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Dieting and children – weighing up the arguments

I was recently invited to join a panel discussing body image on channel 9’s Kerri-Anne. The panel also included social commentator Angela Mollard, psychologist Ian Wallace, and Sally Symonds who is a weight loss consultant. The conversation got rather heated at points with quite different opinions expressed over dieting and the oft-reported obesity epidemic in particular. I’d love you to take 12 minutes to watch the vision below as I think these are conversations we should all be having, particularly at this time of the year (pre-Summer / beach time) when the diet industry really ramps up its push to have us all believe that we could transform our lives if we simply said “No” to food and transformed our bodies.

I asked expert Lydia Jade Turner to offer her insights and further unpack the above exchange. Lydia is a psychotherapist and the Managing Director of BodyMatters Australasia. BodyMatters Australasia is a specialist clinic that was established to not only treat disordered eating, but to diminish the complex factors that contribute to our global epidemic of eating problems. Lydia’s expertise has been featured at my blog before, both here (“Look good by doing very little’) and here (“Fat talk “).

 

Should children be weighed at school?

Children inevitably play the ‘compare and despair’ game, and for many, a comparatively higher weight will result in a deep sense of shame. Contrary to popular opinion, research shows that shame does not lead to sustainable health-giving behaviours, but instead increases risk of unhealthy weight loss behaviours and clinical eating disorders.

Weighing children in front of their peers also sends the message that weight is the most important determinant of their health, and that their health is everybody’s business. In fact weight tells us very little about a person’s health except at statistical extremes.

Although it is commonly assumed that being ‘overweight’ is automatically unhealthy, in North America research shows that the overweight category (BMI = 25 to 29) is now outliving every other weight category.

Given we share much of the same cultural DNA, it would not be surprising if that were the case in Australia. We also know that being a bit ‘overweight’ can actually be protective against certain diseases including certain types of cancer, and especially protective for the elderly population.

 

Should fat children be removed from their home?

In the Kerri-Anne clip, Psychologist Ian Wallace immediately paired the idea of fat children with trips to McDonalds and fast food outlets. Yet we cannot make assumptions about a child’s lifestyle choices simply by looking at them. It is a myth that all fat children are fat because they eat too much and don’t exercise enough.It is also dangerous to assume that all fat children are fat as a result of abuse and / or neglect.

At BodyMatters we see children at a range of sizes, many of whom are very much loved and supported by their families. While not all fat children binge or overeat, children who do overeat or binge, do so for a variety of reasons: it can be a way of coping with stress, parental divorce, grief and loss issues, a physiological response to dieting.

For some, this will lead to significant weight gain, but for others, they may still be thin. Regardless of size, they deserve help. But threatening to remove them from their families and pressuring those who are fat to lose weight will only exacerbate the situation.

Imagine the message internalized by a fat child who has just been told they may be taken away from their family: lose weight, or your family will be ripped apart. It will be all your fault because you’re too fat. This kind of messaging is likely to put a child at risk of developing disordered eating behaviours, reduced self-esteem, and significant distress.

 

Should fat children be encouraged to lose weight to avoid bullying?

Children will always find something to bully another child about – red hair, poverty, handicap. It does not make sense to pressure a child to change something about themselves in an effort to escape bullying, as this is a form of victim-blaming. Parents and teachers should work to change school culture so that children learn to respect difference and accept that bullying is never justified, and that there are consequences for engaging in that type of behaviour.

 

Is citing genetics just an excuse to be fat?

Earlier this year The Biggest Loser trainer Michelle Bridges wrote an article for the Sydney Morning Herald, claiming that people can outsmart their genetics. Unfortunately we now have evidence that many of The Biggest Loser contestants are weight cycling or have returned to their pre-diet weight.

Research tells us that weight is not as malleable as we think. How we each respond to a lifestyle is different, for example, two people can eat the same amounts of food, and while one person gains weight, another person’s metabolism will kick in and prevent weight gain.

Genetics account for about 70% of a person’s weight, and there are a host of other factors that contribute – socioeconomic disadvantage, ethnic background, Indigenous background, low income households, family history of obesity, regional and remote location.

This may explain why weight loss attempts fail 95% of the population after 2-5 years. Anyone can lose weight in the short term but we simply don’t have solutions that work long term. The good news is when people adopt a healthy lifestyle, they will experience health benefits, regardless of whether or not their weight changes.

We need to be cautious about making assumptions about people’s lifestyle choices based on size. Just as one person emailed the Kerri Anne show expressing frustration at being called Anorexic (even by her teachers) because she was skinny, the same frustration exists for people who are fat who are told they must not exercise enough and make poor food choices. We need to recognize that issues of health and weight are complex.

 

According to weight loss consultant Sally, there are far more people who are overweight/obese than those with Anorexia Nervosa. Should we therefore prioritise obesity issues above concerns about eating disorders?

This argument that “the odd anorexic is a small price to pay” is an unethical one. Nobody chooses to have an eating disorder, in fact we know that dieting is the biggest pathway into an eating disorder. Sufferers typically engage in weight loss attempts with good faith, believing that they are improving their health. Unfortunately this tips some over into a clinical eating disorder.

It’s time we recognized that the solutions typically prescribed to combat obesity are the same behaviours we are diagnosing in those with eating disorders – for example counting every calorie, weighing every gram of food, counting each step in pursuit of thinness. There’s something very wrong with this picture and Sally’s suggestion that we should encourage schools to integrate calorie counting with maths homework is incredibly dangerous and ill-informed.

We cannot continue to pit “The Obese” against eating disorder sufferers. There’s this idea out there that if people are not ‘obese’ or do not meet the strict criteria for an eating disorder, they must be healthy. Yet we know this is simply not true – there are many who exist in between these extremes, but who compromise their health due to body shame and internalization of misguided health messages.

Many put their bodies under enormous strain going on diet after diet, taking diet pills, smoking to control their weight, engaging in bizarre bariatric interventions (for example stomach balloon insertion), so it’s not as simple as sixty percent overweight/obese versus five percent eating disorders.

We would be better off focusing on promoting healthy behaviours, and letting people’s weight fall where it will. Kerri Anne’s statement implying that a poor lifestyle is “okay” when you’re young but will catch up with you when you’re fifty misses the point – if people want to be healthy, then they should be engaging in a healthy lifestyle whatever their age, whatever their size.

 

Sally has managed to keep the weight off since 2002- that’s nearly ten years! Should people aspire to be in the 5% who do manage to keep the weight off?

Sally’s long term weight loss is atypical. While it is wonderful to know she has made some healthy lifestyle changes, the reality is that the outcome of sustained weight loss is not likely to be the case for most. In fact, while I respect that she has a right to tell her story, every time she does, she perpetuates the fantasy that if others just tried damn hard enough, they could lose the weight and keep it off too.

Encouraging people to aspire to be in that five percent that keeps the weight off ignores research that shows inherent risks that accompany weight loss attempts – including weight cycling, disordered eating, reduced mood, eating disorders, food and body preoccupation.

Telling people to lose weight is essentially setting many up to fail – and when weight loss is the main focus, most quit when they find the weight is no longer reducing or has begun to increase. If people want to be healthy, then fitness and healthy dietary choices are important regardless of their size.

 

 

 

Published inBeauty IndustryBody ImageBullyingChild abuseEating DisordersParents

11 Comments

  1. Jan Cullis-Clarke (Bronte Cullis’ mum – the girl with anorexia who was on ch. 9 about 10 years ago) said at a conference I went to once “if your daughter asks you if she can go on a diet, consider it with the same seriousness as if she’d asked you if she could recreationally use crystal methampheatmines. Dieting is the single biggest risk factor for developing an eating disorder.”

    Thank you, Lydia & Danni.

  2. Thanks Lydia for this well considered and rational response.
    Firstly it irritates me immensley that because someone is (in) famous they get to suddenly be an expert. As a trained genetic counsellor, I have done a lot of study in genetics and can assure people there is by no means any simple explanation about how our genes work or don’t work. Geneticists are still researching, studying and discussing about the bits they do know (eg breast cancer) ! So what makes these people like Michelle Bridges, experts and why are they called on to even comment, especially in public forums? To dismiss factors like genetics by such people, including Kerri-Ann and Sally Symonds – none of which to my knowledge have ever studied genetics is maddening. Forcing our bodies to conform to an ideal despite our genetic make-up, circumstances and ability is abuse and disrespect of the worst kind.

  3. Abi Swanson

    Nice comments thanks HAES Coach. Epigenetics really complicates genetics further! Nice one Lydia & Danni- we need more articles like this. Thank you!! Xxx

  4. Eddy

    Great article lydia i think it is so important to have these myths debunked. the thought of kiddies being removed from families- even the fact that we are having these conversations- is totally disturbing.

  5. Rachel

    Thank you! We need to encourage health as the focus, not weight. You can be unhealthy at any point in the spectrum, including a “normal” weight. When will we start talking about that and the myriad of factors (environmental, social, psychological) that contribute to that instead of talking about scales? Thanks to Ella for the great quote from Bronte’s mum too, and to HAES coach for pointing out the true meaning of genetics.

  6. Francesca

    Good point Rachel. To be the healthiest ‘you’ possible should be the focus for everyone regardless of size, body shape,age and genetics.

  7. Can we please stop teaching kids they have to avoid bullying, and start teaching kids NOT TO BULLY?? Perhaps if we focused on forcing the perpetrators to change their behaviours, not the victims, we might not have these issues.

  8. Danni, there was so much about this segment that was frustrating to watch but your response to the issue was rational and logical. It was great to see you got some very important points in the discussion. I’m really glad you were on this panel!
    What I found frustrating about the exchange was when other panelists said genetics and metabolism are just an ‘excuse’ and weight loss is as easy as counting kilojoules in and kilojoules out. What really upset me was the suggestion that children should lose weight to avoid bullying. This is a very dangerous message and as Lydia said, amounts to victim blaming.
    Anyway, I don’t think I need to say anymore on that as you and Lydia have said it all. Thanks for putting this article together Danni, definitely one to share with friends and networks.

  9. Interesting post. It can be tough approaching this subject, but keeping kids fit and healthy is very important. Discussing the issue is the first step toward us tackling it as a society

  10. It can be very difficult to condense one’s point of view into a short tv segment, so just to clarify a few points:
    * In my latest book I discuss at length why diets don’t work for the body, and why they don’t work for the mind. Instead, I advocate successful healthy eating – which incorporates many tenets from anti-disordered eating experts.
    * Genetics don’t account for 70% of a person’s weight, BMR accounts for 70% of a person’s energy expenditure. BMR is determined by a many things (including genetics). However, increasing lean muscle mass and decreasing body fat is an excellent way to boost BMR/metabolism (and thus the number of calories we can consume without gaining weight). Furthermore, another 15% of our energy expenditure is determined by thermogenesis (which can be affected by exercise and food) and the final 15% is directly related to physical activity.
    * The study of how epigentics affects our weight is still in its infancy. However, I am mindful of the discovery of leptin. Leptin resistance was initially copped a lot of blame for obesity. However, doctors then discovered that leptin resistance decreased as weight decreased. The medical bias in obesity studies is something that Lydia Jane Turner explored brilliantly in one of her ABC segments earlier this year.
    * Certainly my results are atypical – I’ve lost 50% of my original body weight and kept it off and few people can say that. But losing weight and keeping it off isn’t a fantasy. The National Weight Control Registry, for example, contains the names of thousands of people who have lost a lot of weight and kept it off for a significant amount of time (over 50% of those did it without a diet).
    * Disordered eating of any kind isn’t healthy and it’s not a case of pitting one kind against another. However, obesity affects many more people. It also cost Australia’s health system over 56 billion dollars in 2009. Fix the obesity crisis and the health care system would be significantly healthier in itself.
    * There is a difference between how we treat and view children versus adult overweight / obese people

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