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Pre-reading: Where the Fight Against Child Obesity Can Go Very, Very Wrong

Do you think that being thin is the same as being healthy? You must be able to argue for your point of view.

Discuss the following statement: "dieting is dangerous [and] can lead to a full-blown eating disorder".

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© Antonina Bilobrovska/iStockphoto.com
© Antonina Bilobrovska/iStockphoto.com
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Harriet Brown: Where the Fight Against Child Obesity Can Go Very, Very Wrong

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Speak and text 1 of 6

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Soon after starting her middle school "wellness" class, my daughter Kitty announced at the dinner table, "Sugar is bad for you, and from now on I'm skipping dessert."

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That, it turned out, was the beginning of her descent into the hell of anorexia nervosa, a disease that kills 20 percent of those who develop it.

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Genetics and neurobiology made Kitty vulnerable to having an eating disorder. But the messages the teacher drilled into the class -- cut back on "unhealthy" foods like dessert, don't eat dietary fat, get as much exercise as possible -- helped tip her over the edge into the restricting and overexercising that nearly killed her.

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The subtext conveyed in the class stays with her to this day: Don't be fat.

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Speak and text - 2 of 6

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Parents whose children develop eating disorders often report that a school health or wellness class triggered the illness. That their daughter or son took to heart the message that being fat is bad and being thin is good, and wound up struggling with anorexia, bulimia, or another eating disorder.

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Which is one reason I'm conflicted about the report released in mid-May by Michelle Obama's task force on childhood obesity.

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Many of its recommendations are far-sighted and positive: Support breastfeeding. Encourage physical activity and limit screen time for kids. Allocate more money for the school lunch program. Support farm-to-school initiatives. Get more grocery stores into low-income neighborhoods. Teach kids how marketing affects their food choices. Create more sidewalks and bike lanes.

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The trouble is, these ideas are all presented in the service of a single goal: to make kids thinner. The report, "Solving the Problem of Childhood Obesity Within a Generation," assumes that thin is synonymous with healthy, and that we can (and should) make kids thinner.

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My fear is that some of these recommendations, put into practice, will wind up hurting kids. Take, for instance, the one asking pediatricians to regularly calculate children's Body Mass Index (BMI) and talk to parents about how to help kids "achieve a healthy weight."

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What's wrong with that? For one thing, it suggests a standardized notion of a "healthy weight." But kids, like adults, come in many shapes and sizes, and the best way to determine their "healthy weight" is to look at their individual pattern of growth, not the BMI chart. Studies of twins raised apart show that genetics and biology play the major role in determining a child's weight. A 2001 study pointed out that thin children have the same risk of adult obesity as fat children -- and that, in fact, the thinnest kids had the highest health risks as adults, whether they stayed thin or not.

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Speak and text - 4 of 6

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For another thing, focusing on weight often has unintended results. A series of studies done at the Rudd Center for Food Policy and Obesity revealed high levels of fat bias among doctors -- bias they freely express to patients, which in turn damages the trust relationship crucial to good medical care. Many heavy people just stop going to the doctor, which doesn't help their health. And sometimes doctors miss major health diagnoses because they can't see past a patient's weight.

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I worry that emphasizing weight rather than health will make life harder for all children, fat and thin, in our already appearance-obsessed culture. These days, kids start worrying about being fat as early as age five. They're already hugely self-conscious about how they look and whether they fit in. As a journalism professor, I am often astonished at the levels of physical self-loathing and physical insecurity my college students express -- even those who are thin, beautiful, and seem outwardly self-confident. Do we really need to turn up the pressure to be thin?

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Speak and text - 5 of 6

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I worry especially that heavier kids, who already face discrimination, stigma, and bullying, will become even more vulnerable to low self-esteem and self-destructive behaviors. Advocates argue that this is one reason to "cure" childhood obesity -- to spare kids the kind of pain that can literally ruin their lives. But we don't know how to make kids thinner any more than we know how to make adults thinner.

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Because ironically, one of the major consequences of obesity-prevention programs is . . . obesity. Study after study has established that over the long term, dieting promotes weight gain rather than weight loss. In one 1999 study, teenage girls who tried to lose weight wound up heavier at the end of high school than those who didn't. Other studies correlate higher levels of dietary restraint with higher BMIs. The harder we try to make kids thinner, the more likely they are to be fat.

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And the more likely they are to develop an eating disorder. Two-thirds of all teenagers diet. A third say they use "extreme measures" to try to lose weight. For kids already at risk because of genetics and family history, dieting is dangerous behavior that can lead to a full-blown eating disorder.

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By focusing exclusively on childhood obesity, we're not just putting kids in danger; we're missing a rare opportunity to shape both public policy and cultural attitudes. And we're missing the chance to convey to all children, no matter what their BMI, the real meaning of health: It's about feeling good -- body, mind, and spirit. It's about feeling good in and about yourself. And it's way bigger and more important than a number on the scale.

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So, Mrs. Obama and the rest of the task force, let's take your thoughtful, creative ideas and your passion for the well-being of children, and use them in the service of a goal we can all get behind: improving the real health of American children.

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True or false

Vís í nýggjum vindeyga
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Task 1.8.1

Talk about it

  • The bias or prejudice against fat people, especially by doctors. Is being obese socially less acceptable than being anorectic?
  • Do you think it has become acceptable to judge people on the basis of their weight? Do you think people are biased against people who are obese?
  • Do you agree with Harriet Brown that we might go too far in our fight against obesity?
  • Harriet Brown claims that the real meaning of health is feeling good? Do you agree?
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Record your own news segment for a radio and tv-show

Record your own segment on obesity or other eating disorders using your mobile phone or web camera. The following people must participate in the segment: a radio reporter, a teenager, an expert. Furthermore you are welcome to include a concerned parent, a politician or other people you might find relevant to your story. You are free to choose whether the stories you talk about are real or imagined, and which angle you want to put on obesity or other eating disorders (anorexia, bulimia etc.) Your segment should be between 5 to 10 minutes.

You might want to create a group on Facebook where you can upload your podcast or video.

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Glossary

skip

s leypa um

descent

[de'scent] n niðurferð 

anorexia nervosa

n matstikni

genetics and neurobiology

[ge'netics] [neurobi'ology] n her: arvur og nervar

vulnerable

l viðbrekin

drill into

s (her) duka

Restricting and overexercising

[re'stricting] [over'exercising] n avmarkan og ovurvenjing

subtext

n undirliggjandi týdningur, fjaldur boðskapur

convey

s geva, koma við

conflicted about

[con'flicted] her: hava mótstríðandi kenslur um

task force

n arbeiðsbólkur

recommendation

[recommon'dation] n viðmæli

far-sighted

l framskygdur

breastfeeding

n bróstaføði

encourage

[en'courage] s eggja

allocate

s tilluta, seta av 

farm-to-school

n av garði í skúla

sidewalk

n gongubreyt (US)

in the service of

her: fyri at tæna

assume

[as'sume] s halda

synonymous with

[sy'nonymous] l tað sama sum

pediatrician

[pedia'trician] n barnalækni (US)

a standardized notion

her: føst fatan

unintended

[unin'tended] l ikki tilætlað

bias

n fordómur

appearance-obsessed culture

her: mentan, sum er heltikin av, hvussu vit síggja út

self-conscious

[self-'conscious] l sjálvtilvitaður

astonished

l kløkkur

physical self-loathing

[physical self-'loathing] vamlast við egnan kropp

outwardly

h at síggja til

stigma

n skomm

over the long term

í longdini

correlate

[cor'relate] s (her) knýta saman

restraint

[re'straint] n afturhald

full-blown

[full-'blown] l fullmentur

ISBN: 9788761657954. © Rithøvundarnir, Systime A/S og Nám 2011