"Mom, Am I Fat?"

doctor measuring overweight boy

Conversations That Could Save Your Child's Life

Your child’s room is strewn with clothing as she searches desperately for something to wear that “looks decent.” As the piles become heaps, still nothing looks good enough. She peers into the mirror and sees only that her physical appearance does not measure up to the standards she has set for herself. Her eyes see “fat” everywhere she looks: her belly, her thighs, her face, her hips. She turns to you and the dreaded question emerges. “Mom, am I fat?” You look at your daughter in wonderment. To you, she is the picture of health, trim and fit. Now comes the challenge… how to respond.

To quote W.C. Fields, “Sometimes a cigar is just a cigar;” sometimes such a question is simply an innocent request for a status report on her body size and appearance. More often than not, however, it can be a thinly veiled indicator of other underlying concerns and a confession of your child’s fears… about being fat, about losing self-control, about dealing with her own self-loathing, about an obsessive compulsivity regarding food and body weight that interferes with her daily functioning. This question could be a sign that she has begun the descent down the slippery slope to a clinical eating disorder.

overweight girl stepping on scale

“Are you kidding/crazy? Of course, you’re not fat! You are just right!” is a response that might imply you are questioning her judgment and sanity in even having asked such a question. She may see you as biased in her favor, or just plain dishonest and not to be trusted. Deciding that you just don’t know what looks good or how important it is to be thin, she might decide to leave you out of the loop altogether next time. It’s a good likelihood that a response like “Well, you do look a little rounder around the middle,” could plunge her further into an anxious preoccupation with body image and the resolve to diet rigorously. It is no wonder that parents feel confused, trapped, and frightened in what appears to be a no-win situation with their daughters… some of whom, these days, are no older than five or six.

It is a parent’s responsibility to investigate the query with open ears and an open mind, to tread softly but assuredly, prepared to recognize potential problems and respond clearly and decisively in an effort to nip problems in the bud. Once your child has chosen to bring you into her inner world by sharing what may be her deepest concerns, don’t be afraid to hone in to decipher what your child may really be saying. Discovery of the significance of a child’s comment or question happens through a process called active listening.

Four Easy Steps to Active Listening

Active listening establishes a healing connection between parent and child that allows parents to remain authoritative and parental, to teach important life lessons and impart self-actualizing values. Active listening responses often take the form of questions.

“Mom, Am I Fat?”

1. The listening parent is able to hear what is spoken, as well as unspoken, bypassing the obvious to reveal what is at the heart of the question.

“I wonder what makes you ask such a question. Do you doubt your own capacity to know how you look?”

2. The child is invited to listen to herself, to begin the process of self-discovery.

“What might be leading to these concerns now?” How long have you been thinking about this?” “What are your own ideas about this?” “Are you actively trying to lose weight now?” “Does your concern make you alter the way you eat or dress?” “If you were to decide to lose weight, how would you go about doing so?

3. The parent hears the feelings underlying the content of the question posed.

“It sounds to me as though you may be worried about how you look. When you are surrounded by skinny girls at school who don’t eat lunch, it’s normal to wonder if maybe there’s something wrong with you."

4. The child is offered the opportunity to find a meaningful solution to a problem revealed.

girl holding an apple and a donut

“Let me explain a few things that may help you think about this. Did you know that… a. Dieting is the worst way to lose weight? b. Kids who diet increase their odds of becoming overweight adults? c. The best way to manage being overweight is to eat differently (more regularly, more nutritiously) not less. d. 20 percent of the weight that girls gain in puberty needs to be gained in fat so that their body can prepare to bear a child one day.”

Eating disorder prevention starts with a parent’s willingness to listen and to establish an effective parent/child connection through probing but sensitive and caring communications. The nature of this connection and parental support will change through the years and life stages to accommodate the growing child’s changing needs and increasing autonomy from childhood through adolescence, young adulthood, and beyond.

About the Author:

Abigail Natenshon, MA LCSW, GCFP is a psychotherapist who has specialized in the treatment of eating disorders with individuals and families for the past 36 years. Natenshon is founder and director of Eating Disorder Specialists of Illinois and is the author of When Your Child Has An Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers