Empty Plates and Empty Promises: Dieting and Diet Culture in Children

Caroline Christian, Ph.D. Student in the EAT Lab
 
​Every parent wants to help their child lead a happy and healthy life. For parents of children in larger bodies, this can feel like a difficult challenge. Many parents are left scrambling, without much guidance, to find answers.
 
The question, “How do I help my child be healthy?” may lead to a google search, with search terms like, “diets for kids” and “child weight loss.” This quick search can then lead to a rabbit hole of ads and articles about dieting and weight loss products for kids, most of which are aimed at “helping” parents and kids in larger bodies. However, lurking behind the guise of health are pages of products selling thin- (rather than health-) focused weight loss programs to hopeful parents, and even some targeted directly to young children.
 
What is not reflected in these ads, however, is the immense short- and long-term harm of dieting in children, specifically diets that involve restricting calories or nutrients to promote weight loss. We live in a diet culture, which means we live in a society that values thinness and equates thinness to health, morality, and beauty. Diet culture promotes losing weight at all costs, even health. Diet culture messages about weight loss are not limited to google; they are all around us, and all around our kids. Now, more than ever, parents must critically consume information about dieting and weight loss and consider how we share these messages with our children. 

A recent scientific review suggests that children’s negative beliefs about larger bodies are influenced by many sources, including peers, parents, teachers, and media use.(1) Such harmful beliefs about weight can begin by around age 3, and dislike of one’s own body often begins around ages 5-7.(2) As young children are exposed to negative messaging and stereotypes about larger bodies, restrictive dieting behaviors become more prevalent. In one study, approximately 60% of 6-13 years old have engaged in restrictive dieting and in a national epidemiological study, approximately 20% of middle school children have used extreme weight-control behaviors, such as skipping meals.(3)

​Importantly, dieting is associated with many negative short- and long-term health outcomes. First, although it may sound counterintuitive, research shows that dieting for weight loss in children predicts overeating and weight gain.(3,4) This is because restrictive diets trick the body into thinking there is limited access to food. In order to protect against starvation, the body lowers metabolism, redirects energy, and stores as much energy as possible to try to gain weight.(5) Cycles of restrictive dieting, especially from a young age, raises the body’s natural healthy weight and increase risk for serious health issues, including heart disease and type II diabetes.(6)
 
All bodies respond to dieting this way; however, children are still developing physically and cognitively, which adds additional dieting risks. For example, if a child is not receiving adequate nutrition due to restrictive dieting, the body will start redirecting nutrients to the vital organs, which leaves limited energy for growth, puberty, and brain functioning. Children who are on diets, even children in larger bodies, may experience stunted growth and delayed puberty.(7) Additionally, children who are on restrictive diets may have difficulty with learning, memory, and attention, due to the brain not receiving the nutrients needed for proper functioning and development, leading to challenges at school and socially.(8)
 
Beyond these physical and cognitive effects, dieting and diet culture messages can take a great toll on children’s and teens’ mental health. Studies suggest that dieting during childhood or adolescence is one of the most important predictors of the onset of eating disorders during this stage.(9) Additionally, experiencing and internalizing diet culture messages is associated with high levels of depression and anxiety and low self-esteem.(1) As children start receiving messages that thin = healthy, good, or beautiful, they often start to view their own body more critically. Children and adolescents who do not meet this thin appearance ideal may feel as though they are the opposite – unhealthy, bad, or ugly – leading to higher depression and anxiety symptoms. In fact, children who have experienced weight-based discrimination are almost twice as likely to engage in self-harm or suicidal behaviors compared to their peers.(10)

Given the risks associated with dieting and diet culture for children in larger bodies, it is especially important for parents, caregivers, and teachers to take an active role in helping promote healthy behaviors in children, without the negative consequences of dieting. Below are some strategies supported by science:
 
1. Remove value labels on foods. One of the most prevalent diet culture beliefs is the idea that some foods are “good” and other foods are “bad.” Most restrictive diets and weight loss plans, including those designed for children, classify some foods, like pizza, ice cream, and pasta, as
“bad.” These messages are quickly internalized by children, who may begin to avoid many “bad” foods, greatly limiting their food variety, and leading to feelings of shame and guilt if they do eat these foods. It is natural for children to enjoy sweets. Incorporating sweets in moderation into a child’s diet can help reduce cravings for and overeating on these kinds of foods. Discussing how different foods make the body feel can also help children build intuition about how to best fuel their body. For example, a child may quickly recognize that a donut for breakfast everyday may not give them the lasting energy to pay attention at school. Listening to their body’s needs is a helpful way for children to start making decisions about food, compared to making decisions based on what the scale says.
 
2. Model healthy eating and body image behaviors. It is no secret that children learn from their parents. Disordered eating in children is directly related to parents’ disordered eating and conversations with parents about eating.(12) When children hear adults saying things like, “Oh, I get to eat this because I worked out this morning,” “I’m so hungry, but I can’t eat because I am already at my points for today,” and “I shouldn’t wear this, it makes me look fat,” it is natural for them to start believing the same things about themselves. These statements put children in a box of feeling like they need to earn their food, restrict their food, and shrink their body. Even if parents are doing everything to feed their child a balanced and nourishing diet, children can still develop unhealthy beliefs about food and their body if parents’ model restrictive eating or negative body talk about themself.
 
3. Teach effective emotion regulation skills. One major cause of unhealthy eating patterns is using food to cope with emotions. While emotions are a natural part of eating, if over- or undereating are one of the only coping skills that a child has, it can lead to a dependence on food to feel good. Parents and teachers have a unique opportunity to help children respond to emotions effectively from a young age. Rather than responding to children’s emotions with food-related rewards or consequences, like “You can get a lollipop if you stop crying,” other strategies may be more helpful and sustainable. For example, parents may help children with taking deep breaths, communicating about their emotions, and practicing basic mindfulness. You can read more about emotion regulation for kids here.
 
4. Diversify experiences around food. Diet culture thrives on the belief that food can be used and manipulated to change one’s weight or body shape. However, the reality and complexity of nutrition is much richer and more enjoyable. By involving children in various parts of the process around food, like taking them to the grocery store or local farms, watching programs like Waffles & Mochi, and letting them help cook dinner, children can begin to see food as more than calories. These experiences also help kids learn about and understand how nutrition can be rewarding.   
 
If you are interested in reading more about the empty promises of dieting and diet culture or how to better support children with developing healthy eating and body image, below are resources for continued reading and learning.
 
Health At Every Size: The Surprising Truth About Your Weight
How to Raise a Mindful Eater: 8 Powerful Principles for Transforming Your Child's Relationship with Food
Why Diets Make Us Fat: The Unintended Consequences of Our Obsession With Weight Loss
Kids, Carrots, and Candy: A Practical, Positive Approach to Raising Children Free of Food and Weight Problems
Your Dieting Daughter...Is She Dying for Attention?

References:

1. Puhl RM, Lessard LM. Weight Stigma in Youth: Prevalence, Consequences, and Considerations for Clinical Practice. Curr Obes Rep. 2020;9(4):402-411. doi:10.1007/s13679-020-00408-8

2. Jensen M. Body Dissatisfaction and Weight Bias in Children. Undergraduate Honors Capstone Projects. Published online May 1, 2019. doi:https://doi.org/10.26076/a9d6-14f6

3. Tanofsky-Kraff M, Faden D, Yanovski SZ, Wilfley DE, Yanovski JA. The perceived onset of dieting and loss of control eating behaviors in overweight children. International Journal of Eating Disorders. 2005;38(2):112-122. doi:10.1002/eat.20158

4. Field AE, Austin SB, Taylor CB, et al. Relation Between Dieting and Weight Change Among Preadolescents and Adolescents. Pediatrics. 2003;112(4):900-906. doi:10.1542/peds.112.4.900

5. Rose KL, Evans EW, Sonneville KR, Richmond T. The set point: weight destiny established before adulthood? Current Opinion in Pediatrics. 2021;33(4):368-372. doi:10.1097/MOP.0000000000001024

6. Roybal D. Is “Yo-Yo” Dieting or Weight Cycling Harmful to One’s Health? Nutrition Noteworthy. 2005;7(1). Accessed August 31, 2021. https://escholarship.org/uc/item/1zz4r4qk

7. Campbell K, Peebles R. Eating Disorders in Children and Adolescents: State of the Art Review. PEDIATRICS. 2014;134(3):582-592. doi:10.1542/peds.2014-0194

8. Datta N, Bidopia T, Datta S, et al. Meal skipping and cognition along a spectrum of restrictive eating. Eating Behaviors. 2020;39:101431. doi:10.1016/j.eatbeh.2020.101431

9. Neumark-Sztainer D, Wall M, Guo J, Story M, Haines J, Eisenberg M. Obesity, Disordered Eating, and Eating Disorders in a Longitudinal Study of Adolescents: How Do Dieters Fare 5 Years Later? Journal of the American Dietetic Association. 2006;106(4):559-568. doi:10.1016/j.jada.2006.01.003

10. Sutin AR, Robinson E, Daly M, Terracciano A. Perceived Body Discrimination and Intentional Self-Harm and Suicidal Behavior in Adolescence. Childhood Obesity. 2018;14(8):528-536. doi:10.1089/chi.2018.0096

11. Robinson E, Sutin AR. Parents’ Perceptions of Their Children as Overweight and Children’s Weight Concerns and Weight Gain. Psychol Sci. 2017;28(3):320-329. doi:10.1177/0956797616682027

12. Berge JM, MacLehose R, Loth KA, Eisenberg M, Bucchianeri MM, Neumark-Sztainer D. Parent Conversations About Healthful Eating and Weight: Associations With Adolescent Disordered Eating Behaviors. JAMA Pediatr. 2013;167(8):746. doi:10.1001/jamapediatrics.2013.78

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