“Mum, can I have some Stagg Chili?” That one I heard recently, directly after lunch. Then two days ago after dinner: “I’m starving; is it okay if I finish off the pavlova?”

With a couple of adolescents in the house we seem to be talking about—and eating—a lot of food these days. Generally I don’t mind this because I know how important calories are for people with CF, although I’m not thrilled about our food bill!

Eating enough of the right things is a critical and ongoing issue for people with CF and I know many parents would love to spend up big at the store if it meant a better weight for their child.

But it’s not always that easy, is it? Just this morning one son told me: “I’m not going to eat today because I feel fat.” Now anyone who has ever looked in the mirror and felt disappointed will know that our self-image is a powerful—and not always accurate—judge. My son who feels fat is not, by any definition of the word, overweight but that’s how he feels at times.

My first instinct when he says this (which he does from time to time) is to very calmly grab him by the scruff of the neck, pull him close to me and yell “You need to eat!” However, I have learned that this approach generally backfires. Instead, I focus on the benefits of food, particularly the much-needed energy it provides for doing all the activities he enjoys. And then, with my fist shoved firmly in my mouth, I walk away. Because, as someone who once counted calories obsessively, I know that once food gets a foothold in your psyche it doesn’t let go. When managing CF, we can’t allow food to become a battleground.

When we lived inFrance, we attended a CF forum at the hospital. One family was struggling to get their two young children to eat enough. When one of the doctors asked how long dinner was taking the father answered ‘two hours’. The clinician then emphasised that eating is not a ‘treatment’. It’s a pleasure (especially for the French). We need to somehow strive to keep it pleasurable and not let it become another obligation to this illness.

This certainly applies for teens. One Dutch study (of non-CF adolescents) showed that ‘Adolescents’ attitudes are the most important determinants of different health-related eating behaviours and intentions to change.’ Interestingly, it wasn’t all about what their friends were eating. It was about how they felt about the food or the meal itself (eg, when they felt positive about breakfast, they ate it more often).

Another interesting study which I read several years ago highlights for me the importance of modelling a healthy attitude about food for our kids. It found that children with CF whose mothers were successful dieters had more difficulty maintaining their own weight. In this case, a heavy focus on not eating by the mothers made it more difficult for the kids to eat enough.

Like so many things in the CF world, it turns out that our attitude (in this case to food) really matters. This is particularly true when it comes to dealing with adolescents who can be masters at causing their parents to twist themselves into a psychological double-knot.

So, what’s the advice from the experts? Relax and enjoy food in your house and, though this is no guarantee, hopefully your adolescents will too.