Did you know that around 1 in 4 British children say they are attempting to lose weight and that rates of eating disorders have escalated? It is horrendous that so many young kids feel the need to focus on weight loss and even have the concept of dieting and weight loss on their minds at such an early age.
Yes, indeed we do have a major obesity problem right now, however, kids usually don’t have much of a clue how to lose weight in a healthy way. It can also set up a skewed relationship with food that can continue throughout their life. Restricting their diet can also pose a risk of developing serious nutrient deficiencies.
The most shocking thing is that the increase in weight loss attempts during childhood is mainly due to a huge spike in relatively slim kids wanting to lose more weight. Research has found that one in seven kids who say they are attempting to lose weight are at what is considered a healthy weight, with absolutely no need to slim down at all. Add in anorexia and bulimia numbers, which is when things become more extreme, then the figures are likely to be much higher.
Childhood is hard enough right now, without the added layer of parents unnecessarily restricting a child’s diet, or a child feeling they need to do this themselves. Schools play a role in shaping children’s body image and the “weigh and shame” approach at schools if BMI is too high has caused some deep upset and anxiety. Peer pressure is also very real, and it is often a friend in the playground calling a child chubby, that can kick-start the feeling that they need to control their weight somehow.
Most kids are not mature or knowledgeable enough to always make the right decision with foods and this is where low calorie/low-fat foods or ultra-processed foods with the number of calories written on the packet can easily be prioritised over nourishing foods. The teen and tween years are especially important to choose nutrient-dense foods as this is a critical time of their life when they need plenty of good quality nutrients to feed a healthy metabolism, gut, brain and immune system. This in turn helps them to navigate the inevitable ups and downs of growing up.
How many people do you know who continue to have a poor relationship with food and a terrible body image, which has clouded the entirety of their adult life? I have never wanted “body shaming” to be a burden for my children. That’s why I worked out very early on as a mum that building a positive relationship with food was key for my kids, not just in the early years but also once they had become teenagers. I hope I have got it right for them (time will tell!) and right now all three children seem to adore their food and have healthy appetites. They also enjoy cooking and appreciate the whole field-to-fork experience.
I do appreciate that I am one of the very lucky ones, as there are so many families coping with significant eating disorders which are not easy to “fix” or to even identify the trigger. And this is where a team of professionals is needed to help support recovery over the longer term.
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The diet culture research
The data cited above was taken during a study period between 1997 and 2016. This Health Survey for England was led by the University of Oxford and followed 34,235 children over nearly 20 years and found by the end that one in four children aged 8-17 in England said they were trying to slim up because either their parents or they wanted to lose weight.
And the big up-shift in these figures was in children who really did not need to lose any weight and were choosing to do this on their own volition. Interestingly the increase was mainly amongst boys, older children, Asian children and children from lower-income households who would say that they were attempting to lose weight.
There is a big caveat though, as the way the data was collected was from quite a leading question where children may respond to what they think the researcher would want to hear. Children were asked if they were actively seeking to manage their weight by responding to following question: “At the present time, are you trying to lose weight, trying to gain weight or are you not trying to change weight? In reality, how would you respond to this question aged 8?
The end data in this paper is from 2016, however, the research has only recently been published, so I suspect things are much worse now as eating disorders have been reported to have spiked during the Covid pandemic and has continued ever since. It has got so bad that almost 10,000 UK children and young people started treatment for eating disorders between April and December 2021 and the waiting lists are extremely long. There has continued to be an unprecedented demand for psychiatric services to support young people with bulimia and anorexia nervosa. Obviously, building a positive relationship with food is only one part of these very complex mental health challenges which can be driven by a myriad of reasons including emotional, psychological and biochemical factors. They can become extremely unwell and this is where an experienced team of eating disorder professionals is needed to help them through.
There has also been a significant rise in body dysmorphic disorder where kids are over-preoccupied by perceived flaws or defects in their appearance which can easily lead to significant distress and social difficulties. This often crosses over with obsessive-compulsive disorder (OCD), depression and anxiety disorders and is thought to be much more common in neurodivergent kids who also have Autism, ADHD or PANS/PANDAS. However social media also plays a massive role, and that is a whole other conversation in itself.
Key nutrients for a healthy mindset
Interestingly the very nutrients that build healthy neural connections and are the building blocks for emotion, self-regulation, the flexibility of mind and robust mental health are often found to be deficient in children who restrict their food intake. Thankfully it is thought that if you are able to rebuild the body with some of these key nutrients then the mood may lift, and anxiety-driven behaviours may reduce over time. In a nutshell – if your key brain nutrients are taken care of, then you are probably less likely to worry about your weight and be more confident in your own body – no matter what your size or shape is.
Focus on Zinc
If you have a child who has lost their sense of smell and taste or has a very narrow set of food choices, has started cutting out whole food groups or is generally less interested in food, then a key nutrient to consider bolstering is zinc via diet and supplementation. Zinc also helps to power up our gastric juices and can help to restore appetite. It is a key nutrient for brain, gut and immune health. Teens and tweens who mainly follow a plant-based diet, are also often more susceptible to a zinc deficiency.
A great deal more zinc is needed whilst going through puberty and this is why the therapeutic intake/upper tolerable limit for zinc rises from 12 mg for 4-8 years olds, to 23mg for 9-13 year olds and 34mg for 14-18 year olds. 100 grams of pumpkin seeds, which is a food relatively high in zinc provides 10mg, so this means that diet alone may not be enough if a young person is deficient, and you may need to consider a food supplement. Even though not 100% diagnostic, white flecks appearing on the fingernails may mean that additional dietary minerals including zinc may be needed.
Blood zinc levels can be tested through your GP if you are concerned.
Omega 3 Fatty Acids
Omega 3 is a key brain food that helps create healthy neural connections. It also helps to build a healthy and diverse gut microbiome which is important for building our brain hormones, called neurotransmitters, which regulate our thought patterns as well as our emotional regulation. Omega 3 also dials down the inflammatory pathways which are known to be part of the overall mental health picture.
Oily fish such as salmon, anchovies, trout, sardines and mackerel as well as seafood are the best sources of omega 3 fatty acids. Grass-fed meat, organic whole milk and some specialist eggs (from chickens who are fed on flax seed) also contain omega 3. Plant-based sources are walnuts, chia seeds, hulled hemp seeds and flax seeds (linseeds). Many people benefit from fish oil supplementation, especially if they don’t eat fish or seafood regularly.
Low Iron & B Vitamins
B vitamins and iron are also vital for nurturing a healthy brain and mood and these tend to be more abundant in red meat, liver, eggs and pulses. Green vegetables and dark green salad leaves also contain folate which is an important B vitamin for mood and brain.
Iron and B vitamins are key brain nutrients that are key for child development and often dip when people restrict their food intake. Even when iron and B vitamins are only a flagging a little in the system, obsessive thoughts, black and white thinking and anxiety can mount.
If you can see your child is tired, irritable or has pale skin then they might need to bolster up their iron levels and B vitamins. A clinical observation is that people with low iron stores (low ferritin in blood tests) often say they are not hungry, have a small appetite or get tummy aches regularly.
Tips are to switch from chicken breast to chicken thighs, pork to beef mince, add pulses to recipes and also to step up green salads and veggies, or blend greens into smoothies.
Often supplementation is needed for a few months to help restore iron and B vitamins to a more optimal level and enough to feed the brain well.
The Gut-Brain Connection
Another important factor that might be driving a poor relationship with food from a biological perspective is an imbalanced gut microbiome. Our bellies contain billions of bacteria that play a role in making vitamins, maintaining a healthy metabolic health, dialling down inflammation and are the building blocks for brain neurotransmitters such as serotonin, dopamine, GABA and acetylcholine.
These are the key brain hormones that regulate our mood and can affect self-esteem and our perception of how our body looks. The right balance of these neurotransmitters play an important role in maintaining a healthy relationship with our body and with food.
Relatively recent research has highlighted that those people who are more rigid with their eating patterns or have eating disorders may be lacking in some of the key beneficial microbes and may also have too many inflammatory gut bacteria which are now known to have the potential to alter mood.
Taking antibiotics or proton pump inhibitors (for reflux) can often deplete the gut microbiome further, so if you child has a history of taking antibiotics or ant-acid medications, then this is when you might consider adding in a probiotic supplement daily to help restore the good bugs that help to make the feel-good neurotransmitters.
The gut microbiome can be rebalanced over time by eating cultured foods such as kefir and live yoghurt apple cider vinegar, kimchi, soya sauce and miso as well as consuming plenty of polyphenol-rich foods such as brightly coloured fruits and vegetables as well as plenty of fibre.
Eight ways to build a healthier relationship with food
We need to encourage a better relationship with food right from the very start of life and these are my top tips. It’s also important to realise that it is never too late to make positive changes, even in older teens and young people:
- Cook from scratch as much as possible – this food is usually more nutritious, more satiating, and better for the metabolism. The more you cook at home, the more chance your children will have to be engaged in preparing and cooking. They will grow to love those home-cooked smells and tastes, and this encourages a better relationship with food over time and they will be more likely to cook for themselves as a young adult.
- Focus on feeding your kids nutrient-dense foods rich in zinc, omega 3, B vitamins and iron. This could be eggs with greens or oats with seeds and nut butter at breakfast, a smoked fish pate or chicken liver pate in their sandwich at lunch and then a lovely piece of salmon with sweet potatoes and lots of green vegetables in the evening. Supplement for a few months if they do not normally eat those foods or you feel it will be an uphill battle getting them to change their diet quickly.
- Build up the gut microbiome by giving them gut-friendly foods and probiotics – this can take time, but it is worth it! The research on the gut-brain link is exploding and there is talk of probiotics acting like psycho-biotics and helping to restore mental health.
- Avoid ultra-processed convenience food (UPF’s) as much as possible – these beige, crunchy foods are generally devoid of the key nutrients needed to raise a healthy child in terms of metabolism, gut and brain health. They are also innately addictive with innocent-sounding ingredients such as yeast extract and natural flavourings which can trigger the reward centre of the brain and can encourage unhealthy eating patterns. The high glutamic acid in these ingredients make them irresistible and may be why a child finds it impossible to resist eating a packet of crisps ahead of a healthy well-balanced meal, and then leaves half their plate, and heads back to the snack cupboard straight afterwards.
- Encourage the love of locally sourced food. Show them how food is grown and find local suppliers who are passionate about where their food is sourced. Involve them in your shopping trips to markets, food fairs and health food shops to help build a love of food.
- Lead by example by sitting down to eat together and eat healthy nutritious foods in front of them yourself! Talk about how delicious food tastes and smells and how nutritious food makes you feel.
- Avoid food shaming – “naughty cake”, “oooooh I shouldn’t eat that”, “I’m such a pig” are easy to roll off the tongue – however, your kids soak up these vibes and they often stick with them for the very long term, even if you don’t realise it at the time. In my mind, we should all be able to eat cake from time to time without a jot of guilt!
- Do your best to work on your kids’ relationship with social media, which has had a huge role to play in the increase in body dysmorphia, eating disorders as well as kids deciding to unnecessarily restrict their diet.
If you are keen to help your child develop a healthier relationship with food, then do read more in my two books The Good Stuff and I Can’t Believe It’s Baby Food which both dig deeper into how to help your kids absolutely love their food and eat their meals with gusto. These books help you to navigate the ups and downs of feeding children, and also give plenty of nutrient-dense recipes that help to nourish a healthy brain and body.
- Trends in weight loss attempts among children in England
- More children aged 8-17 trying to lose weight than a decade ago, including children of a healthy weight
- Our relationship with food is broken – here’s how to fix it
- NHS treating record number of young people for eating disorders
- Answers to Anorexia: Master the Balance of Hope & Healing by Dr James Greenblatt
- Children referred for eating disorder treatments surged by almost two-thirds, figures show
- Incidence and outcomes of eating disorders during the COVID-19 pandemic
- Rising dysmorphia among adolescents: A cause for concern
- Nutritional and herbal supplements in the treatment of obsessive compulsive disorder
- Role of zinc in the development and treatment of mood disorders
- Zinc deficiency and eating disorders
- Neurobiology of zinc-influenced eating behavior
- Omega-3 fatty acids and autonomic function in adolescents with anorexia: A randomized trial
- Effects of Omega 3 Fatty Acids on Main Dimensions of Psychopathology
- The Role of Essential Fatty Acids in Anorexia Nervosa and Obesity
- Omega-3 polyunsaturated essential fatty acids are associated with depression in adolescents with eating disorders and weight loss
- Anorexia nervosa patients display a deficit in membrane long chain poly-unsaturated fatty acids
- Could we be overlooking a potential choline crisis in the United Kingdom?
- The Gut Microbiome and Its Clinical Implications in Anorexia Nervosa
- The gut microbiome in anorexia nervosa: relevance for nutritional rehabilitation
- The Gut Microbiome in Anorexia Nervosa: Friend or Foe?
- Current Understanding of Gut Microbiota in Mood Disorders: An Update of Human Studies
- The Microbiota/Microbiome and the Gut–Brain Axis: How Much Do They Matter in Psychiatry?
- Increase in body dysmorphia and eating disorders among adolescents due to social media