The uneasy relationship between eating disorders prevention and obesity prevention

A recent article in The New York Times, Whether a Child Lights Up, or Chows Down, discussed the growing tension between the anti-smoking efforts directed at teens, and the anti-obesity movement. The first has been losing funding and public visibility, while the latter has become the cause du jour, attracting headlines and funds, especially in the wake of First Lady Michelle Obama’s Let’s Move program for the prevention of childhood obesity. In May, a White House Task Force on Childhood Obesity announced its goal of reducing the current 17 percent rate of childhood obesity to 5 percent by 2030.

No one can argue that smoking is deadly, or that rising obesity rates lead to increased health risks. It is also sad that in this age of shrinking federal and philanthropic funds, supporting one good public health campaign over another has become, as the Times noted, “a kind of weird zero-sum game.”

We all have to fight for recognition of the causes we support or the fields in which we work. For professionals in the eating disorders world, the big concern now is the potential negative effect of the high-profile national anti-obesity campaign. Psychotherapist, social worker and body image expert Kathy J. Kater has put together an excellent summary of these concerns, which you can find posted on the NEDA (National Eating Disorders Association) web site. In “Why "Obesity Prevention is Making Us Fatter" Kater explains how the seemingly laudable goal of obesity prevention can produce unintended harmful consequences.

“Obesity is a measurement of size,” writes Kater. “Implicit in ‘size prevention’ is the anxiety-provoking notion that there is a ‘right’ and a ‘wrong’ size to be.” For those of you with any familiarity with how an eating disorder gets started this statement will set off alarm bells. You’ve probably seen a young girl or boy who starts on the path of dieting because of a careless or mean remark about size or who, by osmosis, picks up our society’s virulent fear of fat. I’ve had moms of 5-year-olds voice to me their shock when they hear their child utter the words, “Mommy, am I too fat?” You can see where this argument is going: Obesity prevention as a goal can increase weight stigma, fear of fatness and body dissatisfaction.

Other good points Kater makes are:

· Weight bias and body dissatisfaction in most people predict poorer and disordered eating and weight gain.

· “Size prevention” denies biological diversity, or the idea that different people have different “set points,” and may be naturally heavier without being overweight.

· People led to believe they are the “wrong size” will be tempted to follow diets for weight loss even though overwhelming evidence shows that 90 percent of weight lost through weight-reduction plans is regained, and over half of dieters who regain add more weight than they lost.

· When “size” is promoted as the reason for healthy eating and fitness habits, the value of health as a primary motive for these positive habits is diminished.

What we need instead of “obesity prevention” programs, Kater argues, is to shift the model to emphasize health as a value rather than size as a goal.” Focusing on “how we live rather than what we weigh” empowers people of every size and shape to be the best they can be, and fosters a tolerance of diversity of size and shape.

Let us know where on the obesity prevention vs. health-as-a-value issue you stand!

Nancy

Marcia Herrin and Nancy Matsumoto are the co-authors of The Parent's Guide to Eating Disorders, Supporting Self-Esteem, Healthy Eating & Positive Body Image at Home (www.childhoodeatingdisorders.com)

Comments

[Jessica]

This article sums up my views pretty much to a T. Obesity is a growing problem in children but it's not the only problem - I agree that the bigger problem is society's attitudes about size. Hopefully with enough of us caring, we will be able to address this and shift the nation's mindset before another generation - a generation that my children will be born into - lives with unhealthy attitudes about size and, well, health.

[Ednutrition]

I totally agree, Jessica. Just think, if everyone started life with healthy attitudes about size, food and weight, we wouldn't be faced with rising rates of obesity in the first place. Anti-obesity programs focus on one symptom of a much broader malaise.

[Gary]

There is an interesting webcast from the recent Meeting the Challenge Eating Disorder Conference in Sydney on prevention of eating disorders and obesity. It is by Prof Dianne Neumark-Sztainer from the university of Minnisota the link is http://www.medicalupdatemedia.com.au/426377/ED_Prevention/index.htm#

[ffxiv gil]

To make people believe they are "wrong size" will be tempted to follow the weight loss diet, despite considerable evidence that 90 percent of the weight loss through weight reduction of the recovery plan, and who more than diet to add more weight to restore more than half They lost.i like the scentence very much.