Sorry, sorry, confused my update windows!

[conuly]

Dear Care and Feeding,

My husband and I have two daughters, “Blake” (16) and “Kaylee” (13). Blake developed the habit of emotional eating to cope with stress in middle school, and during quarantine, she began buying lots of junk food and keeping it in her room to eat whenever she was stressed, doing homework, or even watching a show. We have always provided our kids with healthy meals and snacks while still enjoying junk food in moderation, and have modeled body positivity. But despite numerous talks with Blake about if there was anything we could help her with, she insisted everything was fine, she just liked snacking while doing boring tasks. Now, everything has gotten out of control.

At Blake’s most recent doctor’s appointment, her pediatrician told me that she’s gained a large amount of weight very rapidly and that he was concerned about the impact her diet was having on her quality of life—it had already made activities she previously enjoyed, like biking, a struggle for her, and could lead to more health issues in the future. After a long talk with him, Blake decided that she wanted to stop using food as a coping mechanism, and start helping us cook and prep balanced meals, which she began doing a month ago and says that her relationship with food is already improving.

However, around the same time, Kaylie’s prescription for ADHD meds increased, and while she is having a much better time in school, the medication reduces her appetite, so she’ll pick at lunch but be starving in the evening, and will think nothing of polishing off a bag of veggie straws or plantain chips before dinner. We’re fine with it because these are fairly healthy snacks and fill the gap created by her lunch, but Blake gets irritated when her sister won’t “help her follow through on health goals” by not keeping snacks in the top cabinets so she can’t get them in the night or at least only eating Blake’s pre-made protein snacks. Kaylie is almost underweight, and if she didn’t struggle so much without medication I would take her off of it, so I want to allow her to continue her after-school snacking.

But Blake and my husband both say that we should be supporting Blake’s goal of eating healthier and cutting out processed foods and that it’s unfair to let Kaylie keep “unhealthy” snacks in easy reach of everyone. I am sick of finding crumbs in bedrooms and I want both of my kids to understand that food is fuel, and to eat a healthy amount of it each day, whether it’s from potato or burrito bowls. How do I handle the current “snack war?” I want to support both Blake’s initiative to eat a more balanced diet and ensure that Kaylie actually gets in nutrients!

—Sick of Snack Sniping

Dear Sick of Snack Sniping,

I know you want what is best for your kids and their health, but if you truly want your children to view food as fuel for the body… this is not the way to do it. Food as fuel, which is actually a great, nutritionist-approved concept, is fundamentally about having a neutral attitude toward what you eat. What I’m hearing instead is a lot of value judgment around food happening in your home.

We are deeply imprinted with this rigid mentality around food in our society, so this is not surprising. But today, most nutritionists and dieticians agree that labeling foods as “good” and “bad,” and attaching morality to our food choices, is actually exactly the kind of thinking that can ultimately lead to disordered eating. I feel a little like a broken record, but children shouldn’t be focused on food restriction or attempting to change their body shape. I know from experience that this is potentially setting them up for a lifetime of yo-yo dieting and weight cycling, which many researchers believe may be the cause of more health problems than being overweight.

Having a doctor express concern about Blake’s weight gain probably seemed scary, but you need to remember that fatphobia is ingrained in the medical field, and vague proclamations about potential “health issues in the future” are no substitute for actual measurements of health like bloodwork. If Blake’s fitness level, which by the way is not synonymous with her weight, is keeping her from enjoying physical activity, I think it’s great to focus on helping her be more active. There are other non-weight-related health factors you can emphasize like how her body feels, ways she can get stronger, understanding what gives her energy, and brainstorming how to incorporate joyful movement into her day.

I’m also noticing a contrast between how you are treating your two children—Kaylie’s afterschool snacking is OK because she is thin, but Blake’s is a problem because of her weight gain. You also seem very concerned about Blake’s health, but less about Kaylie’s, despite the fact that being underweight comes with its own health risks. If food is fuel, both children should be allowed to fuel their bodies, regardless of their body type.

Finally, the focus on Blake’s health seems to be missing one crucial element: concern for her mental health. You said she is experiencing stress in middle school and is using food “to cope.” What exactly is happening that she is having so much trouble dealing with? And if she truly is turning to food as a coping mechanism, a therapist may be a lot more helpful than a diet, so she can learn better methods for dealing with stress than trying to numb or comfort herself with food. Regulating the food itself is not going to treat the underlying issue. And in my opinion, the immediate mental health issues she may be dealing with are much more concerning than some vague future physical health issues that may never manifest.

—Emily

https://slate.com/human-interest/2022/10/daughters-snacking-care-and-feeding-parenting-advice.html

Comments

[minoanmiss]

I want to hug Emily.

[conuly]

Yes, this advice is so much better than some people would've given.

[jadelennox]

this advice is perfect and hits all the right notes:

• you've taken medical terminology about removing baggage from food and are throwing it around as if it supports your baggage
• lots of doctors are fatphobic
• you clearly don't care about your girls' physical health, you care about their weight
• you should care about their mental health
• you are doing things that are likely to give them disordered eating habits and thus severe health problems
• food is not morality and you think it is
• if you are worried about your daughter's activity level then you should be worried about her activity level, not her snacks
• underweight is also a potential problem, you knob

[ofearthandstars]

Same! These poor kids are going to develop disordered eating.

[conuly]

Oh god the comments. Why did I read those comments?

There is one heroic person who works with people with eating disorders, and they're fighting an uphill battle against ignorance in the comments.

[harpers_child]

This LW reminds me of myself and my sisters. I've always struggled to maintain a healthy not too thin weight and they both struggle to keep enough weight off to not get the run around from doctors. We've all had these issues since roughly puberty hit. Turns out our thyroids are all fucked. Mom's too.

I'm not saying that unhealthy snacking habits or medication may be playing a part, but you should get some bloodwork done too specifically checking out hormone levels that can fuck with weight gain in either direction. Getting each girl a solo visit with a nutritionist to help with a food plan may be a good idea too.

[zana16]

I’ve met my share of fat-phobic nutritionists, though

[harpers_child]

Oh word. Totally. There are some good ones out there, but finding them can be a bitch.

[cimorene]

This answer was so good but the lw's previous attitude doesn't give me a lot of hope. The letter sent me through the roof with anger.

Not to be a recently diagnosed cliche, but

[feldman]

Has Blake been screened for ADHD, or the related learning disorders and anxiety, etc. that are statistical fellow travelers with it in families?

I've got a 16yo: they have been given more than ample 'fuel' for physical and existential terror, on top of normal growth spurts (often pathologized and shamed in those girls who grow out before up) and completely upended schooling. Also, does her bike even fit her anymore, and are there places to ride it where she won't be catcalled for being a teen girl in public alone?

But sure, smooth sailing once y'all achieve correctly moral nutrition...

[jack]

The attitudes are the important thing to address, but my immediate thought is a practical problem: if people are upset about eating snacks which are sort-of-someone's but also sort-of-communal can people please have a box or a cupboard or lockable something for THEIR snacks which people actually respect? And Kaylee can snack on whatever SHE wants, and Blake can snack on whatever SHE wants, and Blake not get upset because too much of the wrong food is what's available?

it had already made activities she previously enjoyed, like biking, a struggle for her

I'm also quite torn. Anti-fat attitudes are incredibly prevalent, so massively judging people for eating is a gigantic problem and usually makes things worse. But "eating a bunch of snacks that actually don't make you feel good" I think is something that can be not-so-good, and finding alternatives can be good (but like, not if it doesn't seem to be a problem, and not at all costs..)

[green_grrl]

I like this. Blake said quite clearly she’d been snacking during boring tasks and wants to stop doing it. If she has a clear line, like sis’s cupboard is locked, it can help her from falling back into a habit she wants to break.

[movingfinger]

I love plantain and veggie chips, but nothing that comes in a crinkly air-puffed bag is a "healthy" snack (including, say Ricolas) and I admit that to myself when I buy them once in a great while (if they're on special). Absolutely nothing. This was where the devil got into the problem, that the parents think that some of these things are "healthy." If the kid has a "gap" between lunch and supper, processed snacks are not a good stopgap.

Both of the girls would benefit from professional counseling and I think the parents would too, because the parents seem to be a bit at sea with the stresses of adolescence, the stresses of ADHD, and their worry about the health of their children. Unpicking that tangle, for the parents, would help them talk to the girls and guide and support them. I'm worried that Kaylie is sliding into a serious problem by not having a really obvious problem, so to speak. Have they even talked to her doctor about these ADHD meds having a severe side effect?

[petrea_mitchell]

I would add one thing: Find a new family doctor, because this one has cause and effect backwards. LW says Blake enjoyed being active until her health got in the way. That doesn't sound like the weight gain is coming from unhealthy habits! She needs a doctor who can take a broader look at what might be going on with her health.

(Signed, someone who gained an inexplicable amount of weight as a teen and didn't get a diagnosis for the illness behind it until almost 20 years later.)

[shirou]

I don't object to LW trying to help Blake lose weight. Obesity is associated with health problems such as heart disease, stroke, and arthritis.

I do object to LW's focus on weight exclusively instead of weight as only one part of overall health, which also includes physical activity and mental health. The first thing that jumped out at me is that LW never addresses the stress that led Blake to use food as a coping mechanism in the first place. That seems like the better place to start.

[ethelmay]

I would also like to mention that food is supposed to be comforting. It is okay to derive comfort from food. Not having anything else BUT a comfort measure to handle a real problem - well, that's a problem, all right, but the comfort measure part wasn't why. You might as well say that it's sinful to use hot water bottles during your period because you really need endometriosis treatment.

[xenacryst]

I'm with a few of the previous comments, in that, while the answer was good, I think it only touched on a deeper issue in the last paragraph - it's not about the food. It's about emotional problems from adolescence and pandemic and only recently treated ADHD and who knows what all else. I guarantee that if they had the food all squared away there would still be issues among them. They need to address both their attitudes towards food (which are, indeed, all-over-the-map problematic) AND their emotional issues.