It is frightening to think of how many children between the ages of five and twelve think they are too fat and have already tried dieting. The incidence of children needing medical hospitalizations and psychiatric in-patient treatment for anorexia continues to climb. When the eating disorder is identified quickly and appropriate treatment is provided, outcomes are usually positive. That's the good news. The bad news is that millions of children are choosing to starve themselves everyday because they think they weigh too much.

Studies show that girls, especially, are becoming worried about food and their body size by the tender age of five. They usually don't have full-blown eating disorders at that age, but they develop the precursors to anorexia and bulimia -- chronic dieting, obsessing about calories and fat grams, feeling fat and disrupted body image.

Research has identified that by age:

• 5, children describe thin friends as more desirable;
• 6, 40% of children express a desire to be thinner;
  
• 9, 50% have already tried dieting;
  
• 10, more than 50% are afraid of becoming fat;
  
• 13, 80% are dieting to fight the natural maturation process;
  
• 15, 1 of 8 girls diets at least 10 times per year;
• 16, 45% are crash dieting, 40% are fasting and 15% take diet pills;
• 17, 4 of 5 healthy weight young women think they are too fat; and
  
• 20, 95% express a strong desire to lose weight.

Dieting in childhood can delay growth and puberty, cause osteoporosis, affect reproductive functioning later in life, set the child up for lifelong battles with weight and, dieting can result in eating disorders. Dieting in childhood can also set the child up for other psychiatric problems like depression and anxiety.

It is never normal for children to restrict their caloric or fat intake. So, why do they? How can young children see themselves as fat? Children are magnets for what they see and hear. Our culture is obsessed with weight. No matter where you go its likely that you will hear people talk about it, you will read about it, see it on billboards, in magazines, on radio, TV, the internet and consequently, on smartphones.

Children see and hear all these same things. The continual underlying message is "To be successful and happy you must be thin." Unfortunately, many role models that we consider "thin" are actually "anorexic," so we have children unknowingly striving to be anorexic in order to feel that they fit it.

Recently I was at a school and was walking behind two teachers in the hall between class periods. One commented on her thighs rubbing together and the other agreed how disgusting this was and that she too, needed to lose weight. Neither of these women were overweight. If I heard them, how many of the students around them heard, too?

Today's generation of parents grew up during a time when dieting was seen as a normal and healthy thing to do. The influence dieting had on them is unknowingly being passed on to their children. When parents comment on feeling fat, needing to lose weight and eat differently than the rest of the family, children don't differentiate this as adult behavior, they assume this must be the right thing for them, too.

The anxiety adults have about their own weight may also lead them to fear their children are or will be overweight. The negative body image adults have of themselves often gets projected onto their children when there is, in fact, no problem with the child's weight.

It is never a good idea to put a child on a diet. Their bodies need to grow and need appropriate nutrition. If a child is truly overweight, then that may be a sign of emotional stressors or possibly a medical problem. The child may be eating to cope with feelings he/she doesn't know how to deal with otherwise.

Have the child assessed by an eating disorder specialist. Putting a child on a diet usually creates many more problems with food, weight and body image, and diets are ineffective anyway. The parents and the child either end up in continual arguments over what to eat or not eat, or the child shuts down, often sneaks food and begins internalizing guilt.  Either way, in the end, nobody wins.

Adults must keep their own worries about weight away from children. Adults must also help children learn to challenge the stereotypes and messages they will hear about weight. This means that adults may have to assess their own beliefs about food and weight, first. Three excellent resources to help with this are: Underage and Overweight by Francis Berg, Your Dieting Daughter...Is She Starving For Attention? by Carolyn Costin and Like Mother, Like Daughter by Debra Waterhouse.