February 22 2012
Dr. Anthony T. DeBenedet, a board-certified internist and gastroenterology fellow at the University of Michigan Health System (and perhaps more importantly: a father to three young girls), has an important piece in this months’ Time magazine. He writes about his concern that our national obsession with obesity might be creating a generation of eating disordered children (I've written about this issue previously here and here). While DeBenedet agrees that a 17 percent obesity rate among children is a problem, he worries about the impact of designing anti-obesity programs that target the entire population--not just those suffering from obesity.
We know kids and teens react differently than adults to external pressures like persistent messaging. Sometimes these pressures can translate into incredible waves of anxiety and fear. At the extreme, a healthy-weight youth could be pushed to monitor his weight more frequently or even begin an unsupervised diet — behaviors that might represent an impending eating disorder.
As a reminder of those "messages" being sent to young kids in schools today: many schools now send BMI report cards home to parents even though BMI is well-known to inaccurately measure weight and overall health. Some local school districts now have wellness committees to monitor children's overall health throughout the school year. And in two states, children are being fitted with electronic bracelets so that school officials can keep track of their eating habits...at home. Routinely, schools are banning vending machines that sell snack foods and sodas and in many locations, school fundraisers can no longer feature baked goods, pizzas or chocolate. And how about those new television ads that think shaming fat kids will help them lose weight. Yeah, those ads are charming.
Home packed meals are even under attack. In a headline grabbing story last week, one state inspector refused to allow a preschooler to eat her home-packed meal because it wasn't healthy enough.
So what does DeBenedet make of all these anti-obesity efforts?
So the real question is what are children saying and how are they behaving in light of our anti-obesity effort? A nationally representative survey, conducted last September by the C.S. Mott Children’s Hospital National Poll on Children’s Health, attempted to answer this question. The results, released in January, showed that 30% of parents of children age 6-14 report worrisome eating behaviors and physical activity in their children; 17% of parents report that their children are worried about their weight; 7% say their children have been made to feel bad at school about what or how much they were eating; and 3% of parents report their children had a sudden interest in vegetarianism. Certainly these data do not directly link the anti-obesity effort and eating disorders. They also do not offer any insight into whether obese children are actually losing weight. They do, however, serve as a reminder of how vulnerable these “worried” children already are to disordered eating and that everything we do, no matter how well-placed our intent, carries risk.
Given the messaging being pushed on young kids today, it shouldn't really be a surprise that the number of children and young adults being diagnosed with eating disorders is on the rise--some diagnosed are as young as 6 or 7. Equally disturbing is the age at which young girls begin to diet--some as young as 7 and 8 years old. Equally troubling is a report this week that sheds light on a new trend among young girls where they post videos of themselves on YouTube and invite anonymous commenters to answer the question: "am I ugly?"
Dr. DeBenedet is charitable when he says this about government efforts to reduce obesity: "While the efforts are well-intentioned, it’s worrisome to watch the movement gain logarithmic momentum when we still don’t really know whether what we’re doing is actually working — nor do we really know if there will be any downsides to the anti-obesity initiative."
Given the behavior of young girls today, I say we already know the downsides of these anti-obesity initiatives. It must stop...to use one of the left's favorite phrases...for the health of our children.