Diet culture is incredibly prevalent, reaching people of all ages and spreading harmful messages about size, health, wellness, and a person's innate worth. While there are instances in which a medical professional will help a child with their nutritional health, kid diets for losing weight are dangerous and can lead to eating disorders, weight gain, and pathological dieting.
Dr. Raquel Hernandez, assistant professor of pediatrics and medical director of the Healthy Weight Initiative at Johns Hopkins All Children's Hospital, tells Romper that a greater weight "is associated with all sorts of negative, individual behaviors" and has been "for centuries." Bigger people, our biases tell us, are lazy, stupid, gluttonous, and lack self-control, and, as researchers at the University of Liverpool found in a 2019 study published in Obesity, less human. And these assumptions are learned early on, according to a 2017 study published in Pediatrics, which found implicit weight bias in children as young as 9.
Chevese Turner, chief policy and strategy officer at the National Eating Disorders Association (NEDA), tells Romper that "around age 5, [children] begin to tie the cultural implication that body size indicates something bad about someone."
While most people living in contemporary American culture could observe and confirm these biases anecdotally, it has been confirmed via multiple studies, including a 2018 study published in BMC Medicine that found that "weight stigma is likely to drive weight gain and poor health and thus should be eradicated." Weight stigma can be experienced in school, at work, in healthcare settings, and even at home, and the consequences are both painful and significant, "leading to both immediate and long-term consequences for emotional and physical health, reducing quality of life," according to Rudd Center for Food Policy and Obesity.
"A parent wants the best for their child," Turner says. Therefore, they may have an "intense fear" that their child will suffer as a result of weight bias. While cultural mores cannot be undone, the $72 billion weight-loss industry, research from the website MarketResearch.com, which produces industry reports, is a testament to the stickiness of those ideals. And with products like Kurbo, a recently launched WW app marketed specifically to children as young as 8, there is no dearth of options for concerned caregivers.
But the experts urge parents to stay away from a "dieting" model of health and wellness.
"All children, not just those struggling with weight, benefit from a healthy diet. It's brain food," Maggie Murphy, a therapist and licensed clinical social worker at Resilience Counseling Center, tells Romper. "But 'diets' are all about shame that something is wrong with us as they center on a person's appearance."
Hernandez agrees that while modifying eating habits may be medically advised in some cases, "quick fix," image-focused diets are not the solution.
This condition is so complex and the layers upon layers that influence lifestyle in our society are by no means the fault of the parent or child alone.
"Diet implies a temporary plan," she says. "A term we use specifically is 'healthy lifestyle goals.'" She notes that while that may be modifying diet, that can also be adopting better physical fitness habits, getting better sleep, and even working to improve family dynamics. Indeed, Hernandez encourages a "family approach" when it comes to modifying diet.
"What I've oftentimes seen is parents put a strict diet for [a heavier] child and then the other children eat normally. ... That [heavier] child quickly starts to perceive not just the diet but themselves and their body image as something negative," Hernandez says. She strongly encourages parents who're concerned about their child's weight to avoid basing concerns and conversations on physical appearance. "The message should always center around their overall mental and physical health," she says. "A focus on appearance ... is a negative place to start."
Hernandez warns that non-medically advised diets (think any of the branded fad diet you've seen touted on billboards or your social media feed) may have negative consequences. Not only are they unsustainable and therefore ineffective, but they often increase cravings and encourage an unhealthy relationship with food.
Turner points out that most people with eating disorders began unhealthy patterns of behavior within the parameters of dieting — 35% of “normal dieters” progress to pathological dieting, according to a 1995 study published in the International Journal of Eating Disorders, and up to 25% of those individuals develop eating disorders. And research has shown that dieting is common among people who develop eating disorders, according to National Eating Disorders Collaboration.
"Many people who diet go on to have dysfunctional relationships with their food," Turner says, which, while not always identified as an eating disorder, can lead to unhealthy long-term outcomes.
Weight alone was not a sole indicator of overall health, but even in instances in which a medical professional assessed a child as benefiting from a lower body weight or body mass index (BMI), Hernandez says there's is stigma built into the conversation. (It's important to note that BMI is often regarded as a flawed indicator of overall health.) Even the words we use to describe heavier individuals contributes to stigma and misunderstanding.
"Though it's being discouraged now, we use the term 'morbid obesity'... there are no other diseases that use that language. We don't talk about morbid diabetes or morbid asthma," Hernandez says.
The result? Blame and shame. "A lot of people blame the parents and many parents blame themselves when a child reaches an unhealthy weight," she continues, but states that it's not so simple. "This condition is so complex and the layers upon layers that influence lifestyle in our society are by no means the fault of the parent or child alone."
So better than diets that focus on appearance for higher weight children, all suggest, is a focus on healthy lifestyle for every member of the family. "Learn the skills it takes to live a healthy life. Skills, as with nutrition and food, are not always easy and not always fun, but in the long-run work better," Hernandez says.
Or, as Turner puts it, "Shame does not promote good health."
Parents want the best for their children so that they can live happy, healthy lives. But there is no evidence that happiness or health will be found for a child in an unsustainable, non-medically advised diet.
Studies referenced:
Kersbergen, I.; Robinson, E. (2019). Blatant Dehumanization of People with Obesity. Obesity, doi: 10.1002/oby.22460
Skinner, A.C.; Payne, K.; Perrin, A. J.; Panter, A.; Howard, J. B.; Bardone-Cone, A.; Bulik, C. M.; Steiner, M. J.; Perrin, E. M. (2017) Implicit Weight Bias in Children Age 9 to 11 Years. Pediatrics, https://pediatrics.aappublications.org/content/140/1/e20163936
Tomiyama, J. A.; Carr, D.; Grandberg, E.M.; Major, B.; Robinson, E.; Sutin, A. R.; Brewis, A. (2018) How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Medicine, doi: 10.1186/s12916-018-1116-5
Shisslack, C. M.; Crago, M.; Estes, L. S. (1995). The spectrum of eating disturbances, doi: 10.1002/1098-108X(199511)18:3<209::AID-EAT2260180303>3.0.CO;2-E
Experts:
Dr. Raquel Hernandez, assistant professor of pediatrics and medical director of the Healthy Weight Initiative at Johns Hopkins All Children's Hospital.
Chevese Turner, Chief Policy and Strategy Officer at the National Eating Disorders Association (NEDA).
Maggie Murphy, a therapist and licensed clinical social worker at Resilience Counseling Center.
