Being neither overweight, nor a girl, nor a parent, I'm totally out of my depth here.
August 18, 2010 7:41 AM Subscribe
ParentingFilter: best approach for dealing with childhood obesity?
A friend of mine is father and custodial parent of two daughters, one of whom has a serious long-term weight problem. She's 12 or 13, not especially tall, and well over 200#. This likely has a genetic component; mother also has weight issues, and ultimately got (semi-successful) bariatric surgery.
My friend has tried many approaches over the last few years -- encouragement, family exercise outings, bought DDR for the Wii, etc. Nothing has worked; she's only gained weight. Her doctor recently labeled the girl "morbidly obese" and is worried about her health.
My friend, out of ideas, is resorting to a sort of force, i.e. forbidding junk food of any sort to even be in the house, limiting meal sizes and such. In response his daughter sneaks extra food, buys junk food surreptitiously and otherwise seeks to eat as she pleases. Complicating the matter, the girls' (very troubled) mother dispenses candy and snacks during visitation, using them to buy the girls' affection.
My friend occasionally talks to me about what a struggle this is. I don't know what to tell him. I'm very skeptical that any long-term good will come from forcing his daughter to lose weight. On the other hand, I don't have any better ideas. Do you? What's been your experience in similar situations?
Please assume that the medical end of this is already being seen to. I'm primarily interested in the psychological issues involved, rather than possible diagnoses.
A friend of mine is father and custodial parent of two daughters, one of whom has a serious long-term weight problem. She's 12 or 13, not especially tall, and well over 200#. This likely has a genetic component; mother also has weight issues, and ultimately got (semi-successful) bariatric surgery.
My friend has tried many approaches over the last few years -- encouragement, family exercise outings, bought DDR for the Wii, etc. Nothing has worked; she's only gained weight. Her doctor recently labeled the girl "morbidly obese" and is worried about her health.
My friend, out of ideas, is resorting to a sort of force, i.e. forbidding junk food of any sort to even be in the house, limiting meal sizes and such. In response his daughter sneaks extra food, buys junk food surreptitiously and otherwise seeks to eat as she pleases. Complicating the matter, the girls' (very troubled) mother dispenses candy and snacks during visitation, using them to buy the girls' affection.
My friend occasionally talks to me about what a struggle this is. I don't know what to tell him. I'm very skeptical that any long-term good will come from forcing his daughter to lose weight. On the other hand, I don't have any better ideas. Do you? What's been your experience in similar situations?
Please assume that the medical end of this is already being seen to. I'm primarily interested in the psychological issues involved, rather than possible diagnoses.
Control what she eats, enforce excercise. You do not gain weight if your calorific intake is less than your expenditure.
I don't mean to be so simplistic about it, but sometimes someone does have to state the obvious before it can be acknowledged.
posted by Biru at 7:44 AM on August 18, 2010 [1 favorite]
I don't mean to be so simplistic about it, but sometimes someone does have to state the obvious before it can be acknowledged.
posted by Biru at 7:44 AM on August 18, 2010 [1 favorite]
Your friend really needs to read "Your Child's Weight: Helping Without Harming" by Ellyn Satter, a dietitian who specializes in childhood feeding and weight problems. The food dynamic here is clearly an issue. Avoiding pressure, but also providing healthy food, is a delicate but critical balancing act to undertake.
Here's an article that gives you some idea of the approach, and here's the book.
Good luck to your friend and her daughter.
posted by Ouisch at 7:46 AM on August 18, 2010 [5 favorites]
Here's an article that gives you some idea of the approach, and here's the book.
Good luck to your friend and her daughter.
posted by Ouisch at 7:46 AM on August 18, 2010 [5 favorites]
He should get her in to see a therapist. The fact that she sneaks food and tries to get around dad's rules seems like this is more than just a situation where the parents don't feed their kid right and don't make them exercise. It sounds like there is a definite emotional component. If the mom is undermining his work to get the girl healthy, it might be worth talking to his lawyer to see if this might be a custody issue that needs to be worked out in some kind of agreement.
posted by elpea at 7:47 AM on August 18, 2010 [9 favorites]
posted by elpea at 7:47 AM on August 18, 2010 [9 favorites]
Sorry, my article link was broken:
http://www.ellynsatter.com/the-overweight-child-i-47.html
And, on preview, enforcing exercise and strictly controlling food intake is exactly the wrong approach to take in this situation. There is strong clinical nutrition research to back me up. Refer to Satter, please.
posted by Ouisch at 7:48 AM on August 18, 2010 [10 favorites]
http://www.ellynsatter.com/the-overweight-child-i-47.html
And, on preview, enforcing exercise and strictly controlling food intake is exactly the wrong approach to take in this situation. There is strong clinical nutrition research to back me up. Refer to Satter, please.
posted by Ouisch at 7:48 AM on August 18, 2010 [10 favorites]
Anyone who thinks they can control what a twelve year old girl eats is crazy. A twelve year old has a myriad of options for getting food. My suggestion: ignore the eating and the weight. The issue is keeping the girl healthy. The best way is exercise. This, the parent can make happen. If there is no discussion, restriction, or punishments related to food and food intake, it will make it much easier to keep her healthy through exercise.
It sounds like the girl also needs some therapy for issues unrelated to her weight (divorced parents using her as a pawn, etc.)
posted by hworth at 7:51 AM on August 18, 2010 [5 favorites]
It sounds like the girl also needs some therapy for issues unrelated to her weight (divorced parents using her as a pawn, etc.)
posted by hworth at 7:51 AM on August 18, 2010 [5 favorites]
I agree with hworth, but also, your friend needs to monitor what is going on during the visitation with the girl's mother.
posted by roomthreeseventeen at 7:54 AM on August 18, 2010
posted by roomthreeseventeen at 7:54 AM on August 18, 2010
...resorting to a sort of force, i.e. forbidding junk food of any sort to even be in the house, limiting meal sizes and such.
This would have been my first course of action, coupled with the increased exercise that you mentioned.
Is it a realistic proposition to encourage an interest in cooking? I mean cooking alongside good nutrition, fostering an interest in delicious fresh tasty fun stuff and a real appreciation for what she eats rather than shovelling fast food down. I'm sure I've seen a couple of good blogs written by parents on this very subject, with recipes etc., but frustratingly can't find them at the moment.
posted by idiomatika at 7:55 AM on August 18, 2010 [1 favorite]
This would have been my first course of action, coupled with the increased exercise that you mentioned.
Is it a realistic proposition to encourage an interest in cooking? I mean cooking alongside good nutrition, fostering an interest in delicious fresh tasty fun stuff and a real appreciation for what she eats rather than shovelling fast food down. I'm sure I've seen a couple of good blogs written by parents on this very subject, with recipes etc., but frustratingly can't find them at the moment.
posted by idiomatika at 7:55 AM on August 18, 2010 [1 favorite]
It definitely sounds like there's an emotional component to the eating. Sneaking food and eating alone are two big red flags that she might be a compulsive overeater. I speak from experience when I say that restricting her food and shaming her about her weight will only make the behavior worse. nthing the recommendation that therapy with an eating disorders specialist might be helpful.
posted by Colonel_Chappy at 8:00 AM on August 18, 2010 [2 favorites]
posted by Colonel_Chappy at 8:00 AM on August 18, 2010 [2 favorites]
Oh, this is heartbreaking only because it does seem more than a matter of calories and exercise. That poor kid.
Therapy may help, but kids at this age...if they don't want to talk, it may not get too far.
A nutritionist can help to some extent; there can be an emphasis on eating colorful foods and getting the kid involved in cooking. She can learn more that food is fuel, not a reward.
Something to pass along to your friend: the girl is getting to the age where she MAY become more interested in getting healthy because of peer pressure. Sometimes (not always), kids can have a huge mental turnaround (I'm a middle school teacher and some girls have this "Wow, I'm much bigger than the other kids" type of epiphany, but in a positive way) and they begin to take personal responsibility for being healthier.
posted by dzaz at 8:00 AM on August 18, 2010
Therapy may help, but kids at this age...if they don't want to talk, it may not get too far.
A nutritionist can help to some extent; there can be an emphasis on eating colorful foods and getting the kid involved in cooking. She can learn more that food is fuel, not a reward.
Something to pass along to your friend: the girl is getting to the age where she MAY become more interested in getting healthy because of peer pressure. Sometimes (not always), kids can have a huge mental turnaround (I'm a middle school teacher and some girls have this "Wow, I'm much bigger than the other kids" type of epiphany, but in a positive way) and they begin to take personal responsibility for being healthier.
posted by dzaz at 8:00 AM on August 18, 2010
Forbidding snacks and junk is the absolute wrong approach to take. 12 or 13 is old enough that, as your friend is discovering, they will find a way to get snacks in and hide them out of shame. My dad was incredibly strict when it came to "snacks" and as a result, at 30 years old, I still often feel like I need to eat my snacks in private because of the immense shame and guilt I experienced as a child. This is a horrible thing to do.
I would try and encourage your friend to continue to focus more on the activity side of things, rather than food. Obviously they're both important, but it might be more beneficial to try and encourage the family to do some fun outdoor activities. Ask the girl what she likes (maybe out of a range of activities). She's not a young child anymore, and deserves to have some say in the matter. Instead of "family is going hiking this weekend! you are coming!," allow her some choice in what she wants to do. Maybe even the same with junk/snacks. Don't forbid it completely, but allow her to have some say in the matter - let her choose one snack a day, what time of the day she'd like to eat it, and what kind of snack it can be. The key is giving her some freedom and choice in this, so that she feels in control, and leans to feel confident in her own sovereign choices.
Maybe a child therapist would help the girl understand why she turns to food. Sometimes no matter what our parents do, it's never going to work because it's coming from the Parentals. But a unbiased adult to talk things over with, might be what she needs.
posted by raztaj at 8:03 AM on August 18, 2010 [4 favorites]
I would try and encourage your friend to continue to focus more on the activity side of things, rather than food. Obviously they're both important, but it might be more beneficial to try and encourage the family to do some fun outdoor activities. Ask the girl what she likes (maybe out of a range of activities). She's not a young child anymore, and deserves to have some say in the matter. Instead of "family is going hiking this weekend! you are coming!," allow her some choice in what she wants to do. Maybe even the same with junk/snacks. Don't forbid it completely, but allow her to have some say in the matter - let her choose one snack a day, what time of the day she'd like to eat it, and what kind of snack it can be. The key is giving her some freedom and choice in this, so that she feels in control, and leans to feel confident in her own sovereign choices.
Maybe a child therapist would help the girl understand why she turns to food. Sometimes no matter what our parents do, it's never going to work because it's coming from the Parentals. But a unbiased adult to talk things over with, might be what she needs.
posted by raztaj at 8:03 AM on August 18, 2010 [4 favorites]
I'm sorry to barge in so much like this, but this is an extremely important issue, given that there is a child involved, and I'm afraid that links don't fully articulate what I'm getting at.
First - I'm a nutrition student and practitioner. I've done a lot of reading in the area of childhood feeding and obesity, specifically. Satter is not only a dietitian specializing in this area, but also a family therapist, so bear this in mind. The problem here is not merely one of nutrition, it is one of family dynamics and behaviours revolving around food.
Here is her basic approach:
1) The parent needs to provide structure. That means, regular sit-down meals and snacks.
2) The parent needs to provide healthy food at these meals and snacks. Healthy food does NOT mean plates full of veggies, but rather balanced, tasty, reasonable meals and even dessert.
3) The parent needs to, within this framework, NOT attempt to control how much the child eats at meals, or even what she chooses to take from the serving plates.
4) The parent needs to provide safe, regular opportunities for exercise.
5) The parent needs to NOT attempt to control how much the child chooses to exercise at these times.
The reason I stress this so much is that pressure on eating and movement can set up a lifetime aversion or obsession with these things that takes years to unravel. Given the daughter's established genetic propensity toward fatness, mishandling this could lead to extreme weight gain, or eating disorders down the road.
It is very important that this is handled by people who know what they are doing, and not by people casually tossing out weight and nutrition advice.
posted by Ouisch at 8:03 AM on August 18, 2010 [38 favorites]
First - I'm a nutrition student and practitioner. I've done a lot of reading in the area of childhood feeding and obesity, specifically. Satter is not only a dietitian specializing in this area, but also a family therapist, so bear this in mind. The problem here is not merely one of nutrition, it is one of family dynamics and behaviours revolving around food.
Here is her basic approach:
1) The parent needs to provide structure. That means, regular sit-down meals and snacks.
2) The parent needs to provide healthy food at these meals and snacks. Healthy food does NOT mean plates full of veggies, but rather balanced, tasty, reasonable meals and even dessert.
3) The parent needs to, within this framework, NOT attempt to control how much the child eats at meals, or even what she chooses to take from the serving plates.
4) The parent needs to provide safe, regular opportunities for exercise.
5) The parent needs to NOT attempt to control how much the child chooses to exercise at these times.
The reason I stress this so much is that pressure on eating and movement can set up a lifetime aversion or obsession with these things that takes years to unravel. Given the daughter's established genetic propensity toward fatness, mishandling this could lead to extreme weight gain, or eating disorders down the road.
It is very important that this is handled by people who know what they are doing, and not by people casually tossing out weight and nutrition advice.
posted by Ouisch at 8:03 AM on August 18, 2010 [38 favorites]
I think an appointment with a child hood therapist is in order. If she has a "troubled mother", her parents went though divorce, etc, she might be upset and self-medicating with food. Even if that's not the case, she might just need an outlet, someone to talk to anyway. That kind of stuff is a lot for a 12 year old to handle on her own.
I agree with limiting junk food in the house as a start, as a way to begin re-shaping the household's views of food. The whole family, ideally, should transition together into more healthy eating so she doesn't feel ostracized and targeted. Plus, it makes the change fun and sustainable. It could be made into a family learning experience, where all of them learn about nutrition together. I also agree with the note above, that an even more easily-controllable thing would be to encourage a lot more exercise. And again, doing it as a family (as opposed to making her do an cardio video or something boring like that) will help her outlook.
posted by DrGirlfriend at 8:10 AM on August 18, 2010
I agree with limiting junk food in the house as a start, as a way to begin re-shaping the household's views of food. The whole family, ideally, should transition together into more healthy eating so she doesn't feel ostracized and targeted. Plus, it makes the change fun and sustainable. It could be made into a family learning experience, where all of them learn about nutrition together. I also agree with the note above, that an even more easily-controllable thing would be to encourage a lot more exercise. And again, doing it as a family (as opposed to making her do an cardio video or something boring like that) will help her outlook.
posted by DrGirlfriend at 8:10 AM on August 18, 2010
I wanted to add, on the subject of limiting junk food in the house - it's important that junk food not be made into a bogeyman, because it will make her feel like crap when she gives in to a craving, and might encourage hoarding, eating in secret, etc. So rather than an outright ban, I feel it should be framed around the general goal of getting the family to eat better, and to allow themselves treats every so often.
posted by DrGirlfriend at 8:12 AM on August 18, 2010
posted by DrGirlfriend at 8:12 AM on August 18, 2010
Response by poster: Correction: just realized that the girl in question is 15 years old. Time flies!
She got a bit of therapy during the divorce, but it was problematic too. One of the mother's gambits to win custody was to accuse the girls' father of various completely imagined sorts of abuse. Accusations had to be addressed by a therapist, so therapy is potentially divisive. It's not that it couldn't help, but it's unlikely to be the path of least resistance here.
roomthreeseventeen:. ..your friend needs to monitor what is going on during the visitation with the girl's mother.
The only way he has of doing this is the reports he gets from his other (athletic, rail-thin) daughter. She'll call her dad and inform on her sister during visitation, which I'm guessing creates a sort of sibling rivalry dynamic around this, too.
I really appreciate the thoughts being offered.
posted by jon1270 at 8:12 AM on August 18, 2010
She got a bit of therapy during the divorce, but it was problematic too. One of the mother's gambits to win custody was to accuse the girls' father of various completely imagined sorts of abuse. Accusations had to be addressed by a therapist, so therapy is potentially divisive. It's not that it couldn't help, but it's unlikely to be the path of least resistance here.
roomthreeseventeen:. ..your friend needs to monitor what is going on during the visitation with the girl's mother.
The only way he has of doing this is the reports he gets from his other (athletic, rail-thin) daughter. She'll call her dad and inform on her sister during visitation, which I'm guessing creates a sort of sibling rivalry dynamic around this, too.
I really appreciate the thoughts being offered.
posted by jon1270 at 8:12 AM on August 18, 2010
Yeah, uh, this is a sure road towards lifetime screwd-up-ness they're on. I speak as someone who, way back at 140 lbs., was dragged to sports camps, made to endure that cabbage soup diet (with the one day of just bananas!), compelled to run laps at the high school track with the mother who knew I hated running more than anything else (*), and saw screaming fights over who let me eat Oreos (THAT was back at 80 lbs., actually.) I spent all my allowance on awful convenience foods, snuck off to Taco Bell on cabbage days, and decided I was "fat" and gave up while I was just 5 lbs. over the "normal" weight for my height. Woot. 120 lbs. and 15 years after that, I'm finally getting it under control.
Dad needs to be talking to a family therapist about this. Anything that could be called "force" needs to stop until that happens. I wouldn't recommend force with this situation for quite some time yet.
(*) My mom lapped me every time. On a public track, with God and my sisters and, yeah, the general public there. The only thing worse was that one time my dad tried to show me I was walking wrong. In the middle of our street. I was 15.
posted by SMPA at 8:19 AM on August 18, 2010 [3 favorites]
Dad needs to be talking to a family therapist about this. Anything that could be called "force" needs to stop until that happens. I wouldn't recommend force with this situation for quite some time yet.
(*) My mom lapped me every time. On a public track, with God and my sisters and, yeah, the general public there. The only thing worse was that one time my dad tried to show me I was walking wrong. In the middle of our street. I was 15.
posted by SMPA at 8:19 AM on August 18, 2010 [3 favorites]
I think this is one of those questions to which there is no satisfactory answer(s). I spent 20-30 minutes doing a google search of "outcome studies successful weight loss obese children". There is no lack of hits but I think the consensus would be--it is very very difficult. The patterns that seemed to emerge from the ones (abstracts) I scanned appeared to be--consistency, healthy eating, increased exercise, slow and gradual, cognitive behavioral therapy (CBT), multidisciplinary, increased and consistent social support, etc. These issues are difficult under the best of circumstances let alone real life and with real family dynamics. My personal observation is that there is often someone in the family who consciously or unconsciously undermines any consistent effort or program. One of the studies did indicate that "fat camps" where there is total immersion and CBT does appear to produce some long term changes. God Bless him, be a friend, support him in his efforts and hopefully he can stick to a consistent plan that reasonably, and with modest expectations, contains the key ingredients. I have to believe that some ongoing professional/peer support and structure might be useful for him. Good Luck and thanks for asking an easy question with few satisfactory answers.
posted by rmhsinc at 8:24 AM on August 18, 2010
posted by rmhsinc at 8:24 AM on August 18, 2010
That poor girl sounds torn in five different directions. She needs someone who's just an advocate for her and isn't trying to force her to do anything or bargain for anything from her-- a therapist who specializes in adolescents and ideally eating disorders so that she can start developing some sense of self-efficacy and autonomy.
posted by A Terrible Llama at 8:38 AM on August 18, 2010
posted by A Terrible Llama at 8:38 AM on August 18, 2010
My friend, out of ideas, is resorting to a sort of force, i.e. forbidding junk food of any sort to even be in the house
Not to be all hurf durf about it, but there was no junk food in our house, basically ever, when I was growing up (we had birthday cake on our birthdays, the occasional coke in a restaurant, trick or treating and the easter bunny, and that was about it). I don't think that's "force" or a threat - it's how people should teach their children to have good attitudes about food.
Neither me nor my 3 siblings have weight problems as adults. Anecdotal, I know. But I can see in my own life that this had an impact on the way I eat.
posted by Sara C. at 8:39 AM on August 18, 2010 [2 favorites]
Not to be all hurf durf about it, but there was no junk food in our house, basically ever, when I was growing up (we had birthday cake on our birthdays, the occasional coke in a restaurant, trick or treating and the easter bunny, and that was about it). I don't think that's "force" or a threat - it's how people should teach their children to have good attitudes about food.
Neither me nor my 3 siblings have weight problems as adults. Anecdotal, I know. But I can see in my own life that this had an impact on the way I eat.
posted by Sara C. at 8:39 AM on August 18, 2010 [2 favorites]
therapy is potentially divisive. It's not that it couldn't help, but it's unlikely to be the path of least resistance here.
I kinda think it's mandatory in this case. I'm not a real big therapy person but a morbidly obese 15 year old whose father is angry at her and sort of desperate and whose mother is trying to manipulate her through food offerings and mother/daughter pie bonding really needs a professional advocate for her interests.
posted by A Terrible Llama at 8:40 AM on August 18, 2010 [2 favorites]
I kinda think it's mandatory in this case. I'm not a real big therapy person but a morbidly obese 15 year old whose father is angry at her and sort of desperate and whose mother is trying to manipulate her through food offerings and mother/daughter pie bonding really needs a professional advocate for her interests.
posted by A Terrible Llama at 8:40 AM on August 18, 2010 [2 favorites]
With this:
One of the mother's gambits to win custody was to accuse the girls' father of various completely imagined sorts of abuse.
And this:
his other (athletic, rail-thin) daughter. She'll call her dad and inform on her sister during visitation
There appear to be masses of underlying issues with the family dynamic that lie under the surface of the food/eating/weight issues of the one daughter. I know family therapy is probably a touchy subject, but it might be needed to really get at what is going on. Otherwise attempts to address the one daughter's weight issues might never work long-term no matter how well-intentioned.
posted by Rosie M. Banks at 8:42 AM on August 18, 2010 [1 favorite]
One of the mother's gambits to win custody was to accuse the girls' father of various completely imagined sorts of abuse.
And this:
his other (athletic, rail-thin) daughter. She'll call her dad and inform on her sister during visitation
There appear to be masses of underlying issues with the family dynamic that lie under the surface of the food/eating/weight issues of the one daughter. I know family therapy is probably a touchy subject, but it might be needed to really get at what is going on. Otherwise attempts to address the one daughter's weight issues might never work long-term no matter how well-intentioned.
posted by Rosie M. Banks at 8:42 AM on August 18, 2010 [1 favorite]
I hesitate to answer because I'm not an expert at all. However, I do have three children (the oldest is 9) and I know with my children that not once have they stopped an activity they were enjoying to tell me how hungry they were. However, put a tv or computer in front of them and they're starving all the time. When they are busy and engaged, they don't even think about food. Give them something mindless to do and they're about ready to pass out from hunger. And I'm the same way. Keep me busy and bustling around and sometimes it's past lunch time before I realize I haven't eaten lunch yet.
So, my idea is to keep that child busy. But busy with stuff she's interested in. Get her signed up for classes, afterschool activities, or sports, etc. It's a great opportunity for her to tap into her talents and interests. And I don't mean to take up every second of her day, but get her out of the house, even if it's for a photography class. That's another big thing for me - get me out of the house and I'm not inclined to snack like I would at home.
Get her involved in activities she's interested in. Don't force sports if she's not interested. However, there are a lot of physical activities out there that don't even feel like you're exercising - horseback riding (plus you get the therapeutic effects of working with horses) - lessons, not just plodding along trail rides; swimming - not necessarily lap swimming, but just playing around in the pool; geocaching - can I say this enough? - it gets you outside, walking, sometimes on uneven terrain with the payoff of finding the hidden cache.
I realize that the issues presented are more than just overeating, but those are my two cents and 1. curbing the eating and 2. giving her something fun to do to hopefully boost her morale.
posted by Sassyfras at 8:53 AM on August 18, 2010 [1 favorite]
So, my idea is to keep that child busy. But busy with stuff she's interested in. Get her signed up for classes, afterschool activities, or sports, etc. It's a great opportunity for her to tap into her talents and interests. And I don't mean to take up every second of her day, but get her out of the house, even if it's for a photography class. That's another big thing for me - get me out of the house and I'm not inclined to snack like I would at home.
Get her involved in activities she's interested in. Don't force sports if she's not interested. However, there are a lot of physical activities out there that don't even feel like you're exercising - horseback riding (plus you get the therapeutic effects of working with horses) - lessons, not just plodding along trail rides; swimming - not necessarily lap swimming, but just playing around in the pool; geocaching - can I say this enough? - it gets you outside, walking, sometimes on uneven terrain with the payoff of finding the hidden cache.
I realize that the issues presented are more than just overeating, but those are my two cents and 1. curbing the eating and 2. giving her something fun to do to hopefully boost her morale.
posted by Sassyfras at 8:53 AM on August 18, 2010 [1 favorite]
This likely has a genetic component
Yeah, perhaps a physiological chemical imbalance in brain chemistry leading to a psychological predisposition to junk food.
My friend, out of ideas, is resorting to a sort of force, i.e. forbidding junk food of any sort to even be in the house, limiting meal sizes and such. In response his daughter sneaks extra food, buys junk food surreptitiously and otherwise seeks to eat as she pleases. Complicating the matter, the girls' (very troubled) mother dispenses candy and snacks during visitation, using them to buy the girls' affection.
Once again, the poor, sad, it's not their FAULT! argument comes tumbling down. The only way for her to get to a safe weight is to stop overeating, and specifically stop overeating crap. If she doesn't have 24-hour supervision I don't see how anything—diet, fat camp, doctors—none of it will stick. Unless you can absolutely guarantee she's not sneaking junk food with 24-hour / 7-day supervision, you should assume she will continue to find ways to stuff her face.
200+ pounds at 15 years old is a serious, life-threatening health matter. She is killing herself. She is knocking decades off her life expectancy. She needs treatment, removed from all temptation. Before your friend starts pre-judging certain treatments as too extreme (banning all junk food and soda, for instance, is not extreme in the least), consider how extreme the measures one would take if she were in a car accident, or had cancer.
posted by Civil_Disobedient at 9:00 AM on August 18, 2010 [1 favorite]
Yeah, perhaps a physiological chemical imbalance in brain chemistry leading to a psychological predisposition to junk food.
My friend, out of ideas, is resorting to a sort of force, i.e. forbidding junk food of any sort to even be in the house, limiting meal sizes and such. In response his daughter sneaks extra food, buys junk food surreptitiously and otherwise seeks to eat as she pleases. Complicating the matter, the girls' (very troubled) mother dispenses candy and snacks during visitation, using them to buy the girls' affection.
Once again, the poor, sad, it's not their FAULT! argument comes tumbling down. The only way for her to get to a safe weight is to stop overeating, and specifically stop overeating crap. If she doesn't have 24-hour supervision I don't see how anything—diet, fat camp, doctors—none of it will stick. Unless you can absolutely guarantee she's not sneaking junk food with 24-hour / 7-day supervision, you should assume she will continue to find ways to stuff her face.
200+ pounds at 15 years old is a serious, life-threatening health matter. She is killing herself. She is knocking decades off her life expectancy. She needs treatment, removed from all temptation. Before your friend starts pre-judging certain treatments as too extreme (banning all junk food and soda, for instance, is not extreme in the least), consider how extreme the measures one would take if she were in a car accident, or had cancer.
posted by Civil_Disobedient at 9:00 AM on August 18, 2010 [1 favorite]
re: the follow up comment - the approach I outlined before would still apply to a 15-year old. Just with the exception that she is, of course, going to encounter food situations outside her dad's control, and he has to let that go.
The evidence points to childhood overweight being a concern for health, yes, but not necessarily a catastrophic one. What would be catastrophic would be accelerating her weight gain to the point of it affecting her mobility, or pushing her into developing an eating disorder (which disorders have the *highest mortality rate of any mental illness*.)
This situation is almost guaranteed to result one or both of those by attempting the control paradigm.
posted by Ouisch at 9:10 AM on August 18, 2010 [3 favorites]
The evidence points to childhood overweight being a concern for health, yes, but not necessarily a catastrophic one. What would be catastrophic would be accelerating her weight gain to the point of it affecting her mobility, or pushing her into developing an eating disorder (which disorders have the *highest mortality rate of any mental illness*.)
This situation is almost guaranteed to result one or both of those by attempting the control paradigm.
posted by Ouisch at 9:10 AM on August 18, 2010 [3 favorites]
Not to be all hurf durf about it, but there was no junk food in our house, basically ever, when I was growing up (we had birthday cake on our birthdays, the occasional coke in a restaurant, trick or treating and the easter bunny, and that was about it). I don't think that's "force" or a threat - it's how people should teach their children to have good attitudes about food.
That's a terrific way to start and maintain raising kids, and I wish more parents would emulate it. I know my parents were only slightly more lenient than yours when I was a kid. But this girl has been on this track for years and is now an adolescent of 15 with a rail-thin sister. This kind of global "punishment" (that's how it would be seen now, I think) would add to the stress that is one of the reasons why she's eating like this, and make things between her sister and herself even worse.
It's a very tough situation, but I think the approach that Ouisch describes is the only one that seems to have potential to tackle the myriad of issues behind this girl's obesity.
posted by maudlin at 9:15 AM on August 18, 2010
That's a terrific way to start and maintain raising kids, and I wish more parents would emulate it. I know my parents were only slightly more lenient than yours when I was a kid. But this girl has been on this track for years and is now an adolescent of 15 with a rail-thin sister. This kind of global "punishment" (that's how it would be seen now, I think) would add to the stress that is one of the reasons why she's eating like this, and make things between her sister and herself even worse.
It's a very tough situation, but I think the approach that Ouisch describes is the only one that seems to have potential to tackle the myriad of issues behind this girl's obesity.
posted by maudlin at 9:15 AM on August 18, 2010
Nthing therapy with a professional specializing in adolescent eating disorders. Eating alone, sneaking food, disturbed non-custodial mom with her own food issues, acrimonious divorce with crazy abuse allegations, all these are indications that this girl may have been through some bad stuff, which, for all you know, may even be ongoing. The standard Denise-Austin-style calorie reduction and long walks aren't going to do jack until you address whatever underlying trauma/psychological issues are causing the disturbed eating behavior.
If your friend is resistant to the idea of therapy or other professional psych treatment, remind him that his daughter is 12-- on the cusp of teenagerhood. If she's trying to manage her emotions with food now, in a year or two she could be trying to achieve the same end via promiscuous sex or drugs or cutting. As a responsible father, he needs to step in now and get this addressed.
posted by Bardolph at 9:19 AM on August 18, 2010
If your friend is resistant to the idea of therapy or other professional psych treatment, remind him that his daughter is 12-- on the cusp of teenagerhood. If she's trying to manage her emotions with food now, in a year or two she could be trying to achieve the same end via promiscuous sex or drugs or cutting. As a responsible father, he needs to step in now and get this addressed.
posted by Bardolph at 9:19 AM on August 18, 2010
If your friend wants the kid to have an even more fucked up relationship with food, follow Civil_Disobedient's advice.
This isn't really about the food, so aggressively regulating what goes into a 15 year old's mouth is not the way to stop it. If he doesn't address what is causing her to try to gain comfort/happiness/whatever out of food, no matter what draconian policies he enacts, it's not going to work.
This kid needs to see a therapist, she doesn't need a goddamn home-based fat camp.
posted by crankylex at 9:20 AM on August 18, 2010 [13 favorites]
This isn't really about the food, so aggressively regulating what goes into a 15 year old's mouth is not the way to stop it. If he doesn't address what is causing her to try to gain comfort/happiness/whatever out of food, no matter what draconian policies he enacts, it's not going to work.
This kid needs to see a therapist, she doesn't need a goddamn home-based fat camp.
posted by crankylex at 9:20 AM on August 18, 2010 [13 favorites]
What does the daughter want to do? She's 15, she's old enough to have some ideas about how she would best like to deal with things. She might say she doesn't want to do anything, but she also might have some preferences. At 15, there's no very good way to control her 24/7, so unless she wants to get help, there's nothing to do. And she may well be pushing back against the diet attempts, in the "well, if my father wants me to do X, I will do the opposite" way that teenagers often have. (Not that she'd be skinny if he'd just let everything go, just that making strict rules may be counterproductive.)
So, a few things.
1. Make sure your friend is not somehow favouring his other daughter.
2. Tell the sister to stop informing on her sister. It's not necessary, or even really appropriate.
3. Work with the daughter. Does she want to see a therapist? Does she want to see a nutritionist? Does she want to take classes, or see a personal trainer? Does she want to be more involved in making meals?
4. What does she want out of the treats? What could she substitute for them? Fat free frozen yogurt? A single really good cookie or brownie or some sort of treat a day, without shame or guilt?
He can do whatever he wants, but at 15, she's able to get by most of his restrictions, and at 18 she can get by all of them, so he needs to have her active participation.
I think a therapist would be really helpful for her in any case.
posted by jeather at 9:27 AM on August 18, 2010 [2 favorites]
So, a few things.
1. Make sure your friend is not somehow favouring his other daughter.
2. Tell the sister to stop informing on her sister. It's not necessary, or even really appropriate.
3. Work with the daughter. Does she want to see a therapist? Does she want to see a nutritionist? Does she want to take classes, or see a personal trainer? Does she want to be more involved in making meals?
4. What does she want out of the treats? What could she substitute for them? Fat free frozen yogurt? A single really good cookie or brownie or some sort of treat a day, without shame or guilt?
He can do whatever he wants, but at 15, she's able to get by most of his restrictions, and at 18 she can get by all of them, so he needs to have her active participation.
I think a therapist would be really helpful for her in any case.
posted by jeather at 9:27 AM on August 18, 2010 [2 favorites]
You don't say what kind of exercise your friend is encouraging, but some exercise just isn't fun, especially if you're out of shape. I recently started a vinyasa flow yoga class, which I really, really like. The class is very flexible in how much energy you put into it, but as you grow stronger and more flexible and participate more I think you burn on average around 500 calories an hour. In my class, there's a whole range of people, from overweight middle-aged women, to in-shape teenagers, so your friend's daughter likely won't feel out of place.
My teacher also has a mantra that she tells us at the end of every class, that it might be good for your friend's daughter to hear.
"Yoga is not a journey of self transformation, but a journey of self-acceptance."
posted by kylej at 9:55 AM on August 18, 2010
My teacher also has a mantra that she tells us at the end of every class, that it might be good for your friend's daughter to hear.
"Yoga is not a journey of self transformation, but a journey of self-acceptance."
posted by kylej at 9:55 AM on August 18, 2010
Holy hell. This is a nightmare waiting to happen. My parents controlled every morsel that went into our mouths. My sister, brother and I are/have been eating disordered/body dysmorphic.
Here is my previous AskMe which your friend might want to read.
THERAPY with an eating disorders specialist. NOW.
posted by Sophie1 at 10:01 AM on August 18, 2010 [4 favorites]
Here is my previous AskMe which your friend might want to read.
THERAPY with an eating disorders specialist. NOW.
posted by Sophie1 at 10:01 AM on August 18, 2010 [4 favorites]
When it involves a battle of wills, both parties lose.
Unless she wants to lose this weight it won't matter what he does to get her to lose it (therapy might work, but she might also see it yet another attempt at being singled out/controlled) and, actually in trying to force her to change it might make the problem that much worse out of sheer spite, which kinda sounds like what's happening now.
Sure, try therapy but, I also think he needs to stop pressuring her and, instead tell her when she's ready to lose the weight he'll help her in anyway he can.
posted by squeak at 10:03 AM on August 18, 2010
Unless she wants to lose this weight it won't matter what he does to get her to lose it (therapy might work, but she might also see it yet another attempt at being singled out/controlled) and, actually in trying to force her to change it might make the problem that much worse out of sheer spite, which kinda sounds like what's happening now.
Sure, try therapy but, I also think he needs to stop pressuring her and, instead tell her when she's ready to lose the weight he'll help her in anyway he can.
posted by squeak at 10:03 AM on August 18, 2010
Response by poster: Thanks to everyone who has responded. Though some answers ring truer to me than others, I'm going to refrain from stamping Best Answers all over the place because I'm likely to show my friend this thread, and I want to support him no matter what he chooses to do. Besides, the diversity of opinion is part of what makes this so valuable.
Carry on.
posted by jon1270 at 10:30 AM on August 18, 2010
Carry on.
posted by jon1270 at 10:30 AM on August 18, 2010
Listen to Sophie1 and go read her linked post. Bottom line: no matter how overweight (with health consequences) this girl is, micro-managing her food/lifestyle will NOT help and will make things worse.
Without addressing her family issues, she probably will never change her relationship to food without a long, hard, adult-life slog. And if I had a dollar for everyone who NEEDED family therapy but didn't get it because the family was in denial and it was all the one person's problem or there was NO problem and consequently nothing got better for anyone...I'd be rich.
With this girl's family issues - the manipulative, enabling mother, the "perfect" tattletale sister (who is the golden child maybe?) - it's likely that they can throw CBT and fat camps and controlled portions and so on at the problem until the cows come home and NOTHING will get better unless the family issues are addressed. This is far more difficult and painful than simply saying "Jessica is fat and needs to lose weight." But ultimately it's the only thing that will work.
posted by Rosie M. Banks at 10:36 AM on August 18, 2010 [1 favorite]
Without addressing her family issues, she probably will never change her relationship to food without a long, hard, adult-life slog. And if I had a dollar for everyone who NEEDED family therapy but didn't get it because the family was in denial and it was all the one person's problem or there was NO problem and consequently nothing got better for anyone...I'd be rich.
With this girl's family issues - the manipulative, enabling mother, the "perfect" tattletale sister (who is the golden child maybe?) - it's likely that they can throw CBT and fat camps and controlled portions and so on at the problem until the cows come home and NOTHING will get better unless the family issues are addressed. This is far more difficult and painful than simply saying "Jessica is fat and needs to lose weight." But ultimately it's the only thing that will work.
posted by Rosie M. Banks at 10:36 AM on August 18, 2010 [1 favorite]
Not to be all hurf durf about it, but there was no junk food in our house, basically ever, when I was growing up (we had birthday cake on our birthdays, the occasional coke in a restaurant, trick or treating and the easter bunny, and that was about it).
Counterexample. That's how it was in my house when I was growing up, too, and I know 3 of us have struggled with weight.
Hey OP, something to offer the father: whatever he's doing, he should explain it clearly to the daughter. Don't assume she knows, that she can figure it out, that good intentions will be obvious. I recall a few things my parents did when I was a kid that, at the time, seemed like punishments. Discussing it with my dad later, it turns out it was done to make things easier for me or overall with my best interests in mind...but it gave me a real complex at the time.
So hey, talk to the daughter. Lay it all out: weight like this is unhealthy (for X, Y, and Z reasons), you're worried about her health, and you want to *help* her. This isn't a conflict, this isn't a power struggle, this isn't a punishment. You're concerned and you want for her to be able to be healthy.
posted by galadriel at 11:14 AM on August 18, 2010 [1 favorite]
Counterexample. That's how it was in my house when I was growing up, too, and I know 3 of us have struggled with weight.
Hey OP, something to offer the father: whatever he's doing, he should explain it clearly to the daughter. Don't assume she knows, that she can figure it out, that good intentions will be obvious. I recall a few things my parents did when I was a kid that, at the time, seemed like punishments. Discussing it with my dad later, it turns out it was done to make things easier for me or overall with my best interests in mind...but it gave me a real complex at the time.
So hey, talk to the daughter. Lay it all out: weight like this is unhealthy (for X, Y, and Z reasons), you're worried about her health, and you want to *help* her. This isn't a conflict, this isn't a power struggle, this isn't a punishment. You're concerned and you want for her to be able to be healthy.
posted by galadriel at 11:14 AM on August 18, 2010 [1 favorite]
Encourage your friend to try therapy for his daughter again, even if it's not the path of least resistance, and even if it wasn't a good experience in the past. It sounds like the previous therapy was court-ordered. My siblings and I went to court-ordered therapy because of abuse allegations during my parents' ugly divorce, and the whole thing really felt like a formality, not helpful at all. The therapy your friend's daughter attended during the divorce doesn't sound like it was geared toward helping her, but probably just satisfying a legal requirement. She needs personalized therapy with someone who is qualified to speak to these issues.
My little sister (who's 18 now) has struggled since her weight ever since my parents divorced 12 years ago. It was a similar situation to your friend's in that my father would try to buy her affections with food, while my mother constantly worried about her weight and tried to impose restrictions. This never, ever worked and only made the problem worse/drove it underground. Honestly, even if my mother had taken a gentler, less judgmental approach, I'm not sure she would have been successful because she was part of the trauma that sparked my sister's weight problems in the first place. Sometimes parents are too close to help -- and if that's the case, I think the best a parent can do is bring in the proper reinforcements. FWIW, my sister is doing much better after a couple years of therapy. In my opinion, it was absolutely necessary for her to talk through these issues with someone outside the family.
I've had personal struggles with weight and disordered eating too, which I despaired of ever being able to resolve...until I grew up and moved out of my mother's house. By that point, after years of pleas from me, she had stopped harping on me about my weight -- but even so, her own attitude toward food bled over. She subscribes to the all-too-common "these foods are good, these foods are bad" school of thought. As long as your friend's daughter is receiving this message, she will continue to eat "bad" food ESPECIALLY in secret, and she will learn that being healthy is about following rules and restrictions and not being free to make your own choices. So I don't think the answer is to simply remove all the junk food from the house and restrict portions. That makes the whole thing seem arbitrary and punitive to the daughter. I would instead have discussions about the topic where the daughter is encouraged to think for herself about her own habits and motivations.
Your friend might look into the books of Geneen Roth too, for insight into the psychological aspects of overeating and other types of disordered eating. I can't overstate how big of an impact Roth's work had on my thinking. Instead of trying to avoid certain foods, and failing, and then bingeing in secret, and then feeling ashamed and eating more, and repeating the cycle ad nauseum, I began to be able to think, "OK, I want some ice cream. That's cool, nothing evil about ice cream. But why do I want it?" And if I was truly in the mood for ice cream, I slowly learned how to let myself have it without guilt. But I also learned how to recognize when, "Actually, I want this ice cream because I'm feeling sad." And slowly I learned how to address the sadness, or boredom, or whatever, in a more constructive way. I learned how to listen to my body and my emotions instead of the conventional wisdom. This is where therapy can really help. This young girl needs help understanding herself, not the food pyramid.
posted by spinto at 12:25 PM on August 18, 2010
My little sister (who's 18 now) has struggled since her weight ever since my parents divorced 12 years ago. It was a similar situation to your friend's in that my father would try to buy her affections with food, while my mother constantly worried about her weight and tried to impose restrictions. This never, ever worked and only made the problem worse/drove it underground. Honestly, even if my mother had taken a gentler, less judgmental approach, I'm not sure she would have been successful because she was part of the trauma that sparked my sister's weight problems in the first place. Sometimes parents are too close to help -- and if that's the case, I think the best a parent can do is bring in the proper reinforcements. FWIW, my sister is doing much better after a couple years of therapy. In my opinion, it was absolutely necessary for her to talk through these issues with someone outside the family.
I've had personal struggles with weight and disordered eating too, which I despaired of ever being able to resolve...until I grew up and moved out of my mother's house. By that point, after years of pleas from me, she had stopped harping on me about my weight -- but even so, her own attitude toward food bled over. She subscribes to the all-too-common "these foods are good, these foods are bad" school of thought. As long as your friend's daughter is receiving this message, she will continue to eat "bad" food ESPECIALLY in secret, and she will learn that being healthy is about following rules and restrictions and not being free to make your own choices. So I don't think the answer is to simply remove all the junk food from the house and restrict portions. That makes the whole thing seem arbitrary and punitive to the daughter. I would instead have discussions about the topic where the daughter is encouraged to think for herself about her own habits and motivations.
Your friend might look into the books of Geneen Roth too, for insight into the psychological aspects of overeating and other types of disordered eating. I can't overstate how big of an impact Roth's work had on my thinking. Instead of trying to avoid certain foods, and failing, and then bingeing in secret, and then feeling ashamed and eating more, and repeating the cycle ad nauseum, I began to be able to think, "OK, I want some ice cream. That's cool, nothing evil about ice cream. But why do I want it?" And if I was truly in the mood for ice cream, I slowly learned how to let myself have it without guilt. But I also learned how to recognize when, "Actually, I want this ice cream because I'm feeling sad." And slowly I learned how to address the sadness, or boredom, or whatever, in a more constructive way. I learned how to listen to my body and my emotions instead of the conventional wisdom. This is where therapy can really help. This young girl needs help understanding herself, not the food pyramid.
posted by spinto at 12:25 PM on August 18, 2010
It's a very tough situation, but I think the approach that Ouisch describes is the only one that seems to have potential to tackle the myriad of issues behind this girl's obesity.
I agree, but the bottom line is that if there is going to be a change, it has to actually happen. It doesn't matter what the underlying issues are - continuing to offer unhealthy food is part of the problem. The thin sister, and in fact everyone else in the house, should be subject to the change as well. It's not a penalty, "you're fat so you can't eat things you like," it's a dietary change. I don't think weight or overall health is going to change dramatically with only therapy - the eating has to change as well.
posted by Sara C. at 12:48 PM on August 18, 2010
I agree, but the bottom line is that if there is going to be a change, it has to actually happen. It doesn't matter what the underlying issues are - continuing to offer unhealthy food is part of the problem. The thin sister, and in fact everyone else in the house, should be subject to the change as well. It's not a penalty, "you're fat so you can't eat things you like," it's a dietary change. I don't think weight or overall health is going to change dramatically with only therapy - the eating has to change as well.
posted by Sara C. at 12:48 PM on August 18, 2010
I'm all for better overall household eating and exercising changes (and change through example), but let's be honest. The girl is 15 years old and has a mind of her own by now. She will change if and only if she wants to do so. She may need therapeutic help to get there (although not necessarily, but it does seem to this layman that she might be doing some emotional overeating), but as with all therapy it has to come from a place where she wants the change.
Please do not use scare tactics like "you are killing yourself." Her weight is unhealthy, a fact of which she is quite likely aware, but she is also probably aware that many fat people live into old age. The net result of trying to warn her or scare her into change like this is quite likely just going to be her feeling resentful and rebellious.
posted by asciident at 9:01 PM on August 18, 2010 [2 favorites]
Please do not use scare tactics like "you are killing yourself." Her weight is unhealthy, a fact of which she is quite likely aware, but she is also probably aware that many fat people live into old age. The net result of trying to warn her or scare her into change like this is quite likely just going to be her feeling resentful and rebellious.
posted by asciident at 9:01 PM on August 18, 2010 [2 favorites]
jon1270: "In response his daughter sneaks extra food, buys junk food surreptitiously and otherwise seeks to eat as she pleases. "
Tell your friend to please be really, really sure she's doing this (i.e. catch her red-handed). My best friend was "the fat one" and her sister was a juvenile diabetic. Being a diabetic, sis was forbidden sweets and would often sneak them. Their mom would ask my friend, being "the chubby one", if she had stolen it and she'd deny it, then her sister would shoot her a look and my friend would hang her head and say yes, covering for her sister. Perhaps this girl's sister is sometimes doing the same thing.
Also, has this young lady seen a gynecologist, or has her dad inquired about the regularity of her periods? (I know, but it's important.) She may have PCOS which predisposes her to obesity.
posted by IndigoRain at 11:03 PM on August 18, 2010
Tell your friend to please be really, really sure she's doing this (i.e. catch her red-handed). My best friend was "the fat one" and her sister was a juvenile diabetic. Being a diabetic, sis was forbidden sweets and would often sneak them. Their mom would ask my friend, being "the chubby one", if she had stolen it and she'd deny it, then her sister would shoot her a look and my friend would hang her head and say yes, covering for her sister. Perhaps this girl's sister is sometimes doing the same thing.
Also, has this young lady seen a gynecologist, or has her dad inquired about the regularity of her periods? (I know, but it's important.) She may have PCOS which predisposes her to obesity.
posted by IndigoRain at 11:03 PM on August 18, 2010
The daughter is a very unhappy girl. I know, I was in her shoes. She won't lose any weight until she's ready to do so. She won't be ready until she can get her head around why she eats. I strongly recommend therapy.
I have never had therapy, but I know why I overeat. I've also been on lots of diets that didn't work. It's not easy to lose weight and it doesn't get any easier as one ages.
posted by deborah at 12:42 AM on August 19, 2010
I have never had therapy, but I know why I overeat. I've also been on lots of diets that didn't work. It's not easy to lose weight and it doesn't get any easier as one ages.
posted by deborah at 12:42 AM on August 19, 2010
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posted by RedEmma at 7:44 AM on August 18, 2010