My daughters inquiry to you

Question
A few days ago, my 16-year old daughter, Emilia, wrote to you for advice on how to gain some weight. Her email address is [email protected] (as a reminder to you).

Thanks for getting back to her... but I wanted to follow up because she didn't give you all of the info. It's true that she is 5'-6", weighs 110, but she didn't mention that she has lost 20 pounds over the course of the last 10 months, and her periods have stopped. We have been to her physician and had blood work done - all normal results. We have been to a gynecologist, who put her on birth control pills to regulate her period (get it going again - she started on the day of her 13th birthday and had normal periods until about a year ago.)

We have discussed eating disorders, and she is open to discussion. She knows she needs to get on a path of gaining, but refuses several things - she refuses to let me set up some counseling for her. She is embarrassed, but also says she wants to try to handle it together with me. I think she will become open to it as she matures, so for right now, I am biding my time.

She refuses to eat sugar, white flours, and much fat at all. I have done a bunch of online research with her sitting there next to me, and she understands that her body needs fat to function properly - the right kind of fats. Emilia thinks pretzels is junk food, and that yogurt with 1 gram of fat is bad for you. She is exceptionally bright, and is a strong bio/chem student - she is considering following a career in bio, chem, pharmacy, etc. She gets how the body works, and what to do to stay healthy, but that, in combination with society's pressures on young girls to be thin in order to be considered attractive, has caused some problems for us.

She read your email to me, and I appreciated your advice, but now she's convinced that she is correct in her thinking that she really doesn't need that much fat, and that if she simply increases her calories, she will slowly gain weight. She indicated that if she ate lots more fruits and vegentables, she'd eventually gain weight.

I very much appreciate your advice to Emilia. I would appreciate a follow up email from you to her encouraging her to eat a greater variety of more calorie-rich foods, and to not be afraid of ingesting fats, and to try to get up to at least 75 grams.... because she sees 65 as way too high. I'm lucky that I'm able to pack her lunch for school, and she has assured me that she eats it. But then, if she deemed it too high in fat, she will adjust her dinner intake accordingly.

I am counting my lucky stars.... she has a few friends who eats nothing but crap - chips and soda, etc. She also has friends who eat literally nothing - lettuce and a diet Coke for lunch. Emilia's choices are healthy, and she is ingesting some calories and fat, even if it is not enough. She is truly an awesome kid, and I am lucky to have such a smart, motivated daughter - we have a very good relationship, and she trusts me. But, again, I appreciate your willingness to advise her. I have lots of knowledge and advice to give, but advice coming from a Mom sometimes skews a teenager's willingness to cooperate. Thanks again!

Answer
Mindy,

At allexperts we do not receive actual e-mail addresses of the people that contact us... everything is through the website, but I do remember your daughters question to me.

You said you have discussed eating disorders with her, but that doesn't tell me if that is an issue with her or not. In her email to me it said that she is not afraid to gain 5-10lbs.

I think it's great that you have a close relationship and are able to talk about these kinds of things.

Maybe you could suggest that she prepare dinner a night or 2 a week. this way she is making something that she will eat. I would suggest more whole grain/whole wheat products... they are calorie dense, but are low in fat (something that she looks for). Not only that, but you can get 100% whole wheat pasta that doesn't have those refined flours that white pasta does. So, she would still be getting the nutrients, but in a healthier way. Top that off with a serving of mixed veggies smothering the pasta, and a salad a piece of whole wheat or whole grain bread and a serving of fruit and you have come up with an excellent meal, and a healthy one at that. You should encourage her healthy eating habits, and not discourage her from starting early in life. It sounds like she has a good head on her shoulders, and does not want to follow many of her classmates down the road of pizza and potato chip survival! Most kids/teens can get away with that because they still have the fast metabolism. However, if she is restricting her diet too much her metabolism may already be slowing down and if she begins to eat more her weight may balloon up if she starts to eat too much, too fast. Slowly increasing her daily caloric intake will help prevent that... her metabolism will begin to speed back up and the weight gain will not be as quick and noticeable.

And it definitely sounds like she is not taking in enough calories. A sign that your body is not getting enough, for females, is amenorrhea (loss of her period). your body isn't getting enough energy in the diet, so it shuts down certain bodily processes that aren't AS important in order to conserve energy for the more important body processes. Rapid and recent weight loss can also cause cessation of periods, but generally normalize with time, or returning to normal diet. Even a slight weight gain can help normalize her periods again.

Pretzels are not junk food really, but they can be unhealthy if that's all you are taking in. They are naturally a low-fat food, generally containg 1-1.5 grams of fat, but the flour used in them is probably what she is concerned about. Many foods use white flour, unbleached/bleached/enriched flour. These foods have similar effects to what eating sugar does, in that they cause an immediate spike in insulin levels. Your body only uses so much glucose (what these foods are broken down into) at a time, and what it doesn't use goes into stores (fat stores). The idea behind eating whole wheats and whole grains is that they don't cause that spike in insulin levels, and gives a more steady supply of glucose, so your body doesn't put excess into fat stores.

You are definitely right... your body does need SOME fat! Fat and cholesterol are essential for neurological function and also help make up cell membranes, so they it is important in MANY body functions. The truth of it is though, that your body can actually make enough cholesterol on it's own for those bodily functions. Concentrate more on healthy fats such as the mono and polyunsaturateds and the omega fatty acids.

I also wanted to say... along the lines of KNOWING what your body needs and DOING what your body needs... Even though Emilia knows what's going on in her body doesn't mean that she follows that. Like with the eating disorder issue... Let me tell you... I have personally struggled with eating disorders for over 5 years, and even though I know what I'm doing is wrong, that I'm harming my body, and I know what my body needs to survive... it doesn't make me any more likely to follow my own advice! So, her being a bio/chem/pharm major... that's great! But it doesn't make it more likely for her to eat healthily than the next person.

A counselor may not be the right way for her right now, but maybe she would agree to see a nutritionist to help develop a meal plan around what she will eat. I hope that this info helps you and doesn't make things more confusing. And again, if you have any more questions please feel free to contact me again. i try to get back to people as quickly as I possibly can.

Leigh-Anne

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