As a psychotherapist of 34 years specializing in the treatment of eating disorders, I have worked with literally thousands of children and adolescents. Eating disorders and disordered eating have become epidemic in our society. Of the 11 million sufferers in America alone, 87% are young people under the age of 20. Increasingly, these dysfunctions are seen in children as young as age 5.

So, what are the implications of signing kids up for exercise classes? I believe that kids who get their exercise in formalized ways through health clubs and not through a healthy daily active lifestyle are learning unhealthy priorities, and messages about themselves that are all wrong. That so many young kids are becoming afflicted with eating and exercise disorders has a lot to do with a misunderstanding about what is a "healthy" lifestyle and what " fitness" entails, with poor role modeling, with questionable values and priorities, and with underlying emotional issues that drive ritualized and compulsive exercise behaviors. The latter is a problem that develops most frequently with kids who have genetic or chemical propensities towards anxiety or eating disorders.

Exercise disorders, which take the form of exercise compulsions, are a form of eating disorders.

• Eating and exercise disorders are diseases of extremes.
A truly healthy eating lifestyle is about moderation and balance. It comes with healthy, balanced, varied eating that occurs in the form of meals at least three times a day. Healthy eating has nothing to do with thinness or achieving a perfect body.
A healthy fitness or exercise lifestyle includes activity on a daily basis, through walking, biking, sports, playing. It involves turning off the television, and encouraging kids to use themselves more actively and creatively.

For children genetically and temperamentally prone to developing eating disorders, exercise that is formalized can easily become compulsive and extreme and take on perverse meanings, (i.e. if the child does not exercise for the right amount of time, she will become fat; if she becomes fat, she will not be loved or accepted.)

• Eating and exercise disorders are disease of perfectionism and low self-esteem.
For children with low self-esteem and difficulty in self-regulation, formalized exercise and the weight loss that comes of it can become a substitute for self-acceptance and other more meaningful activity. It can begin to feel for the child as the basis for their self-esteem.

• Eating and exercise disorders are diseases of control.
For the child who has difficulty exerting self-controls and relying on herself for self-regulation, formalized exercise can offer an externalized and ritualized sense of pseudo-control that she can ultimately become dependent upon. (i.e., I have to do the Stair Master for 2 hours or else I will lose my friends, fail in school, my parents will divorce, my dog will die.)

• Eating and exercise disorders are diseases of anxiety.
For many, formalized exercise becomes a chief source of stress relief and ultimately can camouflage underlying feelings, which are a source of self-knowledge, problem definition, and therefore, problem solution. With the release of endorphins that comes with formalized exercise, kids can become reliant on brain chemistry changes as a SUBSTITUE for resolving problems, a dynamic that can be a precursor to addictions and eating disorders.

Our children are impressionable and are taking in many of the perverse messages that society inflicts upon woman and girls, particularly. Girls as young as ages 9 to 12, when they reach puberty feel the need to grow SMALLER as they grow older. Just when girls begin to develop and NEED to gain 20% of their body weight in fat so as to be able to menstruate and carry on the species, girls feel the pressure to become rail thin.

Parents, too, need not be taken in by extreme or perverse messages of media and society. Parents need to stay parental and guide their children to living lives that have meaning beyond what their body looks like.

For kids who develop an unhealthy eating lifestyle and who might need to lose weight, eating DIFFERENTLY, not less, and creating a more active lifestyle is more basic to healing than is any form of dieting, food restriction or formal exercise. There is nothing wrong with formal exercise for older or more sedentary individuals; For young kids, however, there are healthier ways to be healthy.

Author's Bio: 

Abigail Natenshon, MA LCSW is a psychotherapist who has specialized in the treatment of eating disorders with individuals and families for the past 33 years. The author of When Your Child Has An Eating Disorder: A Step-by-Step Workbook for Parents and Other Caregivers, Ms. Natenshon is the founder and director of Eating Disorder Specialists of Illinois and a Guild Certified Feldenkrais Practitioner. She and uses this hands-on body-centered technique in conjunction with traditional psychotherapy to augment and promote body image awareness, acceptance and healing.

Abbie consults professionally and speaks widely on the topics of eating disorders… their prevention and treatment, body image, and healthy eating and weight management. She has published widely in books, magazines, journals and newspapers, and has appeared on the Oprah Winfrey Show, the John Walsh Show, and MSNBC News. The creator and host of,, and, she conducts a private practice in psychotherapy in Highland Park where she resides with her husband.