Author: Kelly Goodson MPH, RDN, LDN

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Ugh, my child is picking at their vegetables or meat again!

Raising a Competence Eater 

Children are born intuitive eaters meaning they have the innate ability  to listen to their hunger and fullness. Think of when a baby turns their face away when the bottle or breast is offered, they are telling you, the caregiver, that they are not hungry. Our bodies respond to internal cues and will send signals telling us what we need. When the right structure/environment is set up, children can continue to be intuitive eaters. Instead of having to unlearn diet rules and food restrictions later in life, children can be relaxed in what they eat and give them permission to eat what they want.

“Eating Competence is being positive, comfortable, and flexible with eating as well as matter-of-fact and reliable about getting enough to eat of enjoyable food. Even though they don’t worry about what and how much to eat, competent eaters do better nutritionally, are more active, sleep better, and have better lab tests.” (Satter, 2019). A competent eater is someone who eats intuitively. Intuitive eating (IE) is made up of 10 principles. One of the principles that this post will touch on is ‘Make Peace with Food.’ We will be talking about intuitive eating in more detail in future posts.  

What stands out to me as key to raising a competent eater is structure at meals and snacks. Sitting down with your child to eat three meals and snacks you offer to them. Consider your role as a parent and your child’s role which is what the Division of Responsibility (DOR) in Feeding framework outlines. This was designed by Ellyn Satter, a registered dietitian and therapist and DOR falls under the Satter Feeding Dynamics model. The parents’ job is to decide where you are going to eat, when you are going to eat, what food you are eating (where/when/what) The children’s job is to decide how much and whether to eat the foods offered by the parent. (How much/whether). 

Body autonomy is an important aspect which helps your child feel safe and comfortable. Allowing your child to say no to a food they don’t want to eat extends to other pressures they will face. 

As shown by research, external cues such as praising, pressuring, bribing, threats, distraction, shame or guilt interferes with your child’s innate ability to feed themself. Your child will learn to eat for the wrong reasons, to please you or avoid conflict. This may be something you were taught and our society teaches us.  Using the DOR model as guidance and meeting with a Registered Dietitian or feeding specialist if you need one-on-one support. 

Lean into your kids.  Ask them if they feel pressured to eat or are worried. 

A question to ask yourself as the parent or guardian: Are you adding pressure or adding support? 

If you want to hear from real-life dietitians who implement competent eating and family feeding tips, click here to listen to the podcast.

Restrictive eating- If sugary cereal, juice or sugar is off limits in your house, they will get it from somewhere else like a friend’s house or at school and not tell you. They may eat a lot of sugar or cereal because they know at home they aren’t allowed to eat it. So, they may not be hungry or really crave it, but due to it being forbidden at home, they feel they will never get it again and binge on it. Finding a middle ground where they have access to candy and sometimes eat too much or too little so it’s not elevated. Restriction of food will cause your child to want it more. Think about it for yourself –  have you gone on a diet and you can’t have carbs or high-fat foods, you may have noticed you want it more. 

In Rowell and McGlothlin’s book on Extreme Picky Eating, they discuss the pressure paradox. Pressuring your child to eat can cause them to have increasing anxiety, decrease in appetite, liking food less, and depending on you for every bite. 

Asking them to take a “no thank you bite” or two more bites to get dessert may work in the short-term but long-term backfires. It can make the child become a pickier eater and put even more stress at mealtimes. Praising is also pressure – excitement from you or using a sticker chart when they eat a food puts pressure on your child. They may feel bad if they don’t want to eat the food again. Children are concrete thinkers and until they hit adolescence they do not think abstractly.  

Tip: Don’t pressure them to eat everything on their plate. Offer a preferred food along with a new food. 

 Consider how you talk about food around your children. Do you talk about mommy being bad having this brownie or this is her cheat meal. An experiment to try is offering dessert with mealtime multiple times. See how they react and how the order of what is eaten may change. 

Talk about food in a neutral way so one food is not more elevated and more powerful. I want to point out that desserts like ice cream or higher-fat foods like bacon or chips do taste better than say kale. We can acknowledge that and share with our kids that treats can be part of our day but they may not always get a treat when they ask. To explain this further, if they ask for ice cream at breakfast or they already had lots of candy that day, you can remind them of this in a gentle way and enforce the boundaries. “ We will save this for later or tomorrow since we already had enough today. Other days, you can try letting them have more than enough – let’s say they are playing with their cousins or it’s a holiday. This process allows them to trust their body. 

The goal as parents is to create a safe environment where your kids flourish with their growth, feel nourished, eat food they enjoy, and trust their body.

Resources 

https://www.ellynsatterinstitute.org/how-to-eat/the-joy-of-eating-being-a-competent-eater

https://www.ellynsatterinstitute.org/how-to-feed/the-division-of-responsibility-in-feeding

Helping Your Child with Extreme Picky Eating by Katja Rowell and Jenny McGlothlin*

https://amzn.to/3jLHjPy

Your Child’s Weight Helping Without Harming by Ellyn Satter* 

https://amzn.to/3scR0dH

Podcast: https://sunnysideupnutrition.com/episode/what-does-it-mean-to-raise-a-competent-eater-part-i

Kelly Goodson is a participant in the Amazon Services LLC Associates Program and the books listed above are affiliate links. Thank you for supporting my efforts to promote a positive feeding environment.

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The bad and ugly with BMI – imperfect tool

BMI (Body Mass Index) is an outdated, archaic system being used in the medical system that categorizes people into categories based on weight and is based on bad science.  BMI doesn’t tell you what your skills, health, abilities are. Ilona Maher, a Bronze Olympic athlete is a perfect example of this. Ilona recently was body shamed in a TikTok comment for having a BMI of 30. Her response was perfect. I love how the Olympics has a great representation of diverse body types that shows athletes performing all types of athletic sports. Sarah Robles is another Olympic athlete that trumps the narrative that you have to be thin to be in shape and as a former runner, I have to give a shoutout to ultramarathoner Mirna Valerio. She has done so much in the body diversity/BIPOC space.

@ilonamaher

As long as haters keep saying dumb stuff, I’m gonna keep clapping back

♬ original sound – Ilona Maher

BMI – The BS Measuring Index1 is the perfect way to describe BMI. Read out to find out why BMI is BS (bad science).

History of BMI

BMI was created by  Lambert Adolphe Jacques Quetelet, an astronomer and mathematician, not a medical doctor in 1832. The tool he created was to measure the average weight of a population NOT an individual. He also only studied white European males which does not represent our diverse population. 

BMI wasn’t designed for use on individuals or diverse populations.

 Adolphe Quetelet, the creator himself, stated that it was not for use on individuals, and it was most certainly not designed to measure health. Quetelet had no interest in measuring health or “obesity”; he was a statistician looking at population models rather than a medical practitioner studying individual human health conditions.

BMI does not take into consideration age, sex, race, ethnicity, social determinants of health, muscle mass, bone mass, body fat… It’s simply height over weight squared. It’s been found to be less accurate for people of color and women. 2 

A common critique that you hear about BMI is categorizing athletes as ‘overweight” or “obese.” Since the equation doesn’t take into consideration muscle mass, it technically means that these athletes are considered to have a “disease” as a result of their weight.

BMI  pathologizing that one’s body is “a problem”

Where I see the most harm is how BMI discriminates. It is used in determining who can seek help in many eating disorder clinics and who can get certain insurance coverage for healthcare.  Certain bodies are told they need fixing aka lose weight. Our society assumes that those in larger bodies don’t eat healthy, are lazy, and don’t exercise. Bodies are diverse, and there are many folks in larger bodies who are exercising regularly  and eating a variety of nutrient-dense  foods.  I’ve worked with clients with eating disorders who are in the “normal weight” category who are actively engaging in eating disorder behaviors (restricting, weighing, compulsively exercising) and their behaviors are not healthy. Currently, we use BMI to measure individual health which places people in certain categories such as “normal weight”, “overweight”, “obese”. These labels create a lot of shame and create a notion that being overweight is bad for you and being a “normal weight” is the overarching goal. Research has found that being overweight has the lowest mortality  and those in the “underweight” BMI category have the highest death risk. 3 Labeling can also create worse outcomes, such as individuals in larger bodies avoiding doctors office due to medical trauma they experience. “I’ve lost count of the number of times I’ve gone to an appointment with a really simple issue like a virus … and come away feeling pretty ashamed or frustrated because the doctor chose to only focus on my BMI or weight,” says Chloe Papas, a campaigner and co-organizer of A Plus market — a marketplace for pre-loved plus size clothes in Melbourne. She says this has resulted in her skipping doctor’s appointments in the past to avoid the conversation. “For me, and for many other people in bigger bodies, the BMI can feel almost like a weapon in doctors’ offices or in medical settings,” she says. 4

Shifting from what is the problem with body to how best support my body and asking the questions: 

  • “What is the problem with how my body is seen and treated?
  • What is the problem with using the BMI to categorize a human’s health status?” 5

Kelly is a weight-inclusive dietitian who doesn’t believe in the whole BMI system and believes health is so much more than a number. If you are wanting not to feel like an arbitrary number on a scale and focus on relationship with food and behaviors with food, please reach out and connect and set up an appointment.

Summary of history and biases of BMI

References

  1. BMI is BS Measuring Index from Rebecca Scritchfield book, Body Kindness
  2. Is BMI a Fair Health Metric for Black Women? https://www.healthline.com/nutrition/bmi-for-black-women#bmi-and-black-women
  3. The ‘Obesity Paradox:’ a parsimonious explanation for relations among obesity, mortality rate, and aging? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3186057
  4. The really old, racist and non-medical origins of the BMI https://www.abc.net.au/news/2022-01-02/the-problem-with-the-body-mass-index-bmi/100728416
  5. Unapologetic Eating: Make Peace with Food and Transform Your Life. Alissa Rumsey

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Intuitive Eating – Starting with #1 – Rejecting the Diet Mentality

I recently did a workshop on intuitive eating and while marketing the workshop, I realized that intuitive eating is not well known so I wanted to highlight IE in this blog post today.

Intuitive Eating (IE) is a framework made up of 10 principles created by two registered dietitians, Evelyn Tribole and Elyse Resch. They offer a road map to move away from dieting and finally feel peace in your relationship with food. The focus is on getting away from rigid diets and external food rules and focusing on internal cues for eating. IE is a non-diet approach that is backed up by 140 studies! We will review all ten principles with this post focusing on the first principle.  

1. Reject the diet mentality

2. Honor your hunger

3. Make peace with food

4. Challenge the food police

5. Feel your fullness

6. Discover the satisfaction factor

7. Cope with Your Emotions with Kindness (Cope with your emotions without using food)

8. Respect your body

9. Exercise – feel the difference

10. Honor your health with gentle nutrition

The quiz below can help guide you in helping you know if you are an intuitive eater or need to grow and work on becoming one. Read the statement and answer “yes” or “no” if it mostly applies to you. 

Unconditional permission to eat.

  1. I try to avoid certain foods high in fat, carbs, or calories.
  2. If I am craving a certain food, I don’t allow myself to have it.
  3. I follow eating rules of diet plans that dictate what, when and/or how to eat.
  4. I get mad at myself for eating something unhealthy.
  5. I have forbidden foods that I don’t allow myself to eat.

Eating for emotional rather than physical reasons.

  1. I find myself eating when I’m feeling emotional (anxious, sad, depressed), even when  I am not physically hungry.
  2. I find myself eating when I am bored, even when I am not physically hungry.
  3. I cannot stop eating when I feel full.
  4. I find myself eating when I am lonely, even when I am not physically hungry.
  5. I use food to help soothe my negative emotions.
  6. I find myself eating when I am stressed, even when I am not physically hungry.

Reliance on internal hunger/satiety cues. 

  1. I cannot tell when I am slightly full.
  2. I cannot tell when I am slightly hungry.
  3. I do not trust my body to tell me when to eat.
  4. I do not trust my body to tell me what to eat.
  5. I do not trust my body to tell me how much to eat.
  6. When I am eating, I cannot tell when I am getting full.

If you answered yes to many of these questions, this gives you the opportunity for further work on your relationship with food. Find the section with the most amount of “yes’ responses and start there. 

What IE looks like:

  • Eating foods that satisfy and you enjoy eating 
  • Eating wide variety of foods with no guilt or shame
  • Flexible eating
  • Enjoying social experiences without fear of food 

Dieting may look like: 

  • Counting calories, macros, or points.
  • Measuring all of your food (does not include for baking purposes) 
  • Cutting out food groups for reasons not related to your religion or food allergy 
  • Intermittent fasting 
  • Shakes, powders, cheat days 

With every new diet you start, you experience hope and contentment that you have found an answer to your struggles with food, weight, and more. Eventually after a few weeks or months, you feel defeated, disappointed, and upset that this diet did not work and results were not permanent. Dieting causes biological, psychological, and emotional damage. Biological damage from diets includes decreased metabolism/increased fat retention, increasing binges and cravings, increasing risk of premature death and heart disease due to yo-yo dieting. Psychological and emotional damage includes increased social anxiety (may worry about what you can eat or not eat at restaurants or events), lowered self-esteem, loss of control over eating. Dieting is also linked to eating disorders (“Dieters were eight times as likely to suffer from an eating disorder by the age of fifteen, than non-dieters).” (Evelyn Tribole and Elyse Resch, 2012)

You may decide to give up diets but could be stuck in the diet mentality. This mentality may look like cutting back on food for a special event, drinking coffee or diet soda when hungry, eating low-calorie or low-fat foods, eating perfectly in front of others. 

Diets serve as an external cue that tells us what to eat, how much to eat, or when to eat. Dieting disconnects us from our body signals. You may not know what feeling full or feeling hungry feels like unless it’s extreme. It makes us not trust food, especially carbohydrates.  

Building up your anti-diet toolbox takes time and can include the following. 

Finding social media accounts that make you feel good about yourself and don’t promote diet culture. I can share a list with you if you are looking for new ones! 

Getting rid of magazines and books that encourage dieting or make you feel bad about your body

Deleting tracking apps like MyFitnessPal, MyFatSecret, etc. 

Looking for registered dietitians that specialize in IE, HAES (Health At Every Size) and don’t promote weight loss. Intuitive Eating is a journey that takes time, patience, and a willingness to look inward. Having support is crucial. 

Not weighing yourself everyday. You may want to gradually do this by cutting back to 1x/week, then once/month or you may be ready to throw out the scale.

 There are multiple studies that show how intuitive eating can help you feel better, reconnect and trust your body.

A new meta analysis (data combined from 89 studies!) showed Intuitive eating is POSITIVELY associated with:  Body appreciation⁣, Body image flexibility⁣, Body function⁣, Body acceptance by others⁣, Mindfulness⁣, Positive affect⁣, Self-compassion⁣, Self-esteem⁣, Social support⁣, and general wellbeing. ⁣

The drawbacks of the study is that it is cross-sectional, which is an observational study and cannot be used to establish causal relationships and most of the participants were white females. Having experimental studies and following people over longer periods along with recruiting more diversity including different races, ethnicities, and genders. 

By embracing intuitive eating, it allows for less fear, guilt, freedom, body trust, more variety, joy with eating, and less disordered eating. Intuitive eating can be a transformative approach for many people, helping to foster a healthier, more balanced relationship with food and body image.

Consider: How many diets have you tried and what was the result? Has dieting ever helped you improve your health sustainably?  What holds you back from intuitive eating? 

Sources 

​​Denny, K. N., Loth, K., Eisenberg, M. E., & Neumark-Sztainer, D. (2013). Intuitive eating in young adults. Who is doing it, and how is it related to disordered eating behaviors? Appetite, 60, 13–19. https://doi.org/10.1016/j.appet.2012.09.029 

Intuitive Eating: A Revolutionary Anti-Diet Approach by Evelyn Tribole and Elyse Resch https://amzn.to/3zxhARo*

Linardon J, Tylka T, and Fuller-Tyszkiewicz M. (2021) Intuitive eating and its psychological correlates: a meta-analysis. Int J Eating Disorders

Kelly Goodson is a participant in the Amazon Services LLC Associates Program and the book listed above is an affiliate link. Thank you for supporting my efforts to promote a positive feeding environment.