Reflections on Uncomfortable Conversations Between Parents and Children About Weight

A WebMD/Sanford survey revealed just how uncomfortable parents are talking with their children about weight—more than sex, drugs, smoking, or alcohol. You can read the whole story here.  What struck me most about this piece was the reasons why parents are hesitant, or even terrified, to talk with their children about weight. As reported by Daniel DeNoon (italics mine):

What makes parents so reluctant to talk to children about the risks of being overweight? Many don’t think it’s a problem until their children are obviously overweight, says family psychologist Susan Bartell, PsyD, a consultant to WebMD on the surveys.

“But the next issue I see often is parents are really afraid they will trigger an eating disorder,” Bartell tells WebMD. “And then the other thing is they don’t know how to talk to kids about weight. They think they will hurt their kids’ feelings or damage their self-esteem.

And kids aren’t making this talk any easier. Nearly three-fourths of them (72%) say the discussion would be more embarrassing to them than to their parents.

Bingo. Afraid they will trigger an eating disorder and  damage their self-esteem. We’re not afraid that a discussion about sex, drugs, cigarettes, or alcohol will damage our children’s self-esteem, in fact the opposite is true. Conversations about those topics could actually protect our children from situations that could be deeply damaging to their self-esteem. Why is weight so different? Alas, Freud was right: The first ego is a body ego. Our body esteem is part of our self-esteem. The problem arises when our body esteem defines our self-esteem. On another note, it’s not the kids’ fault that the topic would be embarrassing to them. Neither parents nor their children have a blueprint for how to talk about weight without engaging all of the peripheral topics that make it so electric like self-esteem, personal responsibility, mood, affect regulation, stigmatization. It’s easy to stand back and say we should just be able to have non-emotional, objective conversations about weight; but we all know that’s not going to happen. Talking about weight is not like talking about the weather.

We need more data on what conversations to have and how to have them. Opinions we have; data, we have not. We need evidence-informed guidelines about how physicians should discuss weight/BMI with parents (with younger patients present and with adolescent patients either present or out of the room), and how parents can discuss these topics with their children. Just as an aside, I had a conversation with a pediatrician colleague and friend of mine yesterday about this topic and she reminded me that there is no opportunity for a pediatrician to talk with a parent without the child in the room unless the child is an adolescent—so whatever is said about weight or BMI is heard by the child. Sometimes, she said, they need to speak in code with the parent. But we know how attentive little ears are in that situation.

So we tell parents just to focus the conversation on healthful eating and physical activity. There is a lot of merit to that approach, but what if our children want to talk about weight? Do we have an obligation to discover a way to discuss weight without engaging all of those peripheral electric topics that make it such an uncomfortable and embarrassing topic? The fact that the first ego is a body ego lies at the root of this conundrum. The fact that our culture socializes us to conflate self-esteem with body esteem perpetuates it.

There are going to by myriad individual differences in how best to approach this topic with children, but that should not thwart our investigations into the topic. Our research agenda should be driven by neither opinion nor fear, but rather by the overarching need to determine how best to advise physicians and parents on this important topic.

And once again our militaristic language needs to be pointed in the right direction—no more wars on childhood obesity or fighting fat—those aren’t the enemy. Save that language for the battles against Big Food, Big Beverage, Big Media, and Big Diet that contribute massively to why we even need to have this conversation.

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News and Observer: In Haiti: Hardship, hope and some progress

The front page of the News and Observer today featured a striking picture of a young girl viewing her reflection in a small mirror inside her family’s tiny home in Corail, Haiti. A very poignant image captured by Patrick Farrell. Illustrates the complexity of our relationship with our reflections. A shared glimpse of this girl’s inner world. I wonder what all she has witnessed in her short life during such a turbulent time in her country and what she sees and remembers as she looks at herself. View the picture here.

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Two Tips for Transforming Your Mirrors

Math on Window

So today’s post about mirrors has little to do about self-image, but more about self-preservation. This is a story about inheriting a family heirloom mirror that really, well, doesn’t so much go with modern design and a clever idea about how to transform that ancient eyesore of a mirror into a daily planner. Titled Drab to Fab : From Ugly Mirror to Gorgeous Weekly Planner in 8 Steps. Read more on this fun decorating tip here.

I came upon another transformative idea for mirrors after a recent visit home by my son the math major. Hopefully you can see it here, but every available glass surface in his room—every window and, yes, the bathroom mirror became targets for math problems. Now that he’s back in school, at least I have this mathematical reminder of his visit! So a couple of dry erase markers can turn your mirror into a big white board, a todo list, a platform for poetry, or a glass canvas for artwork. Whatever it takes to change your relationship with the mirror! Just make sure you invest in Windex!

Don’t forget to visit or grab a copy of The Woman in the Mirror at your local bookstore.

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My New Year’s Wish

My wish for the New Year is that all of the branches of the eating disorders field realize that we are all working towards the same end…to understand and eliminate eating disorders. Rather than focusing our critiques on each other, let’s focus our energy outwards and take on Big Food, Big Diet, Big Fashion, and Big Media. We have to rise above our differences and unite via our commonalities. We could accomplish so much more together. For inspiration, and to illustrate how powerful individual voices can be when united, listen to Eric Whitacre’s Virtual Choir. We too could have that kind of impact, but only if we work together.

Happy New Year

To read more about his Virtual Choir concept, watch this:

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Month Without Mirrors

The following post is reproduced with permission from Autumn Whitefield-Madrano from her blog “The Beheld: Beauty, And What It Means”.  To hear more about her project, please visit

I abstained from looking at my reflection for the month of May 2011. The goal was to loosen the grip that self-consciousness has had on me for much of my life—that happened, to a degree, but what I discovered during my month without mirrors was the way in which I use mirrors to manage other facets of my life. You can read my reflections (get it?!) throughout the experiment here, read the conclusion here, or just check out the following individual entries:

 The reason behind the project: “Sometimes I look in the mirror and see myself, or whatever I understand myself to be. Other times, I distinctly see an image of myself.”• Week 1: My mirror shroud, and what it’s like to go to the gym without looking in the mirror.

• What the mirror fast taught me about how I regard strangers: “Not feeling like I had an accurate reading of whether that fellow was looking at me with approval, disdain, lust, curiosity, attraction, or repulsion left me feeling adrift. I had no anchor to hold onto, no private feeling of, ‘Well, I do look nice today’ or ‘I wish he would stop staring at the enormous pimple on my chin.’ Without having any idea what he might be seeing, I had no idea how I should feel about him looking at me.”

• Why looking into the mirror actually require no mirrors at all: “I turned the box on its side to look at the nutritional information, then withdrew my hand from the box as though it were a hot iron. Because I’m not supposed to be looking in mirrors.”

• News flash, ladies! You don’t always have to look pretty: “Letting go of the imaginary control the mirror gives forces me to lift the controls I believed I have over my physical allure. I thought I always had to look pretty because I thought it was something that was within my control, when it isn’t. Clean, groomed, and reasonable, yes. Beyond that? It’s up to you, not me.” 

• On vacation with no idea what I looked like: “I felt present, and quiet, existing in the eyes of someone I care for, and he existing in mine. I did not feel beautiful. It did not matter.”

• What it’s like to shop for clothes when you can’t look at yourself: “‘You can always ask what we think,’ said the salesperson, and smiled. ‘It’s what we’re here for.'”

• What the etymology of the word mirror teaches us about our relationship with our reflection.

• A Month Without Mirrors, Day 31: “What I didn’t realize until I was unburdened from some of my self-imposed (and likely invented) expectations was exactly how much of my energy was going into appearing. Appearing to be interested, appearing to be womanly, appearing to be a professional lady, appearing to be pretty. No wonder I’m exhausted.”

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That’s My Face but Not My Body! Virtual Mannequins in the Mirror

A few days ago I tweeted about a disturbing report that the clothing company H&M was affixing human heads onto computer generated bodies to sell swimwear and lingerie. This post arrived in response to that tweet from an anonymous reader via email.

For background read:


Growing up in the 90’s, I understood that it would be impossible for me to look like the fashion models I saw in magazines. This information was passed down to me by older women (namely my mom, teachers, and aunts) who explained that models were airbrushed and often had massive amounts of plastic surgery. We’ve all heard the story about how if Barbie were a real person she wouldn’t be able to stand up because her boobs would drag her to the ground. Like most girls, I grew up inundated with cultural messages from the fashion industry about what it means to be an attractive woman. I felt the irony when everyone around me was simultaneously telling me “girls can do anything.” Although not happy nor content with these messages, I became comfortable deflecting the “thin ideal” that we have grown accustomed to tolerating from the media.

NOW the fashion industry has kicked it up yet another notch! In 2011, ultra thin airbrushed models are being traded in for non-human digitally created images! Don’t companies like H & M know that their advertisements have the ability to impact millions of women and girls and the way they feel about their bodies (many of whom are completely unaware that they are looking at computer generated bodies)? The worst thing about it is the size and shape they chose to be their perfect image. They created prepubescent females with no curves and no flaws. I find it highly disturbing that H & M’s rebuttal is that these new models will allow consumers to pay attention to the garments and take the focus off of the bodies! Are they kidding?? I hope one day the Surgeon General of the United States will step in with a mandatory warnings on these adds (other countries have already started the trend): WARNING ADVERTISEMENT MAY BE HAZARDOUS TO YOUR HEALTH: MODELS ARE NOT REAL. Until this time, my daughters and nieces will grow up in a world where I will have to explain to them that fashion models are not only airbrushed, but computer-generated as well.

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Going Mirrorless

Proud2BeUS has catalogued several of the “Go Mirrorless” movements here 


And Psychology Today blog unveils how Facebook can be a blow to your mood

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Fancy on the inside?

An anonymous reader sent in this poignant post today. We all deserve to feel fancy on the inside…read more…

The holidays. Nearly ubiquitous with parties, potlucks, informal get-togethers, and, occasionally, a fancy catered affair where folks get decked out in their finest. This season was no exception as I dressed and got ready to attend such an event. After nearly an hour of hair and makeup and carefully selecting a dressy-but-not-too-dressy dress, I looked myself over in the mirror and thought, “Not bad!” and with that I headed out to meet up with friends and enjoy the evening. The event was beautifully and tastefully done and the attendees were dressed to match. Looking around at the women in the room I was struck by the tailored dresses, expertly coordinated jewelry, and perfectly coiffed hair … and I instantly felt like a little kid playing dress-up in her mother’s clothes. Something about being around these incredibly beautiful, wealthy women had me feeling like an imposter. While my outward appearance was fancy enough to be acceptable at the event, I just didn’t feel fancy enough on the inside. It’s funny how sometimes we don’t even need to have a mirror present to have our supposed personal “shortcomings” reflected back on us. Somehow, within an instant, my self-confidence had fallen and I’d gone from enjoying my evening to feeling awkward and out of place. I realized that comparing ourselves to others is such a powerful and self-defeating habit and one that has to stop if we really want to end negative self-talk and develop a positive self-image. Thankfully, I had great friends with me who, with their lively conversation and shared laughs, quickly reminded me why I was having so much fun in the first place and what was really important about that night. I can only hope that the next time I’m at the same kind of event I remember this lesson and can feel “fancy” in my own skin no matter how fantastically dressed anyone else is.

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Mirrors may help to relieve arthritis pain

As women, it can be difficult for all of us to have a good relationship with the mirror! However, science occasionally encourages us to adjust this attitude. The following summary highlights the key points of an article entitled “Mirrors can alleviate arthritis” from   The article highlights that mirrors can positively contribute to our health and well-being. To read the full article, please go to

A new study from the University of California, San Diego reports that mirrors may be an effective treatment for persistent arthritis pain. Laura Case and colleagues at the university were familiar with previous work that found mirrors to be an effective treatment for chronic pain (such as phantom limb pain), so they hoped to extend this success into the treatment of painful joints.

Researchers recruited eight volunteers with osteo- or rheumatoid arthritis to look into a mirror at Case’s healthy hand where their hand should have been. Then, to “strengthen the sensation of the hand-swap,” researchers simultaneously touched Case’s hand and the volunteer’s painful hand (Sanders, 2011). Finally, volunteers were asked to watch and mimic Case’s hand movements to increase the sensation that the hand in the mirror was actually their own.

Researchers found that volunteers reported an average 1.5-point decrease in pain (on a 10-point pain scale) in the “mirrored” hand. A few participants even reported a 3-point drop! While the long-term effectiveness of this treatment has not been evaluated, this innovative study provides great hope for people hoping to alleviate arthritis pain. Free of side effects, the new therapy may prove to be a cost-effective method of pain relief for people of all ages.


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What to Look for in the Mirror in the UK, Australia, and New Zealand

A big package just arrived on my doorstep from Bloomsbury in the UK and it was copies of the UK edition of Woman in the Mirror. The UK Cover actually has a real mirror on the cover. So, the woman in the mirror is YOU! On the back cover, Susan Ringwood, Chief Executive of beat says ‘The Woman in the Mirror is all of us and this compelling account of how feelings about our bodies affect us throughout our lives is filled with inspiration and hope.’ So when you are looking for the book in the UK or Australia or New Zealand…look for yourself on the cover!!!

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