By Patricia Pearson
Arkansas has tipped the scales on the childhood-obesity crisis - literally
Last week, officials there announced that they had weighed 276,000 schoolchildren during the past year and discovered that 40% were overweight or obese. Notes have been sent home to parents. Diets, presumably, advised.
Laudatory as this effort sounds, the focus on poundage sends chills up my spine. Are we quite certain that a focus on weight, rather than on health, is the one we wish to convey to our children?
I ask because my 7-year-old daughter and I came across the final episode of Fox's plastic-surgery makeover show, The Swan, a few weeks back, and it was a striking reminder that this society remains one in which the cruel adage still holds: You can never be too rich or too thin.
Even as we wring our hands about the obesity epidemic, we look to television and see ordinary American women submitting to a months-long regimen of dieting, fitness and plastic surgery, to be, not strong and fit, but pretty.
A putative swan song to self-esteem, the show crescendoed to a pageant, in which the ladies were pitted against one another in bathing suits and lingerie, and one got to become the Swan Queen. The lunacy lay less in the liposuction than in this final pageant, in which every woman but the winner was made to feel that she was still lacking a certain je ne sais quois.
Beware of message
We need to be careful that as we prepare to declare war on obesity, we don't knock down the gains made to combat eating disorders.
Our children are particularly vulnerable. Schools are asked, on the one hand, to make kids feel comfortable with "body image," while, on the other, advising them to watch their weight. How are they supposed to navigate such conflicting messages?
If roughly 15% of adolescents have been deemed "obese," it's worth bearing in mind that about 5% suffer from anorexia nervosa and bulimia, according to Michael Levine, a psychologist at Kenyon College in Gambier, Ohio. He is a leading specialist in eating-disorders prevention.
Moreover, it is plausible that some overweight kids are merely the flip side of the coin, in which the currency is image and they binge-eat and crash-diet and lose control of their weight. "Obese girls are more likely to report binge-eating or extreme dieting," Levine says.
A study published by Harvard researchers in the journal Pediatrics last year found that kids between the ages of 9 and 14 who were dieting without medical supervision gained weight over a three-year period. Kids who weren't concerned about their weight maintained it evenly.
Yet here we have diet gurus such as Arthur Agatston of the South Beach Diet letting it be known that children and adolescents should feel free to use his program, as long as they skip the initial two-week phase of stricter food intake.
"The problem," Levine says, "is that we keep thinking in terms of weight, itself. Calories and BMI (body mass index) and optimal weight, and we're essentially fostering a dieting mentality."
This, I might add, is nothing new.
"We've lived with hysteria about obesity for how many years?" Levine asks, rhetorically. "Fifty?"
Obsessing over looks
Is it possible that the longtime obsession with appearance has fed into the very obesity crisis we face? It would be dubious to argue, then, that the answer is a redoubled effort at dieting.
"We need to coordinate obesity efforts with eating-disorders prevention," says Frances Berg, author of Underage and Overweight: America's Childhood Obesity Epidemic - What Every Family Needs to Know. "They are interrelated issues, and it's certainly possible to cause new problems (eating disorders) while trying to fix others (weight gain)."
Consider who it is that picks up the message about being overweight. A study reported last month by the staff at Toronto's Hospital for Sick Children, a world-renowned center for eating-disorders research and treatment, showed that among a sample of 2,279 girls younger than 14, one-quarter were "dieting to lose weight," even though fewer than 8% could be characterized as "above average" in weight for their age group.
"I do strongly feel that we might undo some of the work we've been doing on disordered eating for the last 10 years," says Gail McVey, the study's lead author.
What McVey has found in her work is that girls' attention must be shifted away from food and weight altogether. Talk to them about stress management and peer pressure, teach them media literacy, show them that many of their problems "are displaced onto concerns about being fat."
Contrary to Iowa Democratic Sen. Tom Harkin's best intentions in proposing to ban junk-food vending machines in schools, there should be no such thing as "good" food or "bad" food. Kids should always have access to a variety of foods and athletic activities.
Berg agrees: "We need to shift to a new paradigm. I call it 'Health at Any Size,' and it means focusing on health, not weight, and helping all people be healthy at the size they are."
Patricia Pearson is a freelance writer and author who lives in Toronto. She's also a member of USA TODAY's board of contributors.