Giving fat kids better grades for weight loss, school-wide student weigh-ins and other weight-focused ‘health’ programs are a fast way to create more eating-disordered adults with shorter lifespans, not more healthy people who live longer.
So says child psychiatrist Leora Pinhas, psychiatric director of the Eating Disorders Program at the Hospital for Sick Children.
“Even if you look at standard, traditional training in psychology and cognitive behavioural training…humiliation and punishment are the poorest ways to get behaviour changed,” Pinhas says. “Rewarding desirable behaviours and helping people feel good about themselves is what’s going to predict a change.”
Project reduced kids' health
Pinhas points to the Arkansas Public School BMI (Body Mass Index) Assessment Project in the United States, which is ongoing and began in 2003.
Each year public school students involved in the project are weighed and their BMI is sent home to their parents in a BMI report card. Proponents of the program say the numbers of childhood obesity have flatlined since the program began, yet Pinhas points out that the numbers also flatlined across the entire country.
She said a closer look at the data shows the project’s impact has actually been quite detrimental. There has been an increase in eating disorder rates, concern over kids' BMIs, bullying incidents related to weight, and risky behaviours around food like vomiting after meals and restricting food intake.
Meanwhile, the kids actually ate fewer fruits and vegetables and milk and consumed more cola than before they participated in the project.
What's the real goal?
Western culture and many doctors today keep losing sight of the real goal, she says.
“The goal is not to make thin people,” she says. “The goal is to make healthy people who live long, productive, happy lives. That’s the goal. And sometimes we get so focused on making thin people that we end up creating unhealthy adults with unhealthy behaviours and a shortened lifespan.”
According to Statistics Canada, the most recent numbers collected in 2004 show 9 percent of kids aged 2-17 were obese, compared to 3 percent in 1978/1979.
Pinhas, who is also co-chair of the Healthy Weights Working Group in the Sandbox Project (a Canada-wide effort to bring professionals together to improve the health outcomes of Canadian kids), says parents of kids who are obese, not just overweight, need to tailor their approach specifically to suit their child.
“What I would say to a parent who is worried about their child’s weight and is worried about their child being obese (with a BMI of greater than the 95th percentile), meaning, unhealthy, I think, I would say it depends,” she says. “If you have a child who has always been naturally large but that eats normally, that is physically active, that has good blood pressure, good sugars, it’s just their genetic load, I think the job of the parent is to work with that child to make sure that they maintain a healthy lifestyle and feel good about themselves in a culture that makes assumptions about them that are untrue.”
Bullying acts as a hurdle
It is hard for obese kids to stay physically active faced with challenges like weight-related bullying and exclusion, she says.
“So (the question becomes) how do we empower those children?” she says. “There are studies that suggest people who are fat experience the same kinds of bias and stigma that people in minority groups, coming from different cultures, of different skin colours, experience. The only difference is that people who are fat don’t have any protection in law in the same way that other minority groups do. So how do we help our kids live in a world that is unfriendly.”
And for those kids who do have unhealthy eating patterns and are not able to be physically active?
“If you have a child who doesn’t have access or support to maintain a healthy eating pattern, has eating behaviours that are unhealthy, who is not physically active, I would always tell parents to focus on those things,” she says. “Their weight will be whatever their weight needs to be if they are able to empower and support their child to live a healthy life.”
Focus on the number of the scale will always backfire, she says.
Karen Bridson-Boyczuk is a journalist, author, producer and director. She is a digital media producer specializing in curriculum for TVOParents.com.
