Body Image, the Face of
Obesity and Anorexia

As kids approach puberty they become more susceptible to obesity and eating disorders, but there are things parents can do to be alert and get early intervention ages 

By Melissa Tucker

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This month, we broach the subject of weight and adolescents, specifically two opposing ends of the spectrum: obesity and eating disorders. 

In Arkansas, our discussion about weight centers mostly around obesity, and with good reason. According to the Centers for Disease Control (CDC), 22 percent of high school students in the Natural State are obese. 

“Obesity is an epidemic for America overall,” said Christi Arthur, RDN and certified pediatric nutritionist. “And it’s important to note there’s no area or region in Arkansas that’s immune to obesity, in general. Obesity is basically having excess body fat or weight and a BMI [body mass index] of 30 or above. For children, ages 2 to 19, it’s being above the 95 percentile on the growth chart when compared to other children the same age and sex*.

Some of the factors that contribute to obesity include: genetics; the ability to convert food to energy, which is metabolism; eating behaviors; physical activity; and sleep. 

Arthur said, “Children 6 to 12 years of age need 9 to 12 hours of sleep per 24 hours, children 13 to 18, need 8 to 10. Yet, a 2015 study by the CDC found, based in nine states, that only 58 percent of children in grades sixth to eighth get enough sleep on school nights. And 73 percent of high school students in the United States don’t get enough sleep.” 

As far as physical activity, behaviors begin as young as 6 years. “We often talk about the freshmen 10, or now the freshman 15 or 20, but statistics show children begin to pick up excess weight at a much younger age,” Arthur said. 

Additionally, decreased physical activity can be due to unsafe play areas, no physical education classes being offered in schools and the frequent use of sweetened beverages like, tea and energy and sports drinks.

“The epidemic isn’t the result of one behavior but a variety of factors,” Arthur said. 

The consequences of obesity for school-age children affect their physical, social and emotional health, immediately and long term. Obese children are at higher risk of developing chronic conditions, such as asthma, sleep apnea, fatty liver disease, hypertension, heart disease, Type 2 diabetes and bone and joint problems—all conditions we associate with adults. 

“Additionally, obese children may become targets of bullying, whether face-to-face or online, which can contribute to depression and low self-esteem. And these children have a 70-percent chance of becoming obese adults and developing certain cancers. So, it’s not just about looks—this is very serious,” Arthur said. 

Obesity also seems to contribute to the early onset of puberty, which is often when adolescents’ risk of disordered eating increases. 

Ann Brown is a licensed clinical social worker with more than 20 years experience; she specializes in adolescent and family eating disorders and mood disorders. 

While Brown defines adolescence as ages 13 to 18, she said it’s been her experience that children are developing eating disorders at earlier ages, some as young as 10 or 11. However, it becomes more prevalent at ages 13 to 14, and while eating disorders are less common with boys, the disorders are prevalent with athletes, dancers and models, where competition and stress can precipitate them.

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Brown said she’s seeing more cases of each of these disorders as more people are starting to reach out of help versus in the past when people simply suffered in silence and shame. 

“We still have a long way to go. The social stigma hasn’t changed that much. That’s one reason the Eating Disorders Coalition of Arkansas was founded. Our goal is to educate providers to help with resources and treatment, and to lessen the stigma associated with eating disorders.”

In Arkansas, the treatment options for eating disorders are limited to outpatient care, however, Brown recommends a four-prong approach: outpatient therapy, seeing a nutritionist, visits with a psychiatrist and consultations with general practice physicians. This has shown to be effective in some cases. For individuals with extreme levels of malnourishment, hospitalization and inpatient care is often needed.

We offer the following information about resources for individuals—parents and/or adolescents—who would like to learn more about or get help with eating disorders.

Symptoms of Eating Disorders Include: 
• Change in behavior or appearance, becoming too thin
or dehydration

• Change in friends or withdrawal
• Obsessive attention to food, calories or worry about weight

Arkansas Children’s Hospital Eating Disorders Clinic
1210 Wolfe St.
501-364-2680
archildrens.org

Arkansas Psychiatric Clinic
4 Executive Center Court
501-448-0060
apclr.com

Eating Disorder Coalition of Arkansas
1405 N. Pierce   Suite 212
501-664-0091
edcofar.org

RiverStone Wellness Center offers a support group for those who have a loved one affected by an eating disorder. They meet at 5:30 p.m. every second Thursday of the month at 5905 Forest Place, Suite 230 in Little Rock; there’s no charge to attend. For more information,  call 501-777-3200.

A comprehensive approach is also being utilized to help reduce obesity rates. In some cases, medically indicated surgery and adjunctive therapy is recommended. Additionally, Arthur said, the matter is being address through early intervention in schools. 

In 2003-04, Arkansas schools begin measuring students’ BMI (if approved by the student and parent). Parents then received letters addressing any health concerns, including obesity, children who are underweight and those who are at risk for becoming overweight, as well as general guidelines such as how they can cut back on sugary beverages and/or how to increase nutrients for children who are underweight, and ways to increase their child’s physical activity. “This way students aren’t singled out,” Arthur said. 

Additionally, Arkansas has a grant to use telemedicine in four rural school districts to address issues, such as obesity, exercise, mental and dental health and physical activity. 

Parents should be mindful to model positive behaviors in regards to their own weight. If you’re concerned about your child’s weight, consult your pediatrician or general practice physician. Additionally, shop for, cook and eat meals as a family. This will allow parents to become aware of their child’s eating habits, whether the issue is eating too much or too little. 

*Arthur notes there are different growth charts for children with Down syndrome and other conditions that affect metabolism, such as those for little persons. 

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Ways To Help Children Address Obesity

• Participate in physical activity together. If you don’t have a safe outdoor space, do exercise videos inside. 
 • Have a meatless dinner and/or have a contest to see who can make the best veggie burger. 
 •  Look at your meals’ portion sizes. If you need assistance, consult your doctor. You’ll also find a good number of resources online. 
 • Set concrete guidelines for snacking and teach your child how to choose healthy snacks. 
 • Eliminate or limit processed foods. 
 • When eating out, look at the nutrition facts and make wise choices. 
 • Drink water, low-fat or skim milk and limit
sugary  beverages.