Because children don’t already feel bad about themselves enough, there’s a new book just about to be released titled Maggie Goes On a Diet. I asked Collective Shout colleague, psychotherapist and managing director of BodyMatters Australasia Lydia Jade Turner, for her views.
Written by self-proclaimed “obesity expert” Paul M. Kramer, Maggie Goes On a Diet tells the story of an ‘overweight’ teenage girl who goes from chubby-loser status to become the soccer star at her school, following significant weight loss. The cover depicts a fat child seeing a skinnier version of herself reflected in the mirror.
Yesterday in The Punch, journalist Lucy Kippist praised the book which encourages dieting for girls as young as four.
Kippist argued that widespread criticism of the book was misplaced. Pushing aside concerns about eating disorders and other negative consequences of dieting, she attempted to legitimize the story by citing the statistic that one in four Australian children are obese.
Kippist described the “courage” Kramer had given the central character Maggie to “make changes in her life” and be “rewarded” for them, She ticked off a further benefit to Maggie’s weight loss: avoiding teasing by her classmates.
As a clinician who specialises in eating disorders, I have seen the damage that diets do to children who are labelled ‘obese,’ and what happens to those children when they are grown up.
The typical presentation is anything but one of good health – whatever their size. When we get children to focus on weight loss as a goal – however well intended this may be – we are putting them at significant risk of developing food and body preoccupation, weight cycling, reduced self-esteem, mood disorders, eating disorders, and other health detriments.
Any parent concerned about an ‘overweight’ child needs to know this: no weight loss approach has been shown to be effective for more than 95% of the population after two to five years. There are no exceptions.
While this failure rate for weight loss is based on a 1959 study by Dr Albert Stunkard and Mavis McLaren-Hume, this failure rate has been reproduced by numerous clinical studies, and acknowledged at both the Australian New Zealand Obesity Society conference in 2009 and again at the inaugural International Obesity Summit in 2010.
In addition, weight loss attempts typically lead to long term weight gain – and a weight higher than one’s pre-diet starting weight. So promoting weight loss may actually be contributing to the obesity “epidemic.”
Kippist’s citing of the obesity statistic for children does not justify a weight loss approach. The idea that there are so many more ‘obese’ children out there than ones with clinical eating disorders ignores the great spectrum of young people who do not meet the strict criteria for diagnosis but who compromise their health in pursuit of weight loss in other ways. For example, the Eating Disorders Foundation of Victoria reports that eight per cent of teenage girls smoke to control their weight.
Patients who were put on diets as children tend to tell me that as children, they felt guilty and ashamed of their seemingly oversized bodies. No matter how hard they tried to be “good,” the weight kept coming back and they blamed themselves for lack of “willpower” – rather than seeing the weight gain as a predictable course of dieting.
They felt like failures whenever their siblings were offered second helpings while they were given a list of “forbidden” foods they were not allowed. Or in cases where the family ate the same diet foods as the child in a spirit of solidarity, they felt guilty as they thought to themselves “everybody is being punished because of me.”
Many of my patients are now in a weight category that would see them labelled “obese.” I wonder what havoc has been wreaked on their metabolism, having been put on diet after diet since childhood.
Many have been so desperate to successfully lose weight that they have resorted to lap band surgery, the weight slowly creeping back three years later. They are terrified of returning to their pre-surgery weight.
When I ask them gently, “What was it like for you at that size?” the typical response is silence. Tears well up in their eyes – their pain is unspeakable.
But unlike what we are told in the “confession” sections of diet advertisements, the pain these women experience is not due to the physical experience of their large bodies. It is due to the deep sense of failure accompanied by widespread stigma and discrimination – the meaning that is attributed to their fat bodies.
Society makes assumptions that because a person is fat they must lack discipline, they must be lazy, they must be stupid and therefore worthy of our disdain. The discrimination they face in daily life is relentless – and like any population facing prejudice, risk of developing mental and physical health problems heightens as a result.
Instead of encouraging children to lose weight to avoid bullying, perhaps parents and educators should work together to change the school culture which enables the bullying to occur.
If your child has red hair and gets bullied, is the solution to dye his hair brown? If your child has big ears that stick out, is the solution to get her to undergo ostoplasty so her ears will be pinned back? There’s something illogical about fighting discrimination by getting the victim to change their appearance or behaviour.
A growing movement of health professionals and human rights advocates now recognize that promoting weight loss as a solution to the obesity “epidemic” is unethical.
About 95 percent of obesity research is funded by the weight loss industry- including research grants awarded to researchers at prestigious universities and professors who are beholden to the pharmaceutical company funding their research. This has contributed to many exaggerated health risks associated with obesity.
Then there is scientific bias- science has always been influenced by the zeitgeist of its time, and we are not free from this today. Many working within the health sector are well intended, and it can be difficult to accept that perhaps what one was taught their entire life is actually wrong.
Einstein once said “the definition of insanity is doing the same thing over and over again and expecting different results.” Letting go of the pursuit of weight loss is not the same as giving up – it is recognising that what we’re doing, and have been doing for more than forty years in our war against obesity – isn’t working.
Emerging evidence shows that shifting away from a weight-based model to a health-centred one is showing promising results.
Instead of trying to get your child to lose weight, you can encourage health-giving behaviours which include finding physical activity that is pleasurable for them to engage in; learning to eat in a manner that is in tune with one’s body; accepting that bodies come in different shapes and sizes (as we would expect in any given population); and recognising that health is a multi-faceted, ongoing process that involves physical, spiritual, intellectual, social, and emotional aspects – not a number on a scale.
Helping your child to engage in these changes may not result in weight loss, but will bring about health benefits. More information on the health centred approach can be found at www.sizediversityandhealth.org
See also: Elizabeth at Full Fat Milk has re-worked the title: “Maggie gains back the weight and learns to accept her body”