The latest question for our Ask the Expert panel comes from a worried mum who wants to know how to help her overweight teenage daughter stop bingeing on junk food and have a better diet. Dr Gillian Harris and Dr Elizabeth Shea share their advice
My 15 year old daughter is severely overweight. I am a really healthy eater – as is my husband – and I have tried encouraging her to eat more healthily. When she is at home she will eat the healthy food I cook but she seems to be gorging on junk after school or when she goes out with friends. I have tried talking to her about healthy choices – but I actually think this is more of a psychological issue with her in that I think she eats compulsively and it is more about control issues rather than appetite.
I’ve spoken to our GP and she has told me not to say or do anything but to just let her continue and work it out for herself. I am worried if I make too big a deal of it she will swing the other way and become anorexic or have other eating issues, but at the same time I hate seeing her eat so much and be overweight.
I was chubby as a teenager but slimmed down in my twenties so I think this might be the same for her. What do you suggest I do?
Dr Gillian Harris and Dr Elizabeth Shea reply:
This is a difficult problem given that it involves a teenager, and they are always resistant to suggestion, unless it comes from their peer group!
There are two points here to be considered, excess hunger and mood.
Some people (both children and adults) are more ‘food responsive’ than others. People who are food responsive have to eat food if they see it and it is available to them; they will finish up a whole packet of biscuits, or a whole box of chocolates if they are left around within sight. This is a genetically determined trait. You say that you were chubby as a child, perhaps you too were ‘food responsive’.
Being too ‘food responsive’ often occurs along with another genetically determined trait, that of eating more food than is actually needed for growth and energy. Some children and adults are just less good at keeping their intake down to what they actually need; they are not tuned into internal cues of ‘fullness’. If these two traits come together then you have someone who eats whenever they see food, and doesn’t really know when they have had enough.
You say that she eats well at home, and that could be because you don’t have high calorie foods (biscuits, cakes) available for her to take and eat all the time; which is good. When she is out however, she can eat whatever she sees and as much as she likes, and because she is now a teenager she has the freedom to access her own food.
The second point is that, although you speak to her about healthy choices, you should also be careful not to absolutely restrict foods which you think are ‘unhealthy or use them as treats’, otherwise these foods become more desirable because they are withheld; they become special. These high calories foods (crisps, sweets etc.) are then eaten when feeling low or anxious, because they are seen as a reward and a way to alter mood. It could be that this is why she ‘binges’ on food when not restricted. Is she worried or anxious about anything? Is she using food to control her feelings about life, or about the way that she looks?
You are right to think that you shouldn’t make too big an issue about this, but you do need to carefully structure an intervention plan. Is she worried about her weight? Are her school friends also overweight? Can you provide her with lower calorie, but more filling snacks, to eat on the way home. Where are all these extra calories coming from, and when and why do they get eaten? Think about what her mood might be when she is over eating; is she bored, worried or down? Can you help her deal with this? Carry on with providing reasonable portions of a wide ranging diet, including lots of vegetables at home, and try to find out what drives her when she is over-eating – hunger or mood?
Dr Gillian Harris and Dr Elizabeth Shea run workshops and therapy for children who are food averse and have very restrictive diets at the Birmingham Food Refusal Service. Read more about Dr Harris and Dr Shea