Is the campaign against juvenile obesity responsible for the increase in eating disorders?

How to walk the juvenile obesity-eating disorders tightrope

Posted Jan 08, 2011

If you're a parent, how do prevent your concern about your child's weight from contributing to an eating disorder?

First Lady Michele Obama's "Let's Move" campaign is just one of the highly publicized attempts to raise public awareness about the juvenile obesity epidemic. In launching the campaign the First Lady was criticized for discussing her daughters' weight problems in the media. It was suggested that critical comments about a pre-teen's weight might increase her risk of developing an eating disorder.

According to the White House Task Force on Childhood Obesity one third of our kids are either overweight or obese placing them at greater risk of developing diabetes, heart disease and some types of cancer later in life. In addition to the future health consequences, overweight children suffer stigma and discrimination starting in kindergarten or sometimes, earlier. The concern about juvenile obesity is thoroughly justified, but unless approached with sensitivity, well-intentioned interventions can have negative consequences.

A new report from the American Academy of Pediatrics noted that the incidence of eating disorders is increasing, especially among kids who were thought to be less susceptible. David Rosen, MD, MPH speculated that the increasing focus on weight loss and dieting might be responsible for increases in the frequency of eating disorders among children younger than 12 years, boys, and minority kids who had been less vulnerable.

Some interventions such as mass screenings in school and physician advice to diet along with unrealistic media portrayals of weight loss like the TV program, The Biggest Loser may promote extreme weight loss goals and methods. When these methods don't work, kids may resort to dangerous measures like self-induced vomiting, fasting, laxatives or diuretics.

Parents of overweight kids may feel that they're caught in a bind. On one hand they don't want their children to suffer the medical and psychological consequences of obesity. On the other hand, they are mindful of the risk of an eating disorder when weight loss is emphasized. This is especially problematic for mothers of pre-teen and adolescent girls since maternal over-involvement ("enmeshment") is often viewed as contributing to eating disorders. In my clinical experience I've heard many college-aged bulimics describe their mothers as "my best friend." Often they reported that their mother had shared diets and weight loss programs with them when they were kids.

One possible solution to the conundrum is to ignore weight loss as a goal. Instead, without mentioning weight goals, pounds, or BMI the aim is to encourage healthy eating and enjoyable physical activity. Encouraging healthy eating and activity in school, the media, and at home would decrease stigma that overweight kids experience. In addition, many normal-weight kids have poor diets and spend too much time in front of screens so they would benefit from messages encouraging healthy eating and activity.

As a concerned parent pay attention to the messages you are communicating to your kids. If you're unhappy with your weight make sure that you don't model body image dissatisfaction to your child. Kids don't need to hear about mom or dad's continuing struggles with diets and weight loss. Regardless of your weight, let your child hear you express satisfaction with some aspect of your own appearance, even if it's only a new haircut or article of clothing.

Help your child make healthy food choices and encourage her to be more active. Let him see you enjoying a physical activity, even if it's only walking around the block. Focusing on healthy eating and physical activity rather than diets and weight loss will help your child achieve a healthy weight without increasing the risk of an eating disorder.