It can be tempting to hope that a child’s overeating is “just a phase”, says New York psychotherapist Dr Michelle Maidenberg. But the price of inaction is too high. In a new book, Free Your Child from Overeating. 53 Mind-Body Strategies For Lifelong Health, she offers ways to build a child’s confidence that they have the power to change. Here Dr Maidenberg answers MercatorNet’s questions about her book and the global epidemic that is undermining the health and happiness of nearly a third of the human race.
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MercatorNet: There must be hundreds of books that deal with the issue of childhood obesity. What is different about yours?
Dr Maidenberg: Presently, many books focus on nutrition, exercise, or on developing healthy habits. This book deals with all three topics and how they are intertwined while simultaneously looking at the world we live in and how it affects our children. Additionally, I tackle the issues facing every parent of a child and teen. The focus on topics such as the best ways to communicate and collaborate with kids and teens, addressing their biological, psychological, and social development, how to deal with siblings, and what to do when parents are at their wits’ end. I also discuss children’s social lives, media influences, the effects of technology, and what it means to live healthfully.
I take great care to make sure the emphasis is on making empowering changes that are guided by kids and teen’s values rather than on getting rid of negative traits or characteristics, which would convey that parts of a kid or teen that are “bad” or “unworthy.” The book utilizes the 4Ps model—predict, plan, put into action, and practice—which further emphasizes making change in a lasting way. My book stresses acceptance and appreciation for parents, children, and families. Through encouragement, support, and care, parents can teach their child to make mindful choices that work.
Free Your Child from Overeating. 53 Mind-Body Strategies For Lifelong Health provides a comprehensive mind-body approach that deals with all facets of overeating and the obesity issue. New research has found that mind-body approaches to be significantly effective in the long-term effects of youth health outcomes. It is important to take into consideration the biological, social, political, and economic complexities of this public health issue. A key component that has not been adequately addressed are the psychological barriers to dealing with this issue/disease. In order to achieve fundamental long-term change, we must address these psychological barriers.
Why is it critical to understand the psychological component? Not only do kids and teens have to face normal physical and emotional changes, but in our ever-developing, tech-focused world, they have new pressures to deal with that never existed before. The constant barrage of media and social messages about how they “should” look, feel, and behave enters their consciousness 24/7. Teens are constantly inundated with ideas about what it means to be happy, healthy, and successful. Now, as a parent, you are not only responsible for helping them navigate the expected ups and downs of being a teen; you must also help them deal with an ever-changing kaleidoscope of challenges that weren’t necessarily part of your own experiences.
Kids and teens don’t choose to be overweight. Undoubtedly, if they could control it, they would. They obviously wouldn’t choose to endure the negative consequences of being overweight. What we also know about food today is that it can be addictive. For children, the neurochemical reward center in the brain overrides “willpower” and overwhelms the biological signals that control hunger. They truly cannot help it. We need to provide kids and teens with resources and guidance to help them with this challenge.
The strategies in this book teach kids and teens, parents and practitioners working with kids and teens concrete skills to work through psychological barriers in an engaging, easy to understand way. The strategies are not one-size-fits-all; they focus on the unique needs of kids and teens and their families and assist with sustaining change over time.
Q. “Most kids go through a podgy phase.” – Is that a myth?
A. From a biological perspective, kids and teens are undergoing significant growth spurts as they advance through puberty. A majority of girls typically start their sexual development between ages eight and thirteen and have significant growth spurts from ten to fourteen. Most boys start developing sexually between the ages of ten to thirteen and continue growing until sixteen years of age.
Because of the hormonally driven changes, this phase is sometimes referred to as the “podgy phase” because appetite can often increase and tweens and teens are known to put on some extra weight. It is extremely important for them to have well-balanced meals and to learn to eat healthily, engage in physical activity, and get adequate sleep. This ensures proper development and continued growth throughout this stage of development. Also, because of the rapid changes occurring, understandably, many teens feel uncomfortable about their bodies for a while until they can adapt.
According to a major study conducted by the Centers for Disease Control and Prevention, high school students are known to engage in unhealthy dietary behaviors such as not eating a nutritionally based diet of the recommended amount of fruits and vegetables, drinking sugared beverages, and not eating breakfast consistently. Also, they are not participating in enough physical activity during the week, are skipping out of physical education classes at school, are watching television for three or more hours a day, are on their computers for three or more hours a day, and are often not playing on at least one sports team run by their school or community group.
Additionally, nearly half (48 percent) are trying to lose weight, and 5 percent are resorting to using diet pills, laxatives, or vomiting to lose weight or to keep from gaining weight. The sad fact is that only 10 percent will maintain their weight loss; the rest will be overweight or obese into adulthood. It is obvious that just working through this challenge on the physiological and nutritional level is not enough. The psychological and social components are equally as important to address this challenge, taking the whole kid or teen into account.
Q. Just how bad are the stats for childhood obesity in the US? Are there countries that are doing better?
A. According to Everyday Health, In the last 33 years, not a single country has made serious progress in the fight against obesity. While in 1980, 857 million people worldwide were overweight or obese, by 2013 that number had more than doubled. Today, nearly one third of all living people — a whopping 2.1 billion — are either overweight or obese. These stats, including the graphics, come from a new analysis of 1,749 published studies on weight from around the world, published in the Lancet in May.
The analysis showed that the United States is home to the highest number of overweight and obese people in the world. In the U.S., 70.9 percent of men and 61.9 percent of women are overweight or obese, compared to 38 percent of men and 36.9 percent of women worldwide. Childhood and teen obesity has grown to epidemic proportions in the United States. The numbers are stark and speak for themselves. As of 2010, more than one-third of the children and adolescents in this country were overweight or obese. The Centers for Disease Control and Prevention, the United States National Center for Health Statistics, and the Journal of the American Medical Association have confirmed that childhood obesity has more than doubled in children and tripled in adolescents in the past thirty years.
The percentage of children six to eleven years of age in the United States who were obese increased from 7 percent in 1980 to nearly 18 percent in 2010. Similarly, the percentage of adolescents aged twelve to nineteen years who were obese increased from 5 percent to 18 percent over the same period. In 2011 to 2014, 8.9 percent of two- to five-year-olds had obesity compared with 17.5 percent of six- to eleven-year-olds and 20.5 percent of twelve- to nineteen-year-olds. Although the prevalence rates of youth obesity did not change from the periods of 2003 to 2004 through 2013 to 2014, there has not been any decrease and the rates remain staggering.
There are serious and immediate physical and psychological effects due to being overweight and obese, such as prediabetes, bone and joint problems, social issues, and poor self-confidence, as well as acute long-term risks to our children. Heart disease, stroke, poor self-image/identity, and depression are some of the many problems that can persist from childhood through adulthood due to weight and health issues. The medical and economic toll of this problem remains huge as well. It is estimated that the obesity epidemic carries a $117 billion medical price tag.
What remains confusing is that, although there is a plethora of resources available—from school health class to online sources, to mainstream books on integrating healthy eating and effective exercise regimens—obesity is still a growing trend. Why are we still experiencing a disproportionate number of kids and teens who are overweight and obese?
Q. Obviously, parents are the first line of defense against this epidemic. Why are so many finding the task too hard?
A. For parents of an overweight or obese child or teen, they are probably overwhelmed with the challenge of watching their child struggle. They probably tried cutting back on sweets or seeing a nutritionist for a diet plan, but nothing has worked. If it has, the results were likely temporary and not sustainable. At times they feel frustrated and angry at themselves and their child, and mostly they worry about these issues getting out of control and the long-term negative effects. They accept that it is their responsibility for teaching their children about healthy living and maintaining their weight. They don’t know how they are going to do it. No one ever taught them, and they are not sure where to start or how to go about it.
It’s not theirs or their child’s fault; they and their child likely have been taught to use treatment approaches that only scratch the surface and do not create behavior change. Moreover, parents are concerned about bringing up the topic with their child in fear that they will anger or disappoint their child, create an eating disorder in their child and/or will disclose something to their child that they don’t already know.
Knowing how to make the long-term change through effective communication and practical strategies is what is missing for parents. Free Your Child from Overeating. 53 Strategies For Lifelong Health helps parents learn how to work with their child to identify and define their child’s core values, while at the same time working on behavior, so that change is made at the core and not just peripherally.
Q. What strategies does your book offer parents? What does it offer children and teens?
A. The book has select strategies with pertinent information, tips, and exercises that reinforce working through overeating. The exercises are for kids and teens to complete independently, for them to complete with their parents, for parents to learn and complete independently and/or for practitioners working with kids and teens to learn and complete.
The chapters contain quotations from kids and parents I have interviewed throughout my research, a section referred to as “Check Your Baggage,” which encourages parents to check in with themselves regarding any thoughts and feelings that may have been evoked throughout the learning and conveying of the strategies, and how it may directly impact interaction with their child. Following this there is a brief “Review” section. The review sections are general, but include bulleted lists addressed to parents or kids and teens.
At the end of each chapter is a reference to a guided mindfulness-based exercise (collected at the end of the book with instructions for accessing online audio files) that further reinforces the skills presented. The purpose of the mindfulness-based exercise is to teach parents and children to slow down, to be present and in the moment, to integrate the skills being taught, and to increase their mind and body awareness. Mindfulness has been proven to facilitate clarity in focusing and processing; to boost working memory; to enable more cognitive flexibility and less emotional reactivity; and to work as an effective stress reducer.
This book is applicable to all families. Although its primary audience is families in which weight and health pose challenges, it is also a manual for all families to learn to communicate about the importance of healthy living. Learning about the way the mind functions, the process of accepting ourselves for who we are, and working toward understanding our health values are skills that are of use to everyone. This work fosters independent thinking and the ability to problem solve. It is an empowering approach that suggests behavior change can happen with practice, effort, and ingenuity.
With regard to health and weight, we are always maturing, developing, and growing. As we age, our metabolism changes, and our weight tends to fluctuate. By acquiring these communication skills, problem-solving abilities, and coping skills early on, we can help ourselves experience positive personal growth.
Even though a child may develop without weight or health issues, as we evolve and mature, eating and exercise will eventually become something we all need to manage at some point in our lives. Understanding how we think, feel, and behave in regard to our eating and health in general are strategies from which we can all benefit.
These strategies and skills are relevant and user-friendly for any individual or family. They can be easily taught, reviewed, reinforced, and reintroduced at any point in time.
Q. Among your own clients, are there some who succeed better than others? And why?
A. Among my clients, those families where there is more likelihood for success is where there is a family-based approach. In these families, there is a willingness for parents, as well as kids and teens, to learn the strategies, carry them out and practice them continually. Although there can be success with kids and teens carrying the strategies out independently, it makes it more challenging when their efforts aren’t fully encouraged and supported. It can contribute to frustration, disappointment and feeling unsupported in their efforts, thwarting effective change and progress.
Michelle P. Maidenberg, PhD, MPH, LCSW-R, is the president and clinical director of Westchester Group Works and cofounder and clinical director of Thru My Eyes Foundation. She has successfully treated thousands of patients over the past two decades. She also maintains a private psychotherapy practice. Her cognitive-behavioral therapy program is used with children and teens at Camp Shane and with young adults and adults at Shane Diet and Fitness Resorts. She teaches at New York University and has been quoted in The New York Times, Fitness, Glamour and Parenting. She is a regularly contributing blogger to The Huffington Post.
Slider image: Fighting childhood obesity. Nicole McCraken/Flickr