OPN_Childhood Obesity
Image Credit: The New York Times

I was in the fourth grade, sitting in a doctor’s office, the first time my face flushed with shame. I was, I had just learned, overweight.

I will remember the paediatrician’s words forever: It’s probably from eating all that pizza and ice cream. It tastes good, doesn’t it? But it makes your body big and fat.

I felt my face sear with shame.

There was more: Just imagine that your body is made out of clay. If you can just stay the same weight, as you grow, you’ll stretch out. And once you grow up, you’ll be thin and beautiful. Won’t that be great?

I learned so much in that one moment: You’re not beautiful. You’re indulging too much. Your body is wrong. You must have done it. I’d failed a test I didn’t even know I’d taken, and the sense of failure and self-loathing it inspired planted the seeds of a depression I would live with for many years.

Weight stigma kick-starts what for many will become lifelong cycles of shame. And it sends a clear, heartbreaking message to fat children: The world would be a better place without you in it.

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As the holiday season approaches, with its celebratory family meals and seasonal treats, I worry about the children across the country who will endure similar remarks, the kind that shatter their confidence, reject their bodies and usher them into a harsh new world of judgement.

For the rest of my childhood, I weathered the storm of conversations like the one I had at the doctor’s office. Well-meaning, supportive adults eagerly pointed out my perceived failings at every turn. As the years went on, more and more foods, I was told, were off-limits.

It wasn’t just that I shouldn’t eat them; it was that they were sinful, bad, tempting. Many of those foods — eggs, nuts, avocados — would later fall back into the good graces of healthy eating. At the time, though, they were collateral damage in a crusade to cut calories at all costs. Fibre, vitamins, minerals, fatty acids, protein — they were all sacrificed at the altar of calories in, calories out. The focus was never on enjoying nutritious foods, just on deprivation, will and lack.

How depression became deeper

My life was filled with self-flagellation, forced performances to display my commitment to changing an unacceptable body. Adults asked openly about what I had eaten, when I had exercised and whether I knew how to do either correctly. After all, if I was still fat, it must be my fault.

My body wasn’t just a body, the way a thinner one might have been. It was perceived as a burden, an inconvenience, a bothersome problem to solve. Only thinness would allow me to forget my body, but despite my best efforts, thinness never came.

The more I and others tried to change my size, the deeper my depression became. Even at such a young age, I had been declared an enemy combatant in the nation’s war on childhood obesity, and I felt that fact deeply. Bodies like mine now represented an epidemic, and we were its virus, personified.

The war on obesity seemed to emerge, fully formed, near the turn of the millennium, but its roots run deeper than that. C. Everett Koop, US surgeon general under President Ronald Reagan, made fatness a priority for his office in the 1980s. In 2004, nearly three years after the September 11 attacks, Surgeon General Richard Carmona compared the war on obesity to the war on terror. Suddenly, fat people weren’t just neighbours, friends or family members — we were enemies to be feared.

Billboards of shame

The war on childhood obesity reached its zenith with the 2010 introduction of the national “Let’s Move!” campaign, “dedicated to solving the problem of obesity within a generation.” It was a campaign against “childhood obesity” — not specific health conditions or the behaviours that may contribute to those health conditions. It wasn’t a campaign against foods with little nutritional value, nor against the unchecked poverty that called for such low-cost, shelf-stable foods. It was a campaign against a body type — specifically, children’s body types.

In 2012 Georgia began its Strong4Life campaign aimed at reducing children’s weight and lowering the state’s national ranking: second in childhood obesity. Run by the paediatric hospital Children’s Healthcare of Atlanta, it was inspired in part by a previous anti-meth campaign. Now, instead of targeting addiction in adults, the billboards targeted fatness in children. Sombre black-and-white photographs of fat children stared at viewers, emblazoned with bold text. “WARNING: My fat may be funny to you but it’s killing me. Stop childhood obesity.” “WARNING: Fat prevention begins at home. And the buffet line.” “WARNING: Big bones didn’t make me this way. Big meals did.”

The billboards purported to warn parents of the danger of childhood fatness, but to many they appeared to be public ridicule of fat kids. Strong4Life became one of the nation’s highest-profile fat-shaming campaigns — and its targets were children.

These declarations of an obesity epidemic and a war on childhood obesity all doggedly pursued one question, and one question only: How do we make fat kids thin? In other words, how do we get rid of fat kids?

Pathway to weight stigma

Overwhelmingly, childhood anti-obesity programmes hinged on shame and fear, a scared-straight approach for fat children. As of 2017, fully half of the states required that schools track students’ body mass index. Many require “BMI report cards” to be sent home to parents, despite the fact that 53 per cent of parents don’t actually believe the reports accurately categorise their child’s weight status. And observational studies in Arkansas and California have shown that the practice of parental notification doesn’t appear to lead to individual weight loss or an overall reduction in students’ BMIs. One eating disorder treatment centre called the report cards a “pathway to weight stigma” that would most likely contribute to development of eating disorders in predisposed students.

Experiencing weight stigma has significant long-term effects, too. A 2012 study in the journal Obesity asked fat adults to indicate how often they had experienced various weight-stigmatising events. Seventy-four per cent of women and 70 per cent of men of similar BMI and age reported others’ making negative assumptions. Twenty-eight per cent of women and 23 per cent of men reported job discrimination. For various of the subcategory, the effects of stigma were especially dire for young people, very fat people and those who started dieting early in life. To cope, 79 per cent of all respondents reported eating, 74 per cent isolated themselves, and 41 per cent left the situation or avoided it in the future. Rather than motivating fat people to lose weight, weight stigma had led to more isolation, more avoidance, and less support.

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Despite ample federal and state funding, multiple national public health campaigns and a slew of television shows, the war on obesity does not appear to be lowering Americans’ BMIs. According to the Centres for Disease Control, since 1999 there has been a 39 per cent increase in adult obesity and a 33.1 per cent increase in obesity among children.

Weight stigma kick-starts what for many will become lifelong cycles of shame. And it sends a clear, heartbreaking message to fat children: The world would be a better place without you in it.

Yet, despite its demonstrated ineffectiveness, the so-called war on childhood obesity rages on. This holiday season, for the sake of children who are told You’re not beautiful. You’re indulging too much. Your body is wrong. You must have done it, I hope some parents will declare a ceasefire.

— Aubrey Gordon, who has written under the pseudonym “Your Fat Friend,” is a columnist for Self magazine, a co-host of the podcast “Maintenance Phase” and the author of the forthcoming book “What We Don’t Talk About When We Talk About Fat.”