September 23, 2008

Food for the Shrink.

Eating issues are a very common problem with kids. Here I'll prove it - Who's kid eats veggies?

See what I mean.

When kids are under stress one of the very few things they can control is what they do or do not eat. As parents of type 1 diabetic kids we need to be aware that the eating and emotional link does not disappear with the beta cells.

No. In fact all diabetes does is add to the complexity.

We parents take new eating rules kind of matter of fact -  this is the diet plan. That is it. For us the stakes are too high to not follow the plan. We are talking about our kids lives, that's enough for us - we are following the plan.

The problem is that message doesn't really get through to the kids. They may hear it. Can probably recite it. But they just don't buy it like we do.

Guess what? (This may be hard to believe) The kids are stressed by diabetes. (I know it came as a big shock to me too...)

We need to be aware of food not only as carbs but as a possible indicator of distress. OK maybe we should just settle for not letting food make thing worse.

The New York times recently ran an article about the 6 Food Mistakes Parents Make. One for the six was about forbidden fruit. They say:
Keeping ‘good stuff’ out of reach
Parents worry that children will binge on treats, so they often put them out of sight or on a high shelf. But a large body of research shows that if a parent restricts a food, children just want it more.

In another Penn State study, researchers experimented to determine whether forbidden foods were more desirable. Children were seated at tables and given unlimited access to plates of apple or peach cookie bars — two foods the youngsters had rated as “just O.K.” in earlier taste tests. With another group, some bars were served on plates, while some were placed in a clear cookie jar in the middle of the table. The children were told that after 10 minutes, they could snack on cookies from the jar.

The researchers found that restricting the cookies had a profound effect: consumption more than tripled compared with when the cookies were served on plates.

Other studies show that children whose food is highly restricted at home are far more likely to binge when they have access to forbidden foods.
With the strict eating schedules of some insulin regimes (cough, NPH, cough, cough) some type 1 diets make almost everything forbidden fruit. As a result kids want - more of everything! This can lead to a cycle of escalating parental control and child rebelling with eating off schedule and covering with insulin or not. It really goes off the rails when folks talk about eating in negative terms like sneaking or  cheating.

High from uncovered or off plan eating is tough enough. Not eating for insulin already in the kids is end tougher. Hear of hypos are why a lot of parents do not pre bolus kids for meals. It is just too hard to predict what they may eat. And if they don't what do we do about the lows.

If we parents becoming more controlling and more critical of what we see as a lack of the kid's efforts we are just asking for more trouble. Here is a nice little paragraph on that from our friends at Wikipedia:
Research from a family systems perspective indicates that eating disorders stem from both the adolescent's difficulty in separating from over-controlling parents, and disturbed patterns of communication. When parents are critical and unaffectionate, their children are more prone to becoming self-destructive and self-critical, and have difficulty developing the skills to engage in self-care giving behaviors. Such developmental failures in early relationships with others, particularly maternal empathy, impairs the development of an internal sense of self and leads to an over-dependence on the environment. When coping strategies have not been developed in the family system, food and drugs serve as a substitute.
Let see... Diabetes care takes a lot of controlling (and IHMO it real easy to become over controlling) and that potentially feeds (get it feeds?) into eating disorders. Forbidden food becomes more desirable food... and diabetes forbids food all over the place. Catch 22 anyone?

I don't know what the solution is.

For us it is in part pumps that allow for a more flexible eating regime. Another big but very hard part is to see numbers as numbers without attaching value judgments to them. For me in particular not attaching positive feed back to 'good' numbers. I need to go to the next step and ask about the behaviors that result in numbers and provide positive feed back for good behaviors - what ever the number is. Stuff like; 'What did you do about it?' 'How did you get there?' 'Why do you think you got there?' Followed by. 'That was good thinking on your part.'

Come to think of it, at times the 'good stuff' we tend to keep out of reach isn't food. It is the non judgmental loving positive feed back. Only makes the kids want it more.


  1. Great post Bennet. What particularly hit me was talking about seeing numbers as numbers and not attaching value judgements to them.

    I have always associated that only in regard to high (ie, "bad") numbers. I really, really appreciate, after reading this post, that it is probably much harder to not attach positive feedback to "good" numbers.

    I have never thought about it from that angle.

    Thank you!

  2. Thanks Scott.

    We made the mistake of too positive a replies to good numbers.

    Guess what we got?
    Good numbers.

    We couldn't beleive (there is a clue) what a great streak we were having. Guess what - they weren't the real numbers but the ones we positively reenforced. Who's fault was that?

    Ours. Period.

    We faild as coaches.