, especially for growing bodies.”
Try this instead: “I want us to enjoy all types of foods together, including sweets. However, if you’re interested in learning about balancing the different food groups, we could explore that more together! Maybe there are new foods or recipes we could try?”
“Therapist Tip: Instead, focus on encouraging balanced eating from all food groups, including sweets! Consider an additive (“What can we add to our plates for more nutrition? How can I nourish my body well today?”) rather than a subtractive approach (“What should we stop eating?”) to diet suggestions.”
Finally, if you have noticed potentially concerning behaviors in your teen and want to discuss concerns regarding their weight, consider your goals for this conversation and focus on communicating to them from a place of openness, curiosity, and care.
It may be helpful to ask yourself why you want to talk to your teen about their weight in the first place. If it’s because you are concerned about their health, remember that just as weight is affected by much more than calories and exercise, health is affected by much more than just weight. We encourage parents to always respond with empathy and validation for any emotional pain your teen expresses, while redirecting and reframing any unhelpful focus on size and weight.
The language parents use when communicating with their teens about shape, weight, and diet matters. Studies have shown that when families place the emphasis of their communication on healthy behaviors to improve overall health, rather than on weight changes, kids have better outcomes.
Additionally, we have listed common signs and symptoms of eating disorders in teens:
Skipping meals
Pushing food around on their plate
Cutting food into small pieces
Excessive exercise
Going to the bathroom right after meals
Significant weight loss
Limiting calories/fat/carbohydrates
Not eating around others
Sleep changes/insomnia
Isolation from friends
Preparing food without eating it
Weighing daily or multiple times per day
Eating in secret
Hiding wrappers or food waste
Buying or using laxatives/diuretics/weight loss supplements
Changes in menstrual cycle
We recommend consulting with a trusted medical or mental health professional if you ever have concerns your child may be struggling with an eating disorder. Invite a calm, open, non-blaming conversation with your teen if you have noticed any of these signs. It is okay to express your worries to your teen in a non-punitive, yet firm manner to let them know you are concerned and want to get them the help they may need. Early intervention is key to interrupting the cycle! No one is better equipped to support your child than you as a parent and we are here to help.
To contact Dr. Stephanie Hosford, Dr. Katharine Rogers or inquire about The Body Project:
(704) 910-8381