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By Alexis D. Richards, MD, MSc, Medical Director, Lauren B. Yadlosky, PhD. Clinical Director, and Alicia Hoffman, LCSW, Program Coordinator, Eating Disorders Program at the Children’s Hospital at Montefiore
Bronx Voice
February 27, 2025
BRONX - As we approach national eating disorders awareness week (February 24th - March 2nd, 2025), our team often gets asked about treatment for eating disorders, especially because eating disorders can be so medically dangerous and cause significant psychological pain and suffering for the entire family. The best way to BEAT an eating disorder is to prevent one in the first place! So, we wanted to talk about one of the biggest triggers for body image issues and disordered eating - and it may surprise you!
About half of the youth and young adults who were referred to our outpatient eating disorders program or admitted to our inpatient unit at the Children’s Hospital at Montefiore, started losing weight as a child or teenager because an adult they trusted - a doctor, a parent, a coach - told them they needed to lose weight in order to be healthier. This can lead young people to make dangerous decisions about their nutrition that they can easily lose control of.
We’d like to set the record straight. You CANNOT determine whether a person is healthy or unhealthy based on the size and shape of their body alone. “Health,” just like someone’s body weight and shape, is determined by a lot of factors - like family history and genetics - many of which people can’t easily change or control.
Don’t get us started on BMI and medical terms like “obesity.” The bodies used to develop the BMI chart did not include bodies from all ages, genders, races, and cultures - so while it may be a helpful guide sometimes and for some people, is it NOT equally helpful for all people.
It’s better and much safer to help prevent eating disorders by NOT focusing on weight at all! Better questions to think through (and to help kids think through) are:
Can I move my body in ways that make me feel good? Can I do the things I want to be able to do?
Do I eat all different types of food? Do I eat across all the food groups and am able to enjoy what I’m eating?
Am I able to eat about three meals and two snacks a day and feel satisfied?
Can I stop eating when I’m full?
If your answer to one or more of those questions is “no,” then it gives you a good place to start thinking about possible changes that are NOT based on weight.
For example:
How do I want to be able to move my body?
What is one small step I can take to get me started?
How can I reward myself along the way for taking small steps toward my bigger goal?
Science tells us that 1) changing our health behavior is REALLY hard and 2) taking small, gradual steps over time is the most likely way for us to meet our goals.
One more note about kids and their weight and eating habits. Remember - kids are ALWAYS growing and, especially when they’re about to grow taller, may start eating more and often eat more than most adults! That’s natural - they’re GROWING and that takes A LOT of energy!
Children, adolescents, and young adults need to continue gaining weight each year as their bodies grow taller and denser (even after they stop growing taller) into their early twenties. How fast they gain weight will change, but kids should generally NEVER be losing weight or even staying the same weight from year to year. Even doctors can sometimes get too caught up in things like BMI and numbers on a scale. It’s much more important (and sometimes harder!) to think about health holistically.
So, while we continue to provide life-saving treatment to young people who are struggling with eating disorders, please help us PREVENT deadly and devastating eating disorders. Forget about the number on the scale, or what social media is saying people should look like. Focus on providing your bodies and your children’s bodies with balanced nutrition, age-appropriate movement and play, and support as they continue to grow and develop each year.
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