Friday, March 26, 2010

Casualties in the war on "childhood obesity"

Please read this poignant blog post by a "former obese child."
She covers eloquently, all the reasons why we have to be so careful with language and our public health campaigns and zeal to "help." I fear that this is going to get worse before it gets better.

Label a child as obese or overweight (whether or not that child is healthy or growing in a way that is right for him/her) and s/he will:
  • feel flawed in every way
  • feel less capable
  • be more likely to diet (and gain weight,)
  • be more likely to engage in disordered eating behaviors
  • be less likely to engage in physical activity
And yet, there is a huge push to identify and label children. It doesn't help and often makes matters worse. (With the electronic medical record I fear a whole new layer of harassment and misdiagnoses.)

FYI, the little boy in the picture is "obese" according to current CDC guidelines via BMI...
Share your stories about you or your child being labeled and the consequences?

Here are a few lines from the post from Fatshionista:

"I never had any weight-related health issues...But I began to diet. I did! In elementary school... My pediatrician sent me to a dietician, who prescribed daily menus in strict portions.... As the years passed and I ventured into the numbers-obsessed indoctrination of Weight Watchers and Jenny Craig, my standards become tighter and the “good” food list grew ever shorter... " (My note-this would be the "control model" of eating and dieting.)

"I was extremely hungry, you understand. All of the time... When I’d managed to eat so little as to feel tingling in my extremities and a racing feeling in my chest, I knew I was Doing Well On My Diet."

"Eventually I would surrender, devastated, heartbroken, and eat normal food again, and then the lost weight would return, plus more. And then, after that, I would marshal my forces and make a fresh attack on my fatness, one which would be doomed to failure like all the rest. I would return to exercise; but not the exercise of my younger days, playing games with friends, having fun. Exercise became a chore."


  1. My mother was obsessed with thinness and started putting me on diets at an extremely young age, earlier than I knew what they were. One of the diets I distinctly remember was the Atkins Diet which my dad was also on and getting a slice of cheese and a slice of bologna and that's it, that's what I had to eat between breakfast and dinner. At other times when I was young and dieting, I remember eating a whole apple, including the core because I was so hungry and I ate it so fast I quickly threw up. During the times my parents gave up on trying to make me diet, I binged, even though I didn't know what to call it back then.

    A lifetime of dieting later, I'm huge, I don't know how to feed myself properly, I can't even honestly say I know how to identify when I've had enough to eat.

    I haven't even begun to address the psychological damage and I won't because I'm going out in a bit and don't want to be all weepy, but I share your fear of the long term effects of labeling kids and the "war on obesity".

  2. I'm sorry. What happened to you was child abuse. No fair. I don't want to see this now sanctioned and pushed by the medical and public health establishment.

  3. Lesley really hits the nail on the head when she says that it's not being fat that causes damage, it's being labled as fat. You can get all the horror of being "the fat kid" while you are on the low end of normal weight.

    I suspect that my mother was suffering from a low-level body dismorphic disorder, long before the diagnosis made it into the diagnostic manuals. As long as I can remember, she fought (mostly) imaginary fat, first hers, then, when I hit puberty, mine, too. Hers stayed imaginary, mine manifested after two or three years of yoyo-dieting.

    And "everyone knew" I was fat. Teachers, doctors, other kids, and, of course, myself. Everyone who looked at me saw a fat teen.

    It's only today that I look at the old photos and the meticulously kept weight and diet charts, and I think I must have been living in the Twilight Zone: I had an BMI of 20.5 when everyone was convinced that I desperately needed to lose weight and should exist on 800 calories a day.

    Would I have benefitted from being labled correctly? Maybe -- but it would still have only been a conditional acceptance, "You are OK (=not fat) *for now* See that it stays so." I would have benefitted a whole lot from not being labled at all.

  4. Ugh. Lyorn, it's sad. Your mom wasn't happy, you weren't happy. We are going to see more schools weighing and labeling, more docs labeling who have no idea what they are doing. We need to look at each individual. Are they happy? Are they healthy? Do they feel good? Are they eating with joy and getting nourishment and energy from what they are eating? Are they dieting? All of this focus on "obesity" and health will just take the craziness around food and body image up another notch. I fear we are still as a culture barreling towards rock bottom in terms of our relationships with food and our bodies. Thank you for sharing your story. You are why I do what I do. I find that about half the moms I work with have a history of an eating disorder or disordered eating and this is an opportunity to stop the cycle of suffering.