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Over the past few weeks we’ve been looking at growth, development, and its impact on nutrition and appetite. First of all we looked at babies and little kids; why we measure them, and what to expect in the first few years of life. Last week we looked at how puberty starts earlier than we typically think it does and how it’s an enormously energy and nutrient intense process, with some very active kids requiring as many as 4,000-5,000 calories per day to meet their needs during puberty. Woof.
This week I want to focus on the emotional impact that rapidly changing bodies can have on teens and their embodied experience. We’ll talk about what it means to have ‘positive’ body image, how to support kids as they feel increasingly alienated from their bodies, and how to answer when they ask ‘am I fat?’, especially if they are actually fat.
Before we get into it though, if you suspect your teen is struggling with disordered eating or an eating disorder, speak with your GP who can refer you to local eating disorder services. The eating disorder charity BEAT have some helpful information about how to discuss things with a GP and what to expect at the appointment. If you've noticed your teen is in eating and body image distress, it's important not to make it about the food. So rather than saying things like 'why won't you just eat something?', you could say 'I've noticed you don't seem yourself, would you like to talk about how you're feeling'. In other words, encourage a conversation exploring the underlying problem, rather than focussing on the behaviour. If your teen has lost a lot of weight very quickly and you're worried about their physical health then that may warrant a more direct conversation earlier on. But again, try not to make it about their appearance or behaviours; share your concerns but keep it objective. 'I know you've been struggling with food for a while now and it hasn't got better on it's own so it's time we get some help. I know it's scary but I/other parent/carer/family member will be with you'.
Puberty is a vulnerable time for body image
In last week’s essay I talked about the reason why putting kids on diets is related to a higher risk of disordered eating and eating disorders. The thinking is that a negative energy balance can trigger an underlying genetic predisposition. I once heard eating disorder researcher Cynthia Bulik describe it as being similar to someone with an alcohol dependency having their first drink. For most people, hunger makes us miserable and motivates us to get something to eat. For those who have that underlying predisposition, hunger can bring a sense of calm and relief (which is also why it’s very difficult to convince people with an ED that they’re harming themself).
But even for people who don’t have an underlying predisposition towards an eating disorder, I still don’t recommend putting kids on diets ever (or anyone for that matter, see here).
This is because it reinforces the message that they’re getting from every angle: that their body is wrong. That it’s a problem that needs to be solved. Why would we want to collude with this?
Puberty is a time of rapid changes to the body; not just weight and height, but hormonal changes, brain development, and changes to the hair, skin, teeth, sweatiness and body odour. Kids’ appearance will change a lot as they approach adulthood, and for many teens their bodies might feel out of control and alien. They will reach sexual maturity and might start to explore romantic and sexual relationships for the first time. This is all happening alongside exam pressure, an increasingly complex and shifting social and emotional landscape, social media, AI, the manosphere (!!!), online bullying, IRL bullying, and increasing appearance based pressures.
With teens it’s not a case of if they experience body image distress, but when.
