Mary - Interview 42

Age at interview: 49
Brief Outline: Mary is the mother of 13 year old Kevin - who recently lost a lot of weight on a weight management programme - and 16 year old Sarah who developed anorexia aged 14, but has now recovered.
Background: Mary is a married mother of three children aged 13, 16 and 17.

More about me...

Mary is the mother of 13 year old Kevin and 16 year old Sarah. Kevin has been experiencing problems with his weight for 7 years and recently lost a lot of weight on a weight management programme for young people. When Sarah developed anorexia aged 14, Mary noticed quite quickly and took her to the GP. Sarah and the family received therapy and Sarah has now recovered – although Mary believes she will always have some related issues. Mary’s eldest child has not experienced any weight related issues.
Mary says that Kevin’s weight gain has had the biggest impact on his self-esteem and social life. Kevin is very self-conscious about his body and has asked Mary if he can have liposuction. He was teased about his weight in primary school, and gets very anxious about activities such as swimming, changing in front of others, and staying away from home. Mary says Kevin has never been obese, but was diagnosed overweight, and is one of the bigger boys at school.
Mary feels guilty about what foods she allowed Kevin to eat, because he is a fussy eater and refused to eat fruit and vegetables; she has also felt guilty about working full-time and whether she’s made enough effort to help him – even though she’s tried lots of different things. Mary also says she still feels responsible to some extent for Kevin’s diet and exercise, but thinks he should start taking some responsibility too (he doesn’t want to). Mary says several other factors played a part in her son gaining weight' playing video games, lack of exercise, and having few friends nearby.
Mary says dealing with her son’s problems was very different to dealing with her daughter’s anorexia because she didn’t know where to go for help or what help she could get. When she spoke to the school nurse about Kevin, her son was referred for tests to see if there was an underlying physical problem, but when they found there wasn’t, she didn’t receive any further help or advice. She also feels that even when she got information, it has been difficult to change her son’s behaviour.
The turning point came when they attended a weight management programme. Mary says that even though it was very demanding (4 hours a week for 8 weeks) the programme was really good because they met other kids and parents in a similar situation, they learnt simple ways to identify healthier foods and to prepare healthy alternatives to favourite foods (e.g. pizza), and gave the children realistic goals. Mary says it was also helpful that they didn’t try to make parents feel guilty.
Mary feels that it would helpful if there was more emphasis in schools on health and weight issues and if more places were available where you could get support and information.

Mary isn't sure that there's link between eating behaviour and genes.

I wouldn’t say the sort of eating behaviour is necessarily has sort of been, shall we say, having a genetic influence. I mean I do think when it comes to sort of body shape and, and things like that there is a genetic element to it. So for example I mean I’m, you know, the shape I am. My husband is not skinny either, he’s a certain sort of shape and sort of stocky I suppose. So I think there’s an influence there but I do very much feel with diet that you can change, change things and, and do that. Now, I mean whether, I mean I know people will say, “Oh, it’s your metabolism.” But whether there is a genetic element to that I’m, I’m not quite sure really but I mean I do feel if you eat sensibly and exercise then you can keep a healthy weight. I mean I think maybe to expect to be very skinny when it’s kind of not your build then I think that could be difficult. I mean but no generally I wouldn’t view eating behaviour, for example, as, as kind of having a genetic element at all. I think that’s something that you can certainly do something about. I mean I see strong kind of psychological [laughs] element to it in terms of, you know, eating behaviours being affected by mood and everything but not so much genetic. In that sense, I don’t think you’re born to be fat. I don’t believe that really, you know. 

Mary finds it hard to see her son struggling with his body image.

Well I would say sort of putting it under an umbrella, it sort of a lack of confidence, a lack of self-confidence. And everything revolves about how he looks, or if he’s going somewhere, he was going to wear. Not so much from the point of view of the, the clothes but if he looked fat in them. So that’s a very dominant thing, “Does this make me look fat?” And, “Do I look fat in this?”
And I think how he views himself, as I say, he will be very derogatory about himself. You know, “I hate myself. I’m a lazy, fat boy.” And, and various things like that.
It really just, he can’t, I mean as he would put it in his own words, he just can’t relax in situations because he’s got, you know, he’s always so worried about what people see, see him as and even though we’ve sat down and, you know, tried to talk to him about that people should accept you as a person and it’s not all about your appearance, that doesn’t seem to convince him and I think at that age it probably doesn’t anyway. You know, he, I suppose part of it too is wanting to be part of the crowd. And he doesn’t want to be different in any way.
You know, wish they could just accept people for what they are rather than, you know, but in his mind happiness is associated with being thin. So, you know, and I do worry from time to time, oh, could he tip over the edge into eating disorder or something but hopefully not. 

Mary and her son attended a healthy eating programme together and she thought it was helpful and fun.

I just came across it and then signed up for it and they were, they were very, very good and it was, it was really, really good. I mean he keeps, he would say it’s the only time he really felt something, he did something that really made a difference. And he was so proud when, they got the final measurements and he’d, he’d actually lost, I don’t know, four or five inches off his waist and everything. And it was just really about, you know, we were really committed to it and, and the eating and everything. I mean it still didn’t get him eating a lot of other things but it did stop him eating certain things and it made me far more conscious buying things. And he was doing the exercise twice a week, you know, so which was a big help and they made it fun as well. It was fun sort of things. So yeah, I mean I think it’s a fantastic programme.
I think it one of the things that helped him was I think the feeling that you could change things because I think at times he’s felt quite hopeless about it. He’ll say, “Oh, I’ve tried this and I’ve tried that.” I suppose we, we probably never tried in a structured sort of way so, you know, we’d do things like, “Well, okay, we’re not going to have any chocolate in the house. We’re not going to have any biscuits, or crisps.” Or something. But this was kind of a structured way and, and you were kind of shown that you could change things and you could make a difference. And I think it was realising because that is one of the things that he has a bit of a hang up about, is, “I’m the only fat kid.”
Whereas as that it wasn’t an issue, you know, because everybody else was in the same, same situation. If, if not I would think one or two even a little bit worse, you know. So I think he, he was it just seemed to motivate him I think. It was the fact that, and maybe, I mean he’s never said that to me directly, maybe the fact that, you know, I was spending four hours a week with him doing this. Maybe he felt, “This is serious. We’re doing something serious about it.” Rather than oh, we’ll try and do this and we’ll try and do that, you know.

Mary finds it difficult to help her son and gets frustrated with his lack of motivation.

But I just haven’t managed to find anything. I mean he’s interested, for example, in martial arts but he said, “Oh, I’m not going to do that if I have to go by myself.” So I suppose peer support is probably something as well.
And I, I mean I, I must admit I do get very frustrated with him and, and I have to remind myself at times, I say, “Look, he’s only just thirteen.” Where, you know, I do find myself saying to him, “You have to take a certain amount of responsibility. You know what you need to do. You’ve got a bicycle, can you get up and go out on your bicycle.” [laughs].
So I suppose they would be some of the things really. It’s just finding [sighs] what makes people, sort of, motivated. It’s the motivation I suppose.
Because I would, you know, quite happily take him to the gym and, and things. And I have tried various rouses to get him to do things when I say, “Oh, you know, I’m going out for a walk but it’s quite late, oh, I don’t know if I should go by myself.” [laughs], “Could you come with me?” But he sees through that straight away [laughs]. I mean once or twice it’s worked but he just gets, I mean he just gets bored easily. That’s the other things I think with, makes me feel kind of old when you start saying these things but kids his age just seem to have this like they get bored so quickly. It’s, it’s difficult and I mean at the weekend, for example, we were doing some work in the garden. I said, “Well, why don’t you come out?” Because it was actually very good exercise [laughs] clearing up leaves. I said, “Why don’t you come out and help us?” “Oh no, that’s boring.” Everything is boring and it’s very hard to get them to do things against their will really at this age, you know, getting quite stroppy.

Mary’'s son wasn't keen to go to the MEND programme because the kids all had to wear a group T-shirt.

I really don’t know how it first. I think what happened was I came just came across a reference to it somewhere in something. Oh, I do remember now that there was kind of a free magazine that used to come here, a dietetics thing and there was a little column in the back of it by the MEND (Mind, Exercise, Nutrition … Do it! Programme), Paul, somebody to do with MEND. And I remember reading it and then I looked it up on the website and, you know, it seemed to make a lot of sense. And then sent off an enquiry and they just said there was one happening very locally to us that was starting up. And would be interested in going along to that so we signed up for it and, you know, it was, it was very good. And then for a while after it finished we kept in touch with some of the other parents but that seems to have sort of dwindled. I mean we do still get some information from them which is good. Because it’s like a lot of training I think if you don’t have the back up. So, for example, we got something in just before the summer holidays saying how important to do exercise and giving new ideas and things.
And then they did contact me before Christmas, the local one where we’d been to say that they’d only had a few children on, on it and  would my son like to come along to the exercise sessions? But he thought about it and he wouldn’t go because he said, “Oh, I don’t really know anybody and.” The other thing was that the only thing he did find, sort of, negative about it was, it was at a local leisure centre and they had t-shirts that they had to wear, you know, which said, “MEND” on them and he didn’t like doing that because he said he was really worried that anybody from school would see him and I mean they were fine about it. They said, “Well, you know, we’ll only wear them when we’re up in the classroom.” Or something like that. Not, so that you don’t have to wear them and I mean they didn’t make a big fuss now to be to be fair to them. But I do remember discussing it here with people that on the one hand the good thing about the t-shirts was it made people feel they were a group but on the other hand, in his mind, he saw it as kind of labelling him, “I’m a fat kid.” Even though I said to him, “Most people won’t know what it is.” But that didn’t matter to him, you know.  

There is a lot help available for babies' development but Mary found it difficult to know where to get help for a school age child.

I mean you get a lot of support if you, you know, for babies and kind of probably toddlers. I mean the health visitors are fantastic but then I think they go to school and, it’s not that you’re in a vacuum as such because I mean there is a school nurse and things but you don’t really have that much contact, contact with them.  I don’t know, be always good I suppose if the kids could have some sort of a yearly check up but just a general check up with parents. I mean probably, that’s probably pie in the sky given numbers and resources and things. But  I think part of the problem with a parent getting help, for example, and I would consider myself a fairly well informed parent, is you just don’t know where to go, you know,  well, who do I? You know, I don’t really. Well, I’m the sort of person I always think, “Well you know, he’s not, he’s not really unwell. I don’t really want to bother the GP sort of, you know,  but who else can I go to? You know, maybe, I don’t know, maybe health centres should have a nutritionist or something attached to them or somebody who deals with those sort of issues or something like that because I certainly felt I, I didn’t know if I was to go and approach anybody like that I think I would have had to do it privately. I wouldn’t have known. I don’t know if you can get a referral to a nutritionist or something, you know, it’s through your GP. I wasn’t kind of aware of, of that sort of thing, you know. 

GPs should take more notice of children's weight during routine consultations.

I suppose maybe it would be nice if when you do visit a doctor with your child or something they had the time, to be able to ask you more general things about your child. I mean you tend to only go and see the doctor when somebody is ill. And you know, it tends to be about a specific problem and I’m not sure I don’t know, I can’t say that for a fact, but I’m not sure if I took had taken my son in with, with let’s say a sore throat the doctor would deal with that, but I don’t know if he would kind of look and say, “Well by the way - what’s your diet like?” And notice that there might be an issue with something else, you know. So it would be nice if they could look at the bigger picture I think.  
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