Growth charts are a helpful tool in assessing normal versus abnormal growth patterns. They are composed of a series of percentile curves that illustrate the distribution of height and weight as a child grows. Children who are genetically smaller will be at a lower percentile, and children who are genetically larger will be at a higher percentile. Children and teens tend to stay on or around their curve if they are well-nourished. When a child or teen loses weight or fails to gain weight as expected, growth charts can give us an idea of how much weight gain is necessary.
It's not uncommon for teens to resist having to "get back on their curve", especially when other people in their lives think that they look fine. Resistance from the teen (and sometimes from family members as well) can be even stronger when they are told they may have to gain above what their curve seems to indicate. If your child has received the recommendation to gain "additional" weight, it's important to understand why.
This video does a great job of explaining the role of the growth chart in setting weight goals in eating disorder recovery.
For some people, complete recovery from disordered behaviors and thoughts only happens when they reach a weight that is higher than their growth curve projects. Not everyone follows a single curve throughout their growth and development. A healthy weight is achieved when eating and physical activity are appropriate, when eating disorder behaviors have ceased, and when vital functions are within normal limits.
The following are a few principles of proper nutrition to provide a basic framework for nutritional restoration:
1. Adequacy – oral intake should be enough to meet caloric needs
2. Balance – the inclusion of various food groups to meet macronutrient needs
3. Variety – the inclusion of different kinds of foods within each food group
4. Flexibility – the ability to adapt to situations rather than a set schedule. For example, if your child's friends are enjoying pizza at the pizza shop, she can participate and enjoy the pizza, as well, even though she may have been planning a different lunch.
Growth charts are a handy tool, but they are not the final determination of where your child's weight should be. Your child's eating, mental status, and behaviors tell us more than the growth chart ever can. Remember that recovery is not just about weight, but also about state: your child's overall physical and emotional well-being.
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