WHAT TO BELIEVE? MIXED MESSAGES ON FOSTERING HEALTH IN KIDS

By CRISTIN RUNFOLA
Originally Published on July 30, 2013 at UNC Exchanges

Part 1

Perhaps now more than ever, parents are plagued with contradictory advice and doubt about how to maintain their children’s health. While research is advising parents not to focus on their children’s weight, media messages and many public health campaigns are pushing for just the opposite.

A recent article published in JAMA Pediatrics found that when it comes to talking about eating with kids, weight-based discussions (as opposed to health-based ones) may increase children’s risk for binge eating, unhealthy dieting, and extreme weight control behaviors, regardless of the child’s BMI. (A more in-depth article summary can be found HERE). This article received widespread media coverage, generating excellent public discussions on the topics it raised –read more HERE.

However, recent “anti-obesity” campaigns, such as the Strong4Life campaign initiated by Children’s Healthcare of Atlanta and Dubai’s “Your Weight in Gold” initiative, which target individuals who are overweight or obese and promote weight loss as an end goal, either continue today or have had lingering effects. Who can forget the Georgia print ad featuring a sad, angry-looking girl that read “WARNING…IT’S HARD TO BE A LITTLE GIRL IF YOU’RE NOT. Stop childhood obesity,” for example? Such images evoke strong emotional responses and leave imprints on our brains.

These campaigns cause great unease (and even uproar) among eating disorders professionals. In press statements or blogs, the Academy for Eating DisordersBinge Eating Disorder Association (BEDA), and Association for Size Diversity and Health have presented our concerns HEREHERE, and HERE, citing the potential damage that weight-based discrimination and targeting only weight (instead of behaviors) can have on eating patterns, body image, and self-esteem.

As Boston Children’s Hospital Chief of Endocrinology Dr. Joseph Majzoub notes, however, “The history of obesity for many, many years has been one of blaming people for lack of self control” (The New York Times, 2013). Genes are often excluded from conversation, despite their significant role in determining our weight and size. People are left feeling ashamed for their assumed lack of willpower and inability to make their body change. These tactics can backfire. Read BEDA’s take on this issue HERE.

It’s no wonder that parents are confused about how to broach this topic with their kids. It is well known that parents can play a crucial role in the development of healthy eating and weight for children, but clear, sound, evidence-informed advice for parents on how to do this can be hard to find. And the media do not always present a complete or accurate picture.

Excellent books (such as those by Ellyn Satter) and websites do exist (e.g., http://www.ellynsatterinstitute.org/).  Some of the blogs referenced above provide excellent health promoting strategies and tips for talking about weight with your child. (The hyperlinks should make it easy for you to take a few minutes to peruse them easily.) However, additional outlets across the Internet must be made available to ensure that such information is disseminated to parents from all walks of life.

We encourage healthcare educators to spend some time creating accurate non-stigmatizing resources on this topic that can be made available to parents free of charge. We’ll do our part too! A list of conversational “dos” and “don’ts” for discussing the sensitive topics of weight, health, and body image will follow shortly. Stay tuned…

[Thanks to Emily Bulik-Sullivan for edits]