Body image is so important but it is also intimidating to teach about. We want our kids to be proud and love their bodies, no matter what they look like or how they are different. How do we talk about our own bodies as parents? What comments do we make about others? Our guest Marina gave us some wonderful insights into how we can help young people develop better relationships with their bodies!
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Hilary: Welcome to the Parents Place podcast. My name is Hilary
Jen: And I’m Jen
Hilary: I am incredibly excited about our topic that we have today. We are, so we are thrilled to have a guest here with us on our podcast. Her name is Marina. I'm going to go ahead and turn the time over to her to tell a little bit about who she is and what she does. And at that point, you will then introduce the topic that we have discussed with one another. So, go ahead, Marina.
Marina: All right. Thanks, Hilary. And thank you for having me on the podcast. I am Marina Capella. I'm a pediatrician here in Salt Lake City. I recently opened up my own private practice in Mill Creek called Healing Arts Pediatrics, and I basically have about eight years of experience being a general pediatrician and an urgent care pediatrician. So, I have a lot of experience with children of all ages from about zero to 18-20, and I love practicing pediatrics. I love getting to know children and their families. I love seeing them develop from newborns to feisty teenagers. And it's really a pleasure for me to be able to help families along that journey of parenthood and children to grow and develop into their best selves.
Hilary: That is awesome, and as you guys can probably already tell, she is a wealth of knowledge, which is why we're so thrilled to have her here. And actually, we will have her in upcoming podcast as well. But as we were talking about what topic to discuss, because there are obviously a lot of things that we want to be able to discuss with one another. But she brought up the topic of fostering a positive body image in kids, and when I heard that, I thought, Wow, yes, we need that. That is so important to have in our society, especially today, I feel like. And so, let's start with this Marina. Why don't you just tell us, why do you feel like this topic is an important one to bring up and have a discussion with our listeners and with their parents here?
Marina: Yeah. So, I, as I mentioned in many years of experience in pediatrics, and unfortunately, I do see a lot of problems that stem from children's dissatisfaction with their bodies at all ages, especially tends to start around the pre-teen years and go into the teen years. We see problems like anorexia and bulimia. We see self-criticism that can lead to depression, social anxiety, avoidance of certain activities because of self-consciousness and many more subtle problems related to body dissatisfaction. And on a more personal level, I have personal experiences that have really made me think about this issue for myself, as well as for my patients. I was a larger kid. I had four brothers and we were all just larger kids and we were teased. I remember being teased a couple of times at school. It wasn't ever terrible, terrible or bullying or anything like that, but it was enough to make me really self-conscious about the size of my body and the appearance and also looking back on my childhood. There were things at home that were happening that were sort of reinforcing certain things about my body image. My mom was often dieting. She had had five children. And like many women who have many children, you know, the pounds get added on. And I remember her often weighing herself, often going on diets, often making comments like, I wish I could lose 20 pounds. Why don't these pants or dresses fit just those sorts of frustrations that are very common? And I don't blame her for doing that because as an adult, I've had my own frustrations, but I definitely picked up on those things from watching my mom. Also, my mom and my aunt they were very close as sisters and they were always dieting or trying to figure out how to lose weight. And I remember when I was in late middle school, I found like a diet book, though one of them had, and I begged my mom to buy my mom to buy me these diet pills. And for some reason she did. I think I begged enough and I ended up going on a really unhealthy diet and losing a lot of weight and becoming borderline anorexic for about two years in high school. And I mean, I was eating very little, fighting with my mom all the time about food. It was not very good relationship or situation in general for two years. And then in college, I regained that weight. I fell into this some of the same habits that I had seen my mom engage in. The constant frustration over not being able to lose weight, trying different diets, just really having trouble appreciating my body and feeling good about it. So, looking, I mean, and now it's been it's been an ongoing journey. But. I have lived long enough now that I have a much more positive body image, even though I am not the weight that I once wished I was at, I still am able to love my body and appreciate my body for all of the amazing things that it does for me and work with it instead of constantly feeling like I'm working against it. And looking back, I can see how a lot of the unhealthy body image that I had started as a child. Like I said, I picked up habits from the adults in my life and other people. And I should say again, I'm not blaming my mom because she absolutely did the best that she could. But now I look back at it, and maybe I have learned some lessons that maybe she didn't have the opportunity to learn in the same way. And so, the question for us can be, how can we do a little bit better than the generation before us? So, thinking about these things is important.
Hilary: There is so much I want to say about what you what you've just said, but let me first tell you, thank you so much for being honest and open and transparent and sharing your story because I think that I mean, your story is obviously a unique story, but I also think there are a lot of other people that can hear that and relate to that. And so, I appreciate you being able to share that with us cause it’s powerful. And I think you're right. A lot of what we do when it comes to developing a positive body image starts in the home when we are young. And, you know, as a mother of four, I've been in that position where I'm sure I have said out loud to my children, my girls. Oh, my goodness, yes, these pants don't fit anymore. These are too tight. I looked the way that I did back when I was 19. And you don't think about the effects that those words might have on our little ones. And so, I think that man that that communication components of just that, the words that we say when we're saying and we think we're saying them just to ourselves that really there's always a set of years.
Marina: Yes, unfortunately, kids are very good at observing everything. They're too good at it. But we did that when we were children, too, and the things that we do are often the results of the things that we saw when we were children. We tend to just repeat what we see. I should make another point to that as a pediatrician, as a medical professional, I see how the medical profession also feeds into negative body images. Unfortunately, I think that the medical profession has really piled on the guilt and the shame for people with larger bodies, and there is some reasoning behind this. There's science behind it in terms of extra weight being associated with higher risks of chronic diseases. But the correlation is not 100 percent. There are people in larger bodies that are much healthier in general than some people in really small bodies or in quote unquote normal sized bodies. So, it's not as simplistic as I think sometimes the medical profession makes it out to be. And overall, I think we've gone too far as the profession in blaming everything on obesity. And really, the sad part of that is that we have patients in larger bodies, people in larger bodies who really feel fear and shame going to a doctor because they feel like their doctor won't listen to them. They'll just tell them to lose weight. They will be misdiagnosed or miss a diagnosis over time because they say, Well, you're tired because you're overweight, you're this because you're overweight, lose weight and then will take you seriously. And I think that happens too often, not always, but too often. So, I really try to be the doctor that considers weight as just the number on the scale and a very tiny data point in a much bigger picture of things. And some like colleagues do that as well.
Hilary: That's so good. I remember specifically with one of my one of my babies. With this particular, this particular doctor, you know, as part of your visits, your prenatal visits, one of the things that they always do is they weigh you because of what you do. But I remember that was like, I think it is for many people one of the first things you do walking into that office. But when my doctor would come in, that's one of the first things he would comment on is this is how much weight you gain from the last visit. Right? And I remember feeling so embarrassed and so frustrated that that was one of the initial comments that you would share, and that's during a stage of your life when gaining weight is, you know, it is a necessity for a person as you're carrying this little baby. And so, you know, just it definitely started helped those visits on a low note for myself thinking, “Oh, goodness, that much from the time before”. And you know, and it became my primary focus because that was what was said in that introductory conversation. And so, it was interesting to have a different doctor after that to still I had to, you know, I was weighed because that's part of the procedure. But it wasn't it wasn't emphasized, it was a commented on. And I'm sure that if there was something that needed to be brought up, it would have been brought up. If it was turned by any means, it would have been brought up, but it wasn't necessarily. Thing that we were going to dwell on, because there are things that are more important than that.
Marina: Yes, exactly. Yeah. And people can be really sensitive. Some people don't care if you don't, if you bring up their weight, honestly. But some people care a lot. And I remember one visit with a teenager. I mean this I feel bad recalling this experience because as part of certain, they're called quality measures in health care. We, as doctors are required to sort of check off some boxes that we've done. And one of those is that any time someone's BMI falls within a higher range, we're supposed to check off a box that says we addressed it. We talked about it, we did physical activity and nutrition counseling. And these quality measures are tied to reimbursement. So, the company I was working for was very strict about making sure that we did this. So, I had to have felt like I had to have some conversation and a teenager came into the office and sure enough, her BMI fell into a higher category. So, I had to check out that box and I tried to be very sensitive in how I bring it up. But I'm not always perfect and everybody's a little different. And I think I just we had already had the rest of the visit and it was towards the end and I brought up. I noticed that your weight is such and such, tell me about that. And she just burst into tears. This was a teenage female, and I felt so bad because I mean, I mean, I knew that there was so much behind this, right? You don't just break out into tears if there's not a long history associated with that. So, I try to be as careful as I can, and especially since that experience, even more sensitive because it's a really touchy issue for even kids and teenagers.
Jen: I am tearing up just because this is. I'm sorry and I try to be as vulnerable with our listeners as I possibly can because I want to help normalize things and let them know that they are not, alone in an issue that we talk about. And this has been a struggle for my entire life. You know, I guess not my entire life, probably my medical and right before adolescence 11 and. I remember there were many times going to the doctor and then bringing up that I was gaining weight and whatnot and things that were said at home as well. And it's really hard and I had the attitude of, you're gonna say something? Well, watch this. I'm going to do this much more. You're going to show you me into this. So, I'm going to prove you wrong that I don't care about this or I'm going to prove you're right and I'm just going to continue to, you know, not do healthy things. And you know, it's followed me into my adult life to where I don't go to the doctor. I have to be in serious pain to go because of the fact that they'll either say something, you know, or I'll say, they'll just tell me because it's my weight or when I read the clinician's notes and just to remind myself what we talked about and things like that and just always see what they say about my weight is like crushing. So, it's a really psychological thing, and there was I mean, I know the pinpoint event that happened that changed my perspective with food and with body image and things like that, and it wasn't a great experience. It was more of. I need to protect myself, so this situation doesn't happen again, kind of a thing. And so, I really appreciate the fact that you are sensitive to this with kids because they are so. They're just sponges, and they just. Take in anything and everything that we say, and we really don't know how they're going to take it one way or another. So, I appreciate it.
Marina: Yeah, thank you for sharing that experience. I think it is something that that happens then that we need to talk more about in order to address it. So, I really appreciate you getting vulnerable and sharing that. I think my own sensitivity, I mean, one of the plus sides of the hard experiences I had earlier in my life with weight and still continues. To some extent to this day is that increased sensitivity. So sometimes I think my colleagues who have never struggled with their weight or body image and other ways they do have more trouble being sensitive to this issue. And I don't think they're always mal intentioned, but sometimes it's a, it's a side effect of just not really having a personal understanding of the issue. And I'm sorry you've been through those experiences. So, this is why I am passionate about it, because I heard I've heard too many of those stories and again, that teenager that just burst out into tears. I don't want that to happen to any teenager and even me being as sensitive as I am. For that to happen, it was a wakeup call to how important this really is.
Jen: Yeah, I just think we never know that the background initially, unless we ask those harder questions of just getting that information of, you know, why was this a turning point or whatnot. And maybe they don't want to share that and that's OK as well. I think the other thing is people who haven't struggled with weight being kids, teenagers, doctors, parents, whatever it may be, they think, Oh, just stop eating. Mm hmm. And it's a lot more of a mental. Thing, then, is actually the eating part. In my experience, at least. Yeah, just I can't stop eating. There's lots of other things that. Our play into the whole situation.
Marina: Absolutely, absolutely. And, you know, the people that say, Oh, wait, lost is just as easy as calories in calories out, they really don't understand the whole picture. You have a whole hormonal system that's under very strict regulation and affects our ability to gain or lose or maintain weight. Emotions have a huge, huge role to play in the regulation of that whole system and hunger cues and fullness cues and everything. So I don't believe anybody who says it's just a matter of eating less because it's so much more complicated. I mean, yes, if you eat less, you can force yourself to lose weight, but you can cause other problems secondary to just forcing yourself and feeling miserable. That can lead to mental health problems that are even harder than the original quote unquote problem.
Jen: Ands kids are developing, and so their bodies are changing all of the time.
Marina: Uh-Huh. Definitely. Especially kids.
Hilary: Well, and I even think about genetics. I mean, there are some people that just your body is built differently than other people. And so, you can't necessarily compare one person's body to another because we are in all different shapes. And that's OK. Yeah, exactly. So, you brought up the communication factor. Let's dive into that a little bit more. Given that most of our listeners are parents, educators, individuals that want to help kids and teens. And so how can we be better at communicating a healthy body image? What are some things to say? Maybe what are some things to avoid labels that we want to discourage? What are your thoughts on that?
Marina: Yeah. As we've mentioned, children are constantly observing and picking things up. So, it is worth really watching what we say about our bodies, about other people's bodies and about our children's bodies, because those words really are powerful. But we say how we say it matters, especially to children whose brains and habits are developing in general. I would say it's best to avoid very charged words and labels like fat, obese or even on the opposite end of the spectrum, bony, because kids who are really thin also can suffer from negative body image. And unfortunately, again, I think all parents are doing the best that they can. But unfortunately, I do hear many parents commenting on their child's physical appearance in ways that can really affect their perception of themselves for the rest of their lives. And most of the time, the intent is not bad. In fact, sometimes the intent is loving or playful, but these words really can stick with children for a long time. Well, one example from my life I grew up with parents who spoke Spanish that were from Mexico, and one word that's often used kind of as a term of endearment is gordito. And that means fat or fatty, not a child. And I really believe that a lot of parents use it more as a as a term of endearment, but in a larger societal context, that word definitely has a negative connotation. And so just being careful with how we use words and labels with our children. Even if you intended as a positive thing. Think about what is the larger societal connotation. Would I be OK if someone on the playground called them that? Or if the teacher or another adult called them that? Right? So just being careful, the words we choose. And some people will argue that words like the word fat should be fully embraced. And while I admire some people's ability to do that to embrace the use of those words for themselves, again, if you look at our larger society in general, it has a negative connotation. And so I think if we are applying those labels to others, it's best to avoid them just to be safe. Now, if a child later on decides, I fully embrace that as part of my identity and I embrace it as a positive thing, then fine, that's up to them and they can do that. But in terms of us using those labels or words we have, I think it's better to be careful and to avoid them.
Hilary: I'm thinking of my daughter and she her frame, she actually has quite a thin frame. And there are times where she's young, so we'll go clothing, shopping and I'll have her try things on. And she's at this stage developmentally where she is tall but very lean. And so a lot of times pants will not fit her waist and I will make comments about, Oh my goodness, nothing fits you because you're skinny. And I think things like that just come out and I'm listening to you thinking, Oh, I can see how that could be detrimental. Because even though a lot of people may see the word skinny as being a good thing, that's not necessarily where I want to put her self-worth. I mean, that's not about the way that you look, but about who you are. And so I think even simple things like that, I can I can look at myself and see myself saying those phrases and finding a different way to rephrase those terms.
Marina: Yeah, it's interesting. And I'm glad you bring that up because it is on both ends of the spectrum. And it's not just not just one direction. My husband grew up really, really skinny and I think, you know, he still has some perceptions of himself as like weaker because he was always the skinny kid. So yeah, being careful applies to both sides. I think another thing is we don't just, you know, put labels on children, but sometimes we might be in a park or a grocery store and we see someone and we might be tempted to make a comment about their appearance because our minds just pay attention to the world around us. And sometimes we notice people who are different in their particular way. And so, I think we just need to be careful about the comments we make about strangers as well, because our kids will hear those comments and they might want to imitate similar behavior in terms of commenting about people's physical appearance themselves later on. And we can also have overt conversations with our children about these things. And like, it's not polite to comment negatively about another person's physical appearance that can hurt them. It can be perceived as rude, etc. How would you feel if someone did that to you? Yeah, so that's another thing. Just be careful what we say about strangers wherever we might be.
Hilary: So in an ideal world, I'm thinking, what type, what type of advice do you offer parents with children? How do we what does a healthy appreciation of food and body image? What would we want to do in our home, particularly related with foods and meals? What would be your encouragement to parents on how to develop that with our kids?
Marina: Mm-Hmm. Yeah. I think one of the most important things that parents can do is actually to work on developing a positive body image for themselves because that will radiate down to their children. So, you know, like my mom she was, she was always criticizing her body and dieting. And so, if a, if a child is in an environment where adults around them are doing that, they're going to pick up on those behaviors. But on the opposite end of the spectrum, I think we can really learn to have or practiced having an appreciation and a love for our body, even if our body is not a certain size or a certain weight or certain appearance. We can still practice appreciating and we can practice gratitude for our bodies and all of the amazing things that we can do. So, things that you might say in front of a child would be, wow, that was a hard hike. But I'm so grateful that my legs were able to carry me all that way. Or even if you think you have flabby arms, I love my arms because they allow me to hug the people I love, right? Or I appreciate my wrinkles because they're a sign of all the years that I've lived and all of the lessons that I've learned. So just simple things like that that you can use to kind of offset all the negative stuff that we're likely to hear in our larger society and culture. And it does take some intention because our brains actually have what's called the negativity bias. And so our brains are more likely to pay attention to and remember the stuff that we don't like as opposed to the stuff we do like. So we do have to make a purposeful intention to do these sorts of things and practices that habits that kids. If they see you doing that, they're more likely to think those things than do those things themselves. You asked about food also. So I think we do as parents need to be careful with diet culture. Now, I'm not going to say it's bad to be on a diet. You can be on a diet for a variety of reasons, and many of them can be great reasons. But lots of times when we go on diets, we start to label foods as good or bad. And as a result, kids can start to learn that eating certain foods is bad and they should feel guilty for eating them, and certain foods are good and they should feel virtuous for eating them. And that in and of itself creates a whole problem in terms of the psychology of food that is very tied to body image. So if we can just teach kids to see food as food we eat, when we're hungry, we stop when we're full. I'm not going to feel guilty about eating certain foods, and you really can't do that alongside teaching a healthy habits generally. But you know, you can still overall be encouraging whole foods and fruits and vegetables. But also like if we had birthday cake, you don't want to have to feel guilty about it. So just watch what you say again. It's like if you're saying, Oh no, I shouldn't have eaten that slice of cake. Now I have to go run five miles tomorrow. They're making that connection that there's some guilt associated with eating certain foods.
Jen: Like that you're I mean, lots of what you're saying with kids. It's just that open communication and making sure that that communication is positive, and I think that just is like the thread that should go through all of the parenting and raising kids is making sure that you're having that open communication, making sure that we're doing it in a positive manner so that they are creating those habits no matter what they may be in a positive light instead of guilt and shame, because that can be so damaging.
Marina: Absolutely. Yeah. And I should also add that as much as we try at home to create the perfect environment and to teach our kids they're going to pick things up from other places, they're going to pick things up from peers of school and from friends and from other environments. But if we notice those things that are at odds with what we're trying to teach them at home, we can have open conversations and say, Hey, I noticed that you're saying this or you're doing that or your friends do this. You know, let's talk about it. What? What do you think is the reason? What do you think is the effect? Have that kind of critical conversation if it's age appropriate with them?
Hilary: I feel like we can go on and on, but unfortunately, I think where our time is closing up. So, any last final thoughts, pieces of advice you would offer our listeners out there?
Marina: Mm-Hmm. Just do the best you can. Nobody is perfect. Nobody is ever going to be perfect, but try to do a little better than maybe your parents or the people who raised you did. And just be mindful of what you're doing. So, my major message would be do the best you can. You already are doing the best you can. There are all these, you know, improvement is little by little.
Jen: I want to thank you so much for coming today and being with us. And I know this is going to be so helpful for our listeners and. I encourage our listeners just to pay attention this week to how you're talking to your kids about their bodies and is there maybe a little bit of a change that you can make within your communication with your kids? If you're wanting to get a hold of Hillary or myself, you can reach us at parents@thefamilyplaceutah.org or you can reach out to me on Facebook. Jen Daly - The Family Place. We thank you so much for coming in, and we thank our listeners for listening as well, and we'll see you back here next week.
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