This is a topic that comes up for both girls and boys. How a parent responds to it is important. Often, parents are unsure what to say or do and often dismiss it by saying something like the child is being ridiculous and that they should know they are beautiful. In this session note, I will share what I advised this family and others to say and do.
Aren't kids too young to think about their bodies as fat?
I had been seeing Janie for a few weeks when one session her mom came in and asked to speak with me first. When I got in the office with her she said that she had been noticing that her ten year old daughter, in fifth grade, was doing things like staring into mirrors and pulling at her clothes. Over the previous weekend her mother finally asked her if something was bothering her. Janie responded by saying, "I'm fat."
Karen, Janie's mom, was caught off guard. She couldn't believe her little girl was feeling this way. When I asked Karen how she handled it she said that she assured Janie that she was not fat. She told her that she was beautiful and then hugged her.
However, she was telling me this because she didn't think that was very effective. Karen still noticed that her daughter appeared self conscious in her clothing the past couple of days. She wanted help with how to talk to her so I suggested that Janie join us so we could talk about it together.
The first thing I did was set up the environment so that she was comfortable. I knew it was likely a delicate subject so I wanted her to feel safe and relaxed. After some initial catching up about school and sports I asked her about her comment about being fat. When she shared with me how she felt I did the following things to address this concern:
1. Stayed calm - while it's tempting to show surprise and concern, I wanted Janie to know that I could handle her feelings and hold the space for her to say whatever she needed to. I modeled this for her mom and she reflected back that she knew she had a look of disbelief on her face when her daughter told her how she felt.
2. Normalized her feelings - Both Janie and her mother were surprised to hear that upwards of 80% of 10 year old girls are afraid of becoming fat. The way I put that to her was that she was not alone in how she felt or what she was scared of. I explained that many girls are afraid of becoming heavier, taller, developing breasts and getting their period around this age. I then asked her to explain to us in more detail what about her body she was uncomfortable with.
3. Acknowledgement - when Janie shared that she felt her belly was round and hung over her clothes a little, especially in jeans, I nodded my head and repeated what she said. I placed no judgment on what she said, I simply acknowledged it. She then went on to say that her clothes are uncomfortable and that when she does sports she doesn't like the way the uniforms fit. This allowed us to have a conversation about a few important topics including healthy eating, exercise, genetics and body acceptance.
4. Discussed physical development - once Janie explained that she had felt more hungry lately, getting taller, and starting to experience body odor we talked to her about her changing body. We explained that at this age and for the next several years there would be significant body changes and not all of which she will enjoy. We discussed that her hips will widen, her breasts will start to develop, hair will start to grow on her body and that it is all a part of the amazing process of becoming a young woman. When I put it into context as to why her body was changing she seemed more at ease with the process
5. Focused on what she can shape and what she cannot - naturally we transitioned to talking about food choices and exercise but we also listed things that she cannot change about her body such as height, eye color, shoe size and breast size. This allowed Janie to have a more grounded perspective of what she can and cannot control. Her mom shared her own body image when she was growing up as well as the stages of development that she recalled going through. At this point the conversation was more relaxed and approachable. We weren't trying to discount her feelings but rather join her in her fears and help come up with solutions as well as resolutions (like not hating her height because she couldn't do much about it).
6. Asked mom to take an honest look in the mirror - between magazines, social media, television and negative self talk, many moms don't feel great about their own bodies and they show it. When I asked mom what she believed she was role modeling she was honest in sharing that she also tugs at her clothes, doesn't like what she sees in the mirror and talks about that last 10 pounds she needs to lose. She also shared that they have magazines around the house that mostly show thin models and that likely have a poor influence on how she feels. Karen also shared that when stressed she is an emotional eater and that her daughter knows that. We discussed modeling and self care and mom seemed to understand that at times she has engaged in negative self talk around her body image.
7. Focused on the positives - last, I had both Janie and Karen list the incredible things that their bodies can do. They listed things like run, jump, catch, dance and go upside down. We also talked about their brains, their intelligence, their smiles, and eyes. It was a way for them to broaden their view of their bodies and what they are capable of doing.
By having an honest, accepting conversation Janie was able to process her concerns and move forward with a balanced healthy plan. She has been more kind and gentle on herself and others since.
Note: in this case and many others like it, I am not treating an eating disorder. If you suspect that your child may have an eating disorder you should seek professional help.