Body Image, Honesty, and Openness to Change


One of the foundations of Dr. Pretlow’s philosophy is the principle that the kids themselves are the experts, and they are worth listening to. In fact, we’d better listen to them, or we will wind up spending a lot of resources on programs that are doomed to fail, while ignoring more promising leads. We do this for various reasons, none of them worthy. Of course, the waste of money and human energy on futile projects is not the worst part. The worst part is that a whole lot of kids are facing serious difficulties and are not getting the help they need.

Anorexia is the through-the-looking-glass twin of obesity. The outward manifestation is the opposite of obesity: a skeletal frame rather than a blimped-up pincushion. The eating disorders known as anorexia and bulimia and bingeing are not the same as obesity, but they are about obesity, a fear of fatness that is so powerful that sometimes death seems like the better option. They are all, one way or another, about body image.

At Finding Melissa, a business writer and freelance copywriter named Melissa Wolfe speaks with brutal honesty about her struggles with food issues. She personifies her eating disorder as an entity, somewhat like an abusive boyfriend.

My eating disorder was a consummate liar… It is hard to challenge something when you’re cowering under its threats… I didn’t give myself the space to find out what would happen if I listened to the other voices instead.

Granted, Wolfe was not a child or a teenager during this period of her life. She’s talking about ages 21 to 28, but in analyzing the games her head played with itself, she expresses universal delusions. Very important characteristics are shared by all bad habits and all addictions, in every age group that has a vestige of self-awareness. Wolfe writes brilliantly and ruthlessly about the ways in which the “consummate liar” rationalized and justified the behavior it urged upon her.

Liz Snyder, author of “Real Food, Real Kids, Real Love,” has some things to say about body image — and it’s not just criticism, but a helpful suggestion for parents:

Take a good look in the mirror… Ask yourself, ‘How was I treated as a child, that makes me want to react this way? Was that method good for my body image? Will treating my child the same way I was (especially if it is repeating a pattern of condescension and control) be helpful to her in any way whatsoever?’

The last thing a loving parent would want to do is to cause more damage to a child’s body image, which is fragile enough already, Snyder says. She urges us to think of the child’s heart first, and body second.

Dr. Pretlow’s presentation, titled “What’s Really Causing the Childhood Obesity Epidemic — What Kids Say,” is all about paying attention to the young ones, who share their feelings and thoughts, failures and successes. To listen to them is the first important thing, and the second important thing is to derive meaning from the material they generously share. One of the meanings is difficult to avoid, because the kids state it in so many words: Overindulgence in highly pleasurable foods is an addiction.

Now, we all realize that teenagers tend to exaggerate, and sometimes they parrot the opinions of others, opinions they do not necessarily share. Yet, even making allowances for variables and human nature, there are enough kids making the junk food/addiction comparison that we really should lend an ear.

Your responses and feedback are welcome!

Source: “A Few of the Lies My Eating Disorder Liked Me To Believe,” Finding Melissa, 04/29/10
Source: “Real Food, Real Kids, Real Love: 10 (surprising!) ways to raise a healthy eater,”
Source: “What’s Really Causing the Childhood Obesity Epidemic – What Kids Say,” Weigh2Rock, 2010
Image by graham, used under its Creative Commons license.

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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