Friday, May 6, 2011

Weighing your Actions. More Guidance on Feeding Children and Managing Weight.

I write this in response to the wonderful comments I received on my Frosted Flakes For Healthy Kids post ( And in honor of all the mothers who blame themselves for their children’s weight and eating issues, whether compulsive overeaters or anorexics, or simply obese without the components to label it a disorder. It is, after all, Mother’s Day this Sunday!
"Grandma the clown" in the Big Apple Circus
On behalf of the mothers reading this, let me confess, we don’t always do or say the right things. We, too, are works in progress. We may not have had the best role models for parenting. Or we may be working on juggling too much—working at a job, parenting, running a household, and lastly attempting to meet our own needs (although that one rarely seems to take much of our time!) Or we may not know what’s the best way to parent, or feed our children, or ourselves. We sometimes know all the right things to say, and inadvertently say the stupidest things. (Yes, I’ll be the first to admit it, boys!)

I’d like to highlight a few points that may have gotten buried in the last post:

I believe in balance.

Yes, there's a place for low nutritional value foods, but in a balanced diet. What is a balanced diet? One that contains a variety of foods and nutrients. It contains generous amounts of fruits and vegetables, as well as dairy sources (or milk alternatives for the vegetarians among you). And yes, it could even be chocolate milk and sweetened yogurts. That, too, is balance.
It includes grains and starches of all types. Sure, higher fiber and whole grain choices have great merit. But white pasta or rice and low-fiber French bread has not caused any health risk as part of the Mediterranean diet. And it includes protein sources from animals or plants as well.

I believe that how we eat matters perhaps more than what we eat, when it comes to weight management.

Eating mindfully, at the table, without distraction truly makes a difference. Yes, I know you and your kids are talented at multitasking, but it just has no place when we are eating. Eating mindfully allows you to acknowledge what you are eating. That may be why my anorexic patients struggle with this task; they often prefer not to know what they eating, not to acknowledge it. Limiting eating to the kitchen or dining room also helps us contain things, to give some order to our eating behaviors. It also elevates our eating, to something special.

Parents are responsible for setting appropriate limits with their kids.

This is as true about eating as all other activities. You can say, “you can buy school lunch, but only once per week”. That is your right. And you can say “instead of Lunchables, I’ll make you Lunchable style meals that you’ll enjoy, while limiting the number of highly processed, high sodium and saturated fat items in this convenience boxed lunch.

We need to educate our children and ourselves that immediate gratification in the name of fullness, comfortable fullness, is a fantasy.

We generally do not observe fullness in the 10-15 minutes it takes us to finish our meal. Rather, there may be stomach fullness, the first stage of fullness around that time, which is more volume dependent and can mislead us. For instance, have a bottle of Diet soda with no calories and you’ll feel full. But that fullness won’t last—and it certainly won’t fuel your body! It can take an hour or so for the our brains to sense fullness. The exceptions to this occur in those with slowed gastric emptying from chronic eating disorder behavior, or with gastroparesis, a delay in stomach emptying from conditions such as diabetes and neurological changes.

Acknowledge that it’s normal to feel hungry immediately after their short meal. But reassure them that they can eat again later (in perhaps an hour) when their body really can tell if it needs more. Then honor it! Allow them to eat again, regardless of the time of night!
Isn't this great? Taken at Chateau Chevernay in the Loire, France

Use your resources!

These days, if you don't know how or what to cook or serve your family, there are plenty of resources to assist you. See an RD for individualized guidance or check out to learn balance and portions. Explore the wealth of cook books, websites, and cooking classes in stores, schools and towns.

Physical activity is key.

 Well actually, balance of intake and activity is what’s essential to consider. If you are restricting your intake, I do not support exercise (unless you can fuel it with enough food!). There have been plenty of studies correlating BMI with the numbers of hours of what is now termed “screen time”.

Preventing “now or never” thinking is critical.

Now or never thoughts about foods can happen because you set restrictions on what foods are acceptable to keep around see Jane’s story in last post). But it can also happen, as Quincy Carole pointed out in her comment on that post, when shopping is limited to one day a week. Knowledge that “when it’s gone, it’s gone” may drive us to overeat around the shopping days. The solution, be sure to reassure that there will always be more. If you can, keep additional packages of favorite snacks, so kids realize that they don’t have to get it all in today!
Thanks you readers for inspiring this post with your honest and most valuable comments!

Happy Mother’s Day!


  1. Hm, I don't know... I'm a new follower - doing well in earlyish but solid recovery from an eating disorder (restriction / over exercise / infrequent bingeing). Maybe I'm reading your posts through the lens of my eating disorder -- I admit that's likely the case -- but I find these posts to be very diet-ish to me. Maybe its that you write in a way that supports intuitive eating... and, yet, when I try to do that, I end up "intuitively" restricting. Maybe I'm just not advanced enough of an eater to be able to read this, which is too bad, because you seem like a really warm person. I read in one of your posts how it was 12:55 pm and you weren't yet hungry for lunch, so you didn't eat it. So, you took a snack as you went out in case you got hungry. So, after I read that, I thought "maybe I'm not hungry for lunch either. In fact, I'm not. So I guess I can just eat my afternoon snack later and skip lunch." I am sure that's not the message to take out of this. I wish it weren't hard for me to read about normal, natural, intuitive eating. It really bums me out.

  2. L,
    Valid points--thanks you! As I've mentioned in various past posts, there are times, such as early in ED recovery, that the signals aren't there or aren't received. Hunger can be blunted by anxiety, meds, disordered thoughts, coffee and diet bevs.,exercise, and starvation. So trying to be intuitive at these times will be ineffective. For you and others, the solution is to be counterintuitive! In spite of a lack of hunger, trust that you need to eat. Validate that this is sensible by healthy changes in your vital signs and weight.

    It is my goal when writing these posts to certainly not be "diet-y". For someone anorexic, it's not about simply gaining weight, but learning how to self regulate food intake. Hopefully you can reread these posts and see that!

    Reading and commenting, to me, is a great step forward toward recovery! I appreciate your sharing your conflicts! Hope you'll continue to follow and get support from these posts.

  3. Thanks for that response. That was helpful. For the first time ever (I've had an ED for about 8 yrs), I've been actually consistent (for the most part) and able to follow my meal plan for the past 12 months (8 months of it spent in residential / day program treatment, so that made it easier), but I was starting to doubt my meal plan and starting to wonder if I should be eating more naturally now. I guess I know I'm a far ways away from that because when I ask to not measure food before plating it, my RD (who I LOVE!!) tells me "not yet." Anyway, I was just starting to doubt and overthink eating... and, this morning, skipped my a.m. snack. Then I was going to just delay lunch until I was "sure" I was hungry. I was like "Hiker RD one day didn't get eat lunch yet at 12:55, so I, too, should not eat lunch until after 1... maybe 3pm... i'll just call my afternoon snack lunch and skip lunch..." Anyway, your response was really good and I did eat lunch. You have such valid points. I have lots of physical evidence that eating lunch regardless of how hungry I feel is healthy for me (not just my vitals and weight - my eyesight has even improved in the past year! and my thinking is less obsessive and circular and repetitive and my body feels more alive and relaxed).

    You say "For someone anorexic, it's not about simply gaining weight, but learnign how to self regulate food intake." Can you elaborate on that at some time? What does it mean to self regulate food intake?

  4. As I see it, weight restoration is only one of the goals of recovery from an eating disorder. All individuals ultimately need to learn how to self-regulate their intake. Meaning, to know when they need fuel, and when they have had enough. To realize that eating more than necessary some days won't "ruin" things. I think for those recovering from anorexia it feels very unsafe to be eating without having the physical signals to rely on, to trust. But for this stage, meal plans are the answer. In time, hunger signals resume, and the connection between food and function becomes more clear.

    Hope that helps.
    And if you haven't yet joined as a Follower, please add yourself (with any identity) to the roster!

  5. Yes, that was good to read. Thank you for your response. I really like your blog - I read a lot of the older posts today. You seem to care so much for your patients :)

    I actually am a follower, I just commented under a different name. See, i don't know who else reads... and if I comment under my "follower name," then I risk some people seeing that I'm back in the "blog world," and I have some people in my real life who would worry about me reading things on the computer regarding food or eating disorders (just to clarify: I never read pro ana sites, but i did read blogs of people trying to recover but still very much in their ED). So, now, when I comment on blogs, I don't use my follower name - because some of your readers may or may not recognize my follower name (due to previous presence on other blogs). So, to the "internet community," my follower name is a lot less anonymous than "L" ... hope that makes some sense.

  6. A wonderful post. Parents do have a large measure of influence in those younger years. I never really thought about "the Saturday shopping trip" effects in "it's now or never thinking".... None (of the goodies)ever were put away. It is interesting when you start to see the early relationship you had with food and where it can lead you without awareness and a conscious decision to change it! It is, as you say, about "balance"... not overindulgence nor underindulgence...

  7. I'm not a mom but found this post VERY helpful, almost like a neat little checklist of things to keep in mind as I go about my day-to-day routine. Lori, you have such a knack for providing even-keeled advice, and I for one very much appreciate it. Not only is this great advice, but it's also manageable and can be easily integrated into even my most hectic of days. Thank you!

  8. So glad you found this helpful, from the perspective of the child, which we all are, (as well as a guide for parenting later in life!)
    Thanks for commenting Quincy Carole and Sara!

  9. Hello, another wonderful post. I have a quick question: What does "screen time" mean? I am still struggling with restrictive eating and exercising. I am really trying hard to learn how to balance nutrition, exercise, and rest. Any insight will be much appreciated

  10. Thanks, Anon, for asking! Screen time includes TV watching, computer, video, etc. The link is with kids' weight and number of hours of screen time (higher screen time, higher weights, in general).

    That being said, it sounds like you are not the target audience, so to speak. For you and others like you, giving yourself permission to sit, to rest, to not pace the house or exercise would be progress. It's key to focus not on general patterns in studies, but to recognize what's relevant for you. For your recovery, to achieve balance, a reduction in activity and an increase in screen time may be just what you need. So never mind the studies--don't let the ED thoughts halt your progress by taking this out of context!

  11. Lori,
    Do you really think it's possible for someone who has been obese most of their life to truly learn to eat intuitively, get to a non-obese weight and stay there? Don't you think it would be helpful for someone who "uses" food to have a set eating/meal plan?

  12. @Anonymous-
    I don't just think it's possible. I know it's possible! The only question is what is the realistic goal weight we are talking about. I believe achieving a healthy weight--a weight the supports a normal blood pressure, cholesterol level, etc and allows you to feel well, and eat normally is absolutely possible(that is, if your weight had an effect on those health measures in the first place!).
    The stories I reference, the case studies, are all real (with a change of names). Yes, real people who have struggled with weight their whole lives can stills change their relationship with food.
    First, you need to to start with belief in yourself and the process.
    Hopefully I've given you that.
    Thanks for your question.
    Keep reading!

  13. This is a very good post and rings true. These things are what I am working on with my family and, especially, my 11 year old daughter now on getting healthy and losing weight. I can definately, say that the 15-20 minute fullness factor is true. I call it the 20 minute rule, with my family.

  14. 'It contains generous amounts of fruits and vegetables, as well as dairy sources (or milk alternatives for the vegetarians* among you).'

    ** only ovo-vegetarians and vegans

    I am a vegetarian and I consume dairy products.

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