Let me tell you about Cindy. Cindy is the representation of many, many teenage girls I have seen over the last 20 years. She is 14 and and very self-conscious. She is desperate for approval by her peers and struggles with anxiety and confidence.
One day, Cindy looks at herself in the mirror and decides she is fat. Cindy is not fat. But she weighs herself and is shocked to find she weighs much more than she did when she last weight herself when she was 10. She starts to try to lose weight. She skips some meals. She tells people she isn't hungry. She does 100 push ups at night in her room. She cuts her portion sizes down to tiny amounts. She weighs herself several times a day.
Cindy loses some weight and is thrilled by this. The weight loss gives her a sense of power and reward which is very seductive. So she tries to lose some more weight - and then some more.
Her parents start to notice her weight loss and reduced eating, and are concerned by it - but they don't feel they can do anything - after all Cindy still eats. In fact she still eats junk food. Her weight loss is small. She is only *just* in the underweight category for her BMI. They don't feel it is their job to question her - or to "force" her to eat more. After all, she is old enough to make her own eating and exercise decisions. Isn't she?
Now let me tell you about Jenny. Jenny is the representation of many, many teen girls I have seen over the last 20 years. Jenny is also 14, also self conscious and also desperate for approval, and struggling with anxiety and confidence. Jenny also feels she is fat.
But Jenny doesn't skip meals. Instead Jenny starts eating more food. Feeling depressed and miserable, eating is her only solace. She begs her parents to buy her junk food at every opportunity and they do. Jenny stops playing sport because she is too self conscious to be in gym clothes. Jenny looks for the block of chocolate in the cupboard and eats it in one sitting. Jenny refuses to go for walks with her family. She spends most of her time sitting in front of the computer. She starts putting on weight. Which makes Jenny more depressed, and more likely to binge eat and more likely to avoid exercise.
Her parents notice, and are concerned - but they don't feel they can do anything - after all, Jenny is not significantly overweight. They don't want to make her feel worse. They don't feel it is their job to question her - or to "force" her to exercise or eat more healthy food. After all, she is old enough to make her own eating and exercise decisions. Isn't she?
Unfortunately what I know about Cindy and Jenny is that they are standing on the edge of a metaphorical cliff. They are both at significantly high risk of the mental health problems including even more severe depression, anxiety and eating disorders. This happens to boys too - and increasingly so in my experience.
In order to prevent them falling off this cliff, adults need to step in. Cindy needs to stop weighing herself, reduce her exercise and be required to increase her nutritional intake - whether she wants to or not. Jenny needs to increase her nutritional intake, have her junk food limited and be required to have a more active lifestyle - whether she wants to or not.
None of these things are easy. In fact it is one of the difficult jobs adults and parents will face. But they are absolutely necessary for these girl's emotional health.
The reality is that 14 year olds are simply not old enough to make every final decision about how much and what they eat, and exercise. This is especially true for 14 year olds who have or are at risk of a mental health disorder as are Cindy and Jenny.
When life sucks for teens has a chapter on "I hate the way I look" which is suitable for teens who are self conscious about their appearance.
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