Youth, Diabetes and Obesity: How to Promote Health without Damaging Self-Esteem

Youth, Diabetes and Obesity: How to Promote Health without Damaging Self-Esteem

A new study published Sunday in the New England Journal of Medicine confirmed what conventional wisdom might assume: teens with Type II Diabetes are struggling to manage it. Three treatment approaches tested in this study funded by the National Institute of Diabetes and Digestive Kidney Diseases (i.e. not a pharmaceutical company) showed significant incidents of treatment failure, adverse affects and hospitalization. In short, prevention seems to be the most critical intervention.

With obesity as a leading cause of Type II Diabetes, this latest study underscores the urgency for parents to learn how to talk to children about their health and their bodies. We live in a country in which 1 in 3 children becomes obese by the age of 5. Michelle Obama's "Let's Move" campaign is a brilliant effort to address this epidemic, focusing on increased awareness of nutrition and the importance of exercise, emphasizing critical participation by parents.

But it's tricky. So many teens and adults with whom I work indict painful conversations in which a parent commented on their weight as the tipping point for low self-esteem, eating disorders, depression or anxiety. While these clinical issues aren't caused by one moment in time, we want a conversation with a parent about weight to be a protective factor, not a risk. Here are some suggestions to promote health without attacking self-esteem.

The Set-Up

What's in your pantry? Start with an inventory of what you're providing your child in terms of nutrition. Are you offering healthy and appealing snack foods for after-school hours? Have you helped your child to identify foods she loves to eat but that also happen to be nutritious and filling?

Are you a healthy role model? Demonstrate healthy habits by eating when you're hungry and stopping when you're full. Don't talk obsessively about diets or food restrictions, such as no-carb or gluten-free. Be active.

Active but not athletic? Just because your child doesn't participate in soccer, gymnastics or basketball doesn't mean he's relegated to couch potato. Walking, yoga, Wii Fit or impromptu family dance parties make for good alternatives. Be creative. Make sure your child has the opportunity to be active during the school week and on the weekends.

Our own lenses? Our own painful experiences of body image impact how we see others. Before you decide that your child's weight is a concern, check in with your child's pediatrician to find out what the normal weight range is for your child.

The Conversation

Talk about health not weight. Children, adolescents and teens in particular, are vulnerable to comments about how they look. Telling them they're overweight or not looking good will only make them feel bad. Instead, explore how they make decisions about food and exercise in service of health, not appearance.

Find out about challenges to healthy living. Ask what obstacles make it hard to exercise. Are they getting enough downtime to rest and recharge? What do they know about nutrition? Do they have enough time between activities to eat well?

Help them attune to their own hunger and fullness. So many factors interfere with our ability to listen to our bodies. (Check out Intuitive Eating by Elyse Resch and Evelyn Tribole for more on this). The eyes are indeed often bigger than the stomach.

Do not criticize. From genetics to lack of information, the dynamics contributing to obesity are painful and complicated. Do not make your child feel that being overweight is about being weak. Instead, support your child in creating a lifestyle, tailored to who he is, what's realistic for him, and what's going to promote health. 

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Lucy Rimalower, MA, MFT More Articles By This Author

Lucy Rimalower is a Licensed Marriage and Family Therapist practicing in Los Angeles, Ca. Lucy offers psychotherapy to individuals, couples and families with a variety of treatment needs. Her specialties include working with teens, body image issues, families with same-sex parents, and the unique pressures of the entertainment industry. Lucy facilitates workshops for adolescents on issues such as self-​esteem and the media, drawing upon her experiences in both the field of psychology and the entertainment industry. She has provided consultation for film and television on such topics as adolescent sexuality and couples counseling. www.lucyrimalower.com