1. Preserving Body Image and Self-Esteem Among Overweight Youngsters Joanne Ikeda, MA, RD University of California Extension Nutrition Specialist Dec. 10, 2004 FNEP ITV University of Missouri-Columbia

2. Body Image Internal representation of your own outer appearance – your own unique perception of your body. (Thompson, Exacting Beauty, APA, 2002)

3. Body Satisfaction Satisfaction with various aspects of one’s body such as waist, hips, thighs, breasts, hair, etc. (Thompson, Exacting Beauty, APA, 2002)

4. Self-Esteem Self-esteem is “how much a person likes, accepts, and respects himself overall as a person”.

5. Body Dissatisfaction Discontent/disappoint ment with various aspects of one’s body.

6. How Common is Body Dissatisfaction Among Children of All Sizes in 3 rd to 6 th grade? 45% wanted to be thinner 45% wanted to be thinner 37% had tried to lose weight 37% had tried to lose weight 7% scored in anorexia nervosa range 7% scored in anorexia nervosa range

7. Dieting is considered one indication of body dissatisfaction in children.

8. How Common is Dieting Among Children in US? National Study of 10,000 youngsters 41% of Caucasian children 41% of Caucasian children 40% of Asian children 40% of Asian children 33% of Hispanic children 33% of Hispanic children 22% of Black children 22% of Black children

9. Our Society Promotes Body Dissatisfaction and Dieting Our Society Promotes Body Dissatisfaction and Dieting

10. Who Promotes Body Dissatisfaction in Children and Teenagers? Teen Magazines Teen Magazines TV Shows TV Shows Movies Movies Peers Peers Teachers Teachers Parents Parents

11. “Body dissatisfaction is the most consistent predictor of the onset of eating disturbances.” (Thompson, Exacting Beauty, APA, 2002)

12. Body Dissatisfaction has a negative impact on self-esteem, especially among overweight youngsters.

13. “few problems in childhood have as significant an impact on emotional well-being as being overweight.” Strauss & Pollack, Arch Pediatr Adolesc Med, 2003

14. Promoting Body Satisfaction and High Self-Esteem in Children and Teenagers

15. * Point out that human bodies come in a wide range of sizes and shapes and that there is no “perfect” body size and shape.

16. Celebrate differences in body size and shape among children and adults. Celebrate differences in body size and shape among children and adults.

17. Never imply that there is something wrong with a child’s body no matter what size it is.

18. Promoting Body Satisfaction and High Self-Esteem *Challenge media images of the “perfect body.

19. Want to Be a Teen Vogue “IT” GIRL? Staying up on the latest trends in fashion and beauty is an absolute must for me! Staying up on the latest trends in fashion and beauty is an absolute must for me! I consider myself to be a leader I consider myself to be a leader I secretly (or not so secretly) love to be the center of attention I secretly (or not so secretly) love to be the center of attention Other people look to me for advice on clothes, cosmetics and style Other people look to me for advice on clothes, cosmetics and style

21. Talk About What Characteristics We Value in Our Friends Listens to me when I talk about my Listens to me when I talk about my problems and concerns. problems and concerns. Cares about me. Cares about me. Enjoys doing the things I like to do. Enjoys doing the things I like to do. Is there for me when I need a friend. Is there for me when I need a friend. Doesn’t tell others my “secrets”. Doesn’t tell others my “secrets”.

22. Promoting Body Satisfaction and High Self-Esteem * Advocate & demonstrate respect for the bodies of others as well as your own body

23. Model Body Acceptance and Body Satisfaction Make positive comments about your own body and the bodies of others. Make positive comments about your own body and the bodies of others. Do not make negative comments about your own body or the bodies of others Do not make negative comments about your own body or the bodies of others Verbalize your own rejection of the Verbalize your own rejection of the thin, “perfect” body

24. Believe that discriminating against someone based on their body size is wrong.

25. * Take a Stance Against Size Discrimination Speak up when you see it or hear it Speak up when you see it or hear it Encourage adults to take action if a child is bullied, teased, or discriminated against because of body size. Encourage adults to take action if a child is bullied, teased, or discriminated against because of body size. Tell parents not to allow anyone to tease or harass a child about his/her weight. Tell parents not to allow anyone to tease or harass a child about his/her weight.

26. How to deal with overweight/obesity. Focus on behaviors NOT weight Soda consumption Soda consumption Fruit and Vegetable Consumption Fruit and Vegetable Consumption Fast Food and Snack Food Fast Food and Snack Food Time spent in active play Time spent in active play Time spent watching TV Time spent watching TV

27. Set Behavioral Goals Not Weight Goals Limit TV watching/computer game playing to 2 hours per day Limit TV watching/computer game playing to 2 hours per day Play actively for 60 minutes every day – do something that you enjoy Play actively for 60 minutes every day – do something that you enjoy Walk or bike to and from school Walk or bike to and from school

28. Set Behavioral Goals Not Weight Goals Drink low fat or nonfat milk at meals instead of soft drink. Drink low fat or nonfat milk at meals instead of soft drink. Limit soft drink consumption to one 12 ounce can a day or less. Limit soft drink consumption to one 12 ounce can a day or less. Eat 5 servings a day of fruits and vegetables Eat 5 servings a day of fruits and vegetables Limit fast food meals to 1-2 per week Limit fast food meals to 1-2 per week

29. Discourage Restricted Calorie Dieting in Children or Teenagers

30. Impacts of Dieting on Children’s Health Physical well being Risk of stunting growth in height Risk of stunting growth in height Lower bone density Lower bone density Delayed puberty Delayed puberty Poor nutrient intake Poor nutrient intake Fatigue Fatigue Obesity Obesity

31. Impact of Dieting on Children’s Health Psychological well being Preoccupation with food and eating Preoccupation with food and eating Sneaking and hiding food Sneaking and hiding food Body dissatisfaction, poor self- esteem Body dissatisfaction, poor self- esteem Eating disorders Eating disorders

32. Impact of Dieting on Children’s Health Social well being Subject to size discrimination by adults Subject to size discrimination by adults Teased, harassed, and rejected by peers Teased, harassed, and rejected by peers Apt to become socially isolated Apt to become socially isolated

33. Does Dieting Help Children Achieve Healthy Weights?

34. A Stanford study that followed 692 females from 9 th through 12 th grade found that increased dieting and radical weight loss efforts predicted greater subsequent growth in relative weight and increased risk of obesity. Stice et al, J Consult Clin Psychol,1999

35. Study by Harvard Medical School assessed weight change of frequent dieters compared to those who never dieted. Study by Harvard Medical School assessed weight change of frequent dieters compared to those who never dieted. Over 10,000 youngsters ages 9 to 14 followed for 2 years. Over 10,000 youngsters ages 9 to 14 followed for 2 years. Regardless of their calories, fat, CHO, or their physical activity or inactivity, the frequent dieters were more likely to become overweight than those who never dieted. Regardless of their calories, fat, CHO, or their physical activity or inactivity, the frequent dieters were more likely to become overweight than those who never dieted.

36. Diagnosis and treatment of childhood overweight is the responsibility of the medical profession, it not our responsibility. ► Examine child’s growth history over time ► Consider weight of biological parents and close relatives ► Conduct examination of child for medical problems associated with overweight ► Recommend and provide/refer for treatment

37. Our responsibility is: To help children and adults eat nutritious diets and be physically active. To help children and adults eat nutritious diets and be physically active. To help create environments that promote eating nutritious diets and being physically active. To help create environments that promote eating nutritious diets and being physically active.

38. Promote Body Satisfaction, a Positive Body Image, and High Self-esteem for All Adults and Children. Promote Body Satisfaction, a Positive Body Image, and High Self-esteem for All Adults and Children.

39. Recognize that the best way to decrease overweight is to create environments that promote healthy lifestyles in families.

40. Believe that the vast majority of parents love their children and are committed to fostering their health and welfare.

41. Know that our children are our future and we are strongly committed to caring for them and creating a world in which they can thrive.