Food, Eating, and Body Image: Helping Families Cope with a Dangerous New Culture

1. Food, Eating, and Body Image:Helping Families Cope with a Dangerous New Culture Karen Armitage, MD, FAAP Region 2 Health Officer, NM Department of Health

2. Our culture is changing… • Family structure • What, where and how we eat • Activity levels at work and play

3. A TOXIC CULTURE IS EVOLVING… • Around Food and Eating • Around Fatness • Around Body Image/Attractiveness

4. A TOXIC CULTURE IS EVOLVING… Around Food and Eating • Media messages 24/7 to buy and eat fast food, sugared beverages, snacks. • Sites to buy such foods line city streets. • Public schools offer fast food for school lunch. • Most people eat fast/prepared food every day.

5. A TOXIC CULTURE IS EVOLVING… Around Fatness • Food ads alternate with weight loss ads. • 50% 3rd-6th grade kids want to weigh less, 16 percent have tried to lose weight. • Obesity experts surveyed had more anti-fat bias, i.e. “fat people are lazy, stupid, worthless”, than the general population.

6. A TOXIC CULTURE IS EVOLVING… Around Body Image/ Attractiveness • Average U.S. woman 5’4” , 140 pounds. Average U.S. model is 5’11”, 117 pounds. • Extensive cosmetic surgery make-overs regularly shown on TV and in teen magazines. • 18-year-old girls getting breast-implant surgery nearly tripled: 3,872 in 2002 to 11,326 in 2003. • Men now turn to cosmetic procedures at an even faster rate than women.

7. In the midst of this toxic culture, kids, families and communities need new coping skills… • To protect and promote health • To build and maintain good health habits • To take control of decisions and policies that powerfully affect personal, family and community health

8. BY THE WAY… WE ARE A PART OF THE PROBLEM • This toxic culture arises not just from media and advertisements…health care professionals also stress weight loss via restrictive food diets, in the absence of medical evidence that these practices improve health outcomes.

9. The evidence is in… • Very large, population-based, epidemiological studies • Large, well-designed prospective studies of adult men and women • A few preliminary studies in children

10. Think fitness, not fatness-- Nutrients, not caloric-restriction… • Sedentary adults atall weights are at increased risk for all-cause mortality. • A diet high in animal fat, processed foods and refined carbohydrates increases risk of many chronic diseases.

11. WHAT WORKS? • Increase physical activity • Just move! • Make every daily activity a little more physical. • Schedule physical activity • Make physical activity #1 priority until it is a habit. • Keep it interesting • Look for opportunities to explore all components of physical fitness: aerobic capacity, strength, flexibility and coordination. • “Shake it up” regularly--try new things that sound like fun. • Make some new friends who enjoy physical activities. • Goal: a healthy habit of physical activity each day, not a “forced march” prompted by will power.

12. WHAT WORKS? • Improve nutrition The ideal: a variety of whole foods, prepared at home and enjoyed face-to-face at the table. • Parents’ “food job” vs. kids’ “food job”. • Two “food” questions parents can ask at mealtime. • No more food fights! • Involve parents in school food policies and practices. Goal: healthy eating habits for life

13. WHAT WORKS? • Send this message: “Healthy is beautiful” • Catch people being healthy. • Praise physical activity, a balanced diet, and self-care. • “Talk back to the TV”. • Model the behaviors you want to see in kids. Goal: healthy behaviors, not conformity with media images or stereotypes

14. WHAT WORKS? • Help families build a “healthy relationship” with food, based on these beliefs: Food is fuel for activity Food is building blocks for a healthy body Food is delicious! Goal: healthy attitudes towards food and eating

15. And finally… • Feeling overwhelmed? Pushing back against a toxic, pervasive culture is really hard! • Can we lead others to healthy behaviors? What if we have “issues” from being raised in this culture? THOSE ARE HEALTHY, SANE REACTIONS! • Center yourself with these questions—then act. What would a ‘sober’ relationship with food look like in this situation? “Fake it ‘til you make it”. Am I in the right frame-of-mind to nourish myself with food? Do a H. A. L. T. analysis. Am I “walking the talk” about food, eating + activity, or just talking? Fill the pitcher first, then pour.

16. References • Blair SN, Brodney S. Med Sci Sports Exerc. 1999 Nov;31(11 Suppl):S646-62.Effects of physical inactivity and obesity on morbidity and mortality: current evidence and research issues. • Gaesser GA. Med Sci Sports Exerc. 1999 Aug;31(8):1118-28.Thinness and weight loss: beneficial or detrimental to longevity? • Blair SN, Kampert, JB, Kohl HW 3rd, Barlow CE, Macera Ca, Paffenbarger RS Jr, Gibbons, LW.JAMA. 1996 Jul 17;276(3):205-10.Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. • Schlicker SA, Borra ST. Regan C.Nutr Rev. 1994 Jan;52(1):11-7.The weight and fitness status of United States children. • Schwartz MB, Chambliss HO, Brownell KD, Blair SN, Billington C.Obes Res. 2003 Sep;11(9):1033-9. Weight bias among health professionals specializing in obesity.