My heart raced as we waited in the tiny exam room. We’d been going to the same pediatrician for years. Even before my youngest son was born. He’d seen my three boys grow over the years. Although it had been a year since our last appointment, that one was still etched in my mind. And not for a good reason. This year I was prepared, just in case the doctor suggested my kids lose weight.
As someone who fought for recovery from an eating disorder after decades of struggling, I realize I’m sensitive to comments about weight. Yet I couldn’t deny how troubled I was after our last appointment. When the doctor told me how well my son was growing. How healthy he was. And in the very next breath gestured towards my son and said, “He is getting a little chunky. Watch what he eats. And stop giving him whole milk.”
The old me, who was drowning in food and weight obsession and believed every lie diet culture sold her, would’ve panicked. She’d have answered, “Yes sir,” and immediately gone home to pour the “evil” whole milk down the drain. She would’ve agree 100% that “chunky is bad.”
Thank heavens for recovery.
Thank goodness in recovery I have learned quite a bit. I’ve read research and books, listened to podcasts, and continue doing the hard work of looking at my own internal biases towards fatness. With an education in Psychology, I already understood how research works. What makes it valid and reliable. And how to approach results with a critical eye. So I started digging into the research on weight and health.
And what I found was stunning.
You see- research indicates that health is NOT determined by weight. That we have NOT found any diets that successfully take and keep weight off. And most importantly- our obsession with food and weight has NOT helped anyone’s health outcomes. (My favorite resource on this subject is the book Anti-Diet 1 by Christy Harrison, MPH, RD. This book is filled with information based on science).
As it turns out, we have much better results improving health when we stop focusing on food and weight.
In their research Weight Science: Evaluating the Evidence for a Paradigm Shift2 Bacon and Aphramor concluded, “Interventions should focus only on modifiable behaviors where there is evidence that such modification will improve health. Weight is not a behavior and therefore not an appropriate target for behavior modification.”
Even the APA (American Pediatric Association) recognizes that research does not support talking to our children about their weight and food. They published an article called Preventing Obesity and Eating Disorders in Adolescents3. Describing the pediatrician’s role, they clearly stated, “The focus should be on healthy living and healthy habits rather than on weight.”
It doesn’t even make sense for doctors to tell kids to lose weight…
So why was my pediatrician suddenly calling my son “chunky,” and telling me to focus on his food? It didn’t make sense based on the research behind health and weight. Or based on the APA’s own recommendations. Most of all- it didn’t make ANY sense based on what he had just told me about my son. That he was growing well and was in good health. Yet, this doctor was compelled to caution me against giving my son whole milk, insinuating this was causing him to be “chunky.” (By the way- that son doesn’t even drink milk).
Bringing it back to now
So here I was a year later, in the same office, waiting for well visits for two of my sons. I’d dreaded the appointment for months. I was committed to handling the situation differently this year. After talking with my body image coach, I prepared to set a boundary with the doctor. Before he even came into the exam room I asked to speak with him privately. As I attempted to explain, “I do not want you to talk about my sons’ weight or food in front of them,” he interrupted me. Looking at the intake forms he reassured me, “They are fine. Their BMI‘s are in the normal range.” He missed my point.
I tried again, explaining that I work in the field of eating disorders and I wanted to prevent any sort of body shaming. He shushed me with a condescending, “Of course,” and nudged me back into the exam room. This appointment went well and relief washed over me as we left. But the very next day I was back with my other son. The appointment was fine… until it wasn’t. When the doctor lifted up my son’s shirt to listen to his chest, first he poked him in the stomach. Then in his cheery voice noted, “He’s getting pudgy,” and suggested we “cut back and watch his diet.” He continued talking about decreasing my son’s food “to be careful about his weight.” My otherwise perfectly healthy 9 year old son.
I was so angry, I left the appointment in a daze. After processing what happened, I emailed the doctor. He clearly had not respected the boundary I attempted to set. I tried to rationalize it as a possible misunderstanding. Over the next two days, more emails were swapped. Each one fed the fire growing in the pit of my stomach. The doctor’s tone became increasingly condescending and fatphobic. His defensive emails contained more words than he’d spoken to me in person during our entire 9 year professional relationship. He defended his position stating he most definitely would be talking about weight with my boys as they got older. He cautioned me to “be reasonable” while spewing fatphobic rhetoric at me. The decision to switch pediatricians became a no-brainer. I would not return to his office.
To be clear, I don’t think he is a “bad” doctor. Nor do I think he means to cause harm. He’s a product of a much larger problem. Despite all of the research over the years, our medical establishment is drenched in fatphobia and diet culture.
Doctors- Do No Harm?
I believe most doctors go into the field of medicine to help people. Generally I think most doctors (and humans for that matter) are doing the best they can. The problem is doctors are taught in one of the most fatphobic systems in our world today. Despite research suggesting diets do not work, they continue to be prescribed all of the time. Imagine if doctors prescribed a medication that worked only 3-5% of the time. That’s a failure rate of 95-97%. They simply would not do it. And yet, every single day they recommend diets to patients with those very same failure/success rates.
And it gets worse….
Not only do diets fail, they also come with a long list of harmful possible side effects.
In their study Obesity, Disordered Eating, and Eating Disorders in a Longitudinal Study of Adolescents: How Do Dieters Fare 5 Years Later?4, researchers found numerous negative effects of dieting on adolescents. They noted:
- Dieting and unhealthful weight-control behaviors predict outcomes related to obesity and eating disorders 5 years later.
- Adolescents using weight-control behaviors increased their body mass index compared to adolescents not using any weight-control behaviors and were at approximately three times greater risk for being overweight.
- Adolescents using weight-control behaviors were at increased risk for binge eating with loss of control and for extreme weight-control behaviors such as self-induced vomiting and use of diet pills, laxatives, and diuretics 5 years later, compared with adolescents not using any weight-control behaviors.
So, please tell me again….
WHY exactly are doctors still telling kids to lose weight?
Not only is this approach ineffective, but it causes harm.
Here’s the truth doctors:
Bodies come in all different shapes and sizes.
Body diversity is a real thing. It’s a beautiful thing. Bodies are not wrong based on their shape or size.
And children are growing. As they go through childhood and adolescence their bodies are supposed to change.
Kids are not supposed to lose weight. They are supposed to grow.
When you focus on our kids’ weight, you are missing the boat. Their health cannot be determined by their weight. Therefore you don’t even need to talk about it. And talking about it has potential for harming them. So I’ll say it again- louder for those doctors in the back:
You need to stop telling kids to lose weight.
Now excuse me while I go schedule an appointment with a new pediatrician. Because while I am only one person and I cannot change an entire flawed system, I can teach my children a lesson on boundaries.
I can teach them the value of self worth. Of health. Kindness. And respect. Most importantly, I can teach them the value in learning to love, accept, and value all bodies as they naturally are.
Miraculously, amazingly, uniquely their own.
- Harrison, C (2019) Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating Link
- Bacon, L, Aphramor, L (2011) Weight Science: Evaluating the Evidence for a Paradigm Shift Nutritional Journal Google Scholar
- Neville H. Golden, Marcie Schneider, Christine Wood, Committee On Nutrition, Committee On Adolescence and Section On Obesity (August 2016) Preventing Obesity and Eating Disorders in Adolescents, Pediatrics , e20161649; Google Scholar
- Neumark-Sztainer, D, Wall, M, Guo, J, Story, M, Haines, J, Eisenberg M (2006) Obesity, Disordered Eating, and Eating Disorders in a Longitudinal Study of Adolescents: How Do Dieters Fare 5 Years Later? Journal of the Academy of Nutrition and Dietetics, Google Scholar