What Doesn't Work:
Eat When Hungry,
Stop When Full

By Abigail Natenshon



Dear Abbie,

Your site is WONDERFUL and I plan to use it with the small groups I'm working with on Healthy Eating. There were so many young girls not eating here at the Jr. High School I work at, that I decided to run two small groups, simultaneously. Because I have girls at both ends of the weight spectrum I decided to focus on Healthy Eating. I do, however, have a question about one of your items listed as an eating disorder "sign." That is, "I only eat when I'm hungry." Could you please explain this psychologically and perhaps physiologically?

I ask because in the past year I have been to 2 different conferences for children and nutrition and both said to let the young children self-monitor by eating only when they are hungry and stopping when they are full. The parent's role is to offer nutritious food choices, but do not force the child to eat just because it's "lunch time." This habit will then be carried into adult hood and decrease the chance of being overweight from over eating (the satiety trigger is better developed this way as well). This seems to be opposed to the information on your site (the assessments). I would appreciate any insight you have into this. Thanks again for a great site!

M
School Nurse
San Juan Unified School District
Carmichael, CA



Dear M,

So glad you ask this very poignant question. You are right in your observation that too many people, even health professionals and eating experts teaching at conferences, have misconstrued what would otherwise be a good and practical piece of information about how to eat healthfully.

A child needs to eat three times a day, at least, not including snacks, in order for their metabolism to remain in healthy working order. to burn effectively, thereby assuring a fit and well functioning body.

Freedom and flexibility only have meaning and viability when their roots are deeply embedded in structure. The structure around eating needs to be in the form of three meals; flexibility may come in the form of a smaller or larger portion size, based on the degree of hunger or satiety at the moment.

Here's the rule of thumb: Parents provide nutritious food and the opportunity (and expectation) for the child to eat it, hopefully in the company of loved ones and three times a day; the child determines the amount to be eaten. This is NOT to imply that if a child does not express an interest in eating at mealtimes, the parent should allow the golden opportunity to nourish body and soul to pass. It is through healthy limit setting around food that a parent raises the healthy child, the healthy eater, and an "eating disorder-proof individual" now, and for the future.

When parents choose to bypass limit-setting around the daily eating structure, relying instead on the judgment and problem-solving ability of the child, particularly if that child is dealing with the distorted body image and body perceptions or the malnourishment that go along with eating disorders, the odds are that the child's judgment will be inaccurate and unsound.

When it comes to kids, problems with healthy eating too often come from role modeling after parents who are themselves, unhealthy eaters. How many parents do you know who skip breakfast and feel virtuous about it, or who consider a cup of coffee to be an adequate breakfast? Dieting and disordered eating is what is being taught here, not healthy eating.

Lots of people aren't hungry in the morning till they have been up and about for an hour or so. But the fast of the overnight sleep needs to be broken and breakfast is a must. If one makes it a point to eat breakfast consistently even when not feeling particularly hungry, that person will eventually begin to develop an appetite for it. "Front-loading," or eating more during the early part of the day is, the best way to insure a more limited intake of calories during the latter part of the day.

The best and easiest way to avoid eating disorders as well as obesity in childhood and adulthood is, plain and simple, healthy eating!

Abbie




Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 31years. She is the author of When Your Child Has An Eating Disorder, A Step-by-Step Workbook For Parents And Other Caregivers, Jossey-Bass, 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at www.empoweredparents.com and www.empoweredkidZ.com, www.treatingeatingdisorders.com.

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