Has your pediatrician or nutritionist given your child advice that you think is close to disordered eating? Why should you always seek a second opinion? Where is your young child learning about their body and what it means to be healthy? In this podcast episode, Dr. Cristina Castagnini speaks about the new pediatric guidelines in effect and one mother’s shocking experience with Nicole Prior.


Nicole Prior is a mother to a 4-year-old and fully recovered from an ED. They love anything that keeps them busy and exploring the outdoors.


  • The harm of BMI
  • “The number on the scale”
  • There is no real standard!

The harm of BMI

The BMI system is outdated and often causes more harm than good because it functions entirely on averages. It may deem a person overweight if they are shorter than average but the same weight, even though their health is perfectly fine and their quality of life is good. Nicole’s daughter was recommended to lose weight, at least two pounds, at four years old just because she was shorter than the average child within that weight and age group.
They’re not even done growing! I was just appalled, honestly … I’ve never heard of weight-loss for children other than like … going outside to play or do a sport, but now they’re talking about medication for children to take? (Nicole Prior)

“The number on the scale”

It is so important to realize this: the number on the scale is just a number on a scale. It is not an indicator of health solely on its own. Bodies can be thriving and healthy and capable in many different shapes and at many different ages. It can be harmful for a body to force, starve, or medicate it just to look a certain way because that way is perceived as healthy. A healthy and happy child that is still growing and often plays outside doesn’t need to be medicated to look a certain way unless there is a true medical reason or concern - let alone just because of appearance.
[Young girls and boys] tend to be more self-conscious about their bodies going into age 11 and 12 … and the comments really do have an impact on them and their self-esteem. (Dr. Castagnini)
Let bodies be bodies, and let them enjoy being healthy and living.

There is no real standard!

Between genetic background, pre-existing medical conditions, access to food and medical care, emotional regulation, and mental health, every single person and their body is different. There is no true standard! No one has deviated from the standard because there are none, and guidelines that are based on standards are not entirely helpful. If you want real healthcare for the body, mind, and emotions, then it has to be personalized. A one-size-fits-all approach cannot be successfully used to give everyone great results, especially when they are kids and so much is still unknown.
I want her to be, you know, happy and [to] be how happy she was when we first went [to the doctor] … and I don’t want her to feel like she’s done anything wrong. (Nicole Prior)



  I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "Hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!


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