I was recently invited to join a panel discussing body image on channel 9’s Kerri-Anne. The panel also included social commentator Angela Mollard, psychologist Ian Wallace, and Sally Symonds who is a weight loss consultant. The conversation got rather heated at points with quite different opinions expressed over dieting and the oft-reported obesity epidemic in particular. I’d love you to take 12 minutes to watch the vision below as I think these are conversations we should all be having, particularly at this time of the year (pre-Summer / beach time) when the diet industry really ramps up its push to have us all believe that we could transform our lives if we simply said “No” to food and transformed our bodies.
I asked expert Lydia Jade Turner to offer her insights and further unpack the above exchange. Lydia is a psychotherapist and the Managing Director of BodyMatters Australasia. BodyMatters Australasia is a specialist clinic that was established to not only treat disordered eating, but to diminish the complex factors that contribute to our global epidemic of eating problems. Lydia’s expertise has been featured at my blog before, both here (“Look good by doing very little’) and here (“Fat talk “).
Children inevitably play the ‘compare and despair’ game, and for many, a comparatively higher weight will result in a deep sense of shame. Contrary to popular opinion, research shows that shame does not lead to sustainable health-giving behaviours, but instead increases risk of unhealthy weight loss behaviours and clinical eating disorders.
Weighing children in front of their peers also sends the message that weight is the most important determinant of their health, and that their health is everybody’s business. In fact weight tells us very little about a person’s health except at statistical extremes.
Although it is commonly assumed that being ‘overweight’ is automatically unhealthy, in North America research shows that the overweight category (BMI = 25 to 29) is now outliving every other weight category.
Given we share much of the same cultural DNA, it would not be surprising if that were the case in Australia. We also know that being a bit ‘overweight’ can actually be protective against certain diseases including certain types of cancer, and especially protective for the elderly population.
Should fat children be removed from their home?
In the Kerri-Anne clip, Psychologist Ian Wallace immediately paired the idea of fat children with trips to McDonalds and fast food outlets. Yet we cannot make assumptions about a child’s lifestyle choices simply by looking at them. It is a myth that all fat children are fat because they eat too much and don’t exercise enough.It is also dangerous to assume that all fat children are fat as a result of abuse and / or neglect.
At BodyMatters we see children at a range of sizes, many of whom are very much loved and supported by their families. While not all fat children binge or overeat, children who do overeat or binge, do so for a variety of reasons: it can be a way of coping with stress, parental divorce, grief and loss issues, a physiological response to dieting.
For some, this will lead to significant weight gain, but for others, they may still be thin. Regardless of size, they deserve help. But threatening to remove them from their families and pressuring those who are fat to lose weight will only exacerbate the situation.
Imagine the message internalized by a fat child who has just been told they may be taken away from their family: lose weight, or your family will be ripped apart. It will be all your fault because you’re too fat. This kind of messaging is likely to put a child at risk of developing disordered eating behaviours, reduced self-esteem, and significant distress.
Should fat children be encouraged to lose weight to avoid bullying?
Children will always find something to bully another child about – red hair, poverty, handicap. It does not make sense to pressure a child to change something about themselves in an effort to escape bullying, as this is a form of victim-blaming. Parents and teachers should work to change school culture so that children learn to respect difference and accept that bullying is never justified, and that there are consequences for engaging in that type of behaviour.
Is citing genetics just an excuse to be fat?
Earlier this year The Biggest Loser trainer Michelle Bridges wrote an article for the Sydney Morning Herald, claiming that people can outsmart their genetics. Unfortunately we now have evidence that many of The Biggest Loser contestants are weight cycling or have returned to their pre-diet weight.
Research tells us that weight is not as malleable as we think. How we each respond to a lifestyle is different, for example, two people can eat the same amounts of food, and while one person gains weight, another person’s metabolism will kick in and prevent weight gain.
Genetics account for about 70% of a person’s weight, and there are a host of other factors that contribute – socioeconomic disadvantage, ethnic background, Indigenous background, low income households, family history of obesity, regional and remote location.
This may explain why weight loss attempts fail 95% of the population after 2-5 years. Anyone can lose weight in the short term but we simply don’t have solutions that work long term. The good news is when people adopt a healthy lifestyle, they will experience health benefits, regardless of whether or not their weight changes.
We need to be cautious about making assumptions about people’s lifestyle choices based on size. Just as one person emailed the Kerri Anne show expressing frustration at being called Anorexic (even by her teachers) because she was skinny, the same frustration exists for people who are fat who are told they must not exercise enough and make poor food choices. We need to recognize that issues of health and weight are complex.
According to weight loss consultant Sally, there are far more people who are overweight/obese than those with Anorexia Nervosa. Should we therefore prioritise obesity issues above concerns about eating disorders?
This argument that “the odd anorexic is a small price to pay” is an unethical one. Nobody chooses to have an eating disorder, in fact we know that dieting is the biggest pathway into an eating disorder. Sufferers typically engage in weight loss attempts with good faith, believing that they are improving their health. Unfortunately this tips some over into a clinical eating disorder.
It’s time we recognized that the solutions typically prescribed to combat obesity are the same behaviours we are diagnosing in those with eating disorders – for example counting every calorie, weighing every gram of food, counting each step in pursuit of thinness. There’s something very wrong with this picture and Sally’s suggestion that we should encourage schools to integrate calorie counting with maths homework is incredibly dangerous and ill-informed.
We cannot continue to pit “The Obese” against eating disorder sufferers. There’s this idea out there that if people are not ‘obese’ or do not meet the strict criteria for an eating disorder, they must be healthy. Yet we know this is simply not true – there are many who exist in between these extremes, but who compromise their health due to body shame and internalization of misguided health messages.
Many put their bodies under enormous strain going on diet after diet, taking diet pills, smoking to control their weight, engaging in bizarre bariatric interventions (for example stomach balloon insertion), so it’s not as simple as sixty percent overweight/obese versus five percent eating disorders.
We would be better off focusing on promoting healthy behaviours, and letting people’s weight fall where it will. Kerri Anne’s statement implying that a poor lifestyle is “okay” when you’re young but will catch up with you when you’re fifty misses the point – if people want to be healthy, then they should be engaging in a healthy lifestyle whatever their age, whatever their size.
Sally has managed to keep the weight off since 2002- that’s nearly ten years! Should people aspire to be in the 5% who do manage to keep the weight off?
Sally’s long term weight loss is atypical. While it is wonderful to know she has made some healthy lifestyle changes, the reality is that the outcome of sustained weight loss is not likely to be the case for most. In fact, while I respect that she has a right to tell her story, every time she does, she perpetuates the fantasy that if others just tried damn hard enough, they could lose the weight and keep it off too.
Encouraging people to aspire to be in that five percent that keeps the weight off ignores research that shows inherent risks that accompany weight loss attempts – including weight cycling, disordered eating, reduced mood, eating disorders, food and body preoccupation.
Telling people to lose weight is essentially setting many up to fail – and when weight loss is the main focus, most quit when they find the weight is no longer reducing or has begun to increase. If people want to be healthy, then fitness and healthy dietary choices are important regardless of their size.