Childhood obesity is not nearly as damaging as our fear of it

Unless in quotes, I use the term fat as a neutral descriptor without negative connotations.   

On a January morning in a New York public school, I stood in front of a third grade class holding a bottle of AriZona Mucho Mango Juice Drink and a bag of sugar. I was doing my job as a visiting nutrition educator, spreading the gospel of calorie-counting. There were audible gasps as I shook the bag: forty-two grams of sugar, almost twice the recommended daily limit for kids.

“And what can this sugar do?” I asked. “You’ll get fat,” offered one kid. “Cancer!” shouted another. “You’ll get diabetes like my aunt,” said a girl in the front row. 

As I fielded the responses, a boy fidgeting in the back caught my attention. His face reddened as he unzipped his sweatshirt and tucked something under his arm. His teacher noticed, too; she briskly approached him and held out her hand for the contraband: a bottle of AriZona Mucho Mango. 

This feeling, that fatness is something to fear, is reinforced on television, at the dinner table, and—for fat people—in every public place we go.

Her eyes flashed as she held it up for the class to see. Several of the kids gasped again. “John, you’re gonna get fat!” shouted his classmate. He sank lower in his chair. Suddenly, I found myself blushing too. What was this? What exactly was I hoping to accomplish here? The teacher noticed as she strode past me to dispose of the offending juice, and she patted my arm. “Don’t feel too bad,” she whispered. “Someone’s got to put the fear of God into these kids before it’s too late.”

For the past several decades, that’s exactly what we have been doing. Adults, panicked about the so-called “child obesity epidemic,” have taught children to fear diabetes, heart disease, and most of all, the unbearable experience that is being fat. And this fear is not only unwarranted, it’s actively damaging to kids’ mental and physical health.

A legacy of fatphobia

This feeling, that fatness is something to fear, is reinforced on television, at the dinner table, and—for fat people—in every public place we go. But it didn’t come from nowhere. At least as far back as 1960 and John F. Kennedy’s treatise against flab, “The Soft American,” America has had a documented history of this kind of fear-mongering. 

But the rhetoric around weight—and kids’ weight in particular—has clearly grown increasingly hysterical over the last generation or so. Nothing is too alarmist: Shortly after 9/11, Surgeon General Richard Carmony referred to obesity as “the terror within” and warned that “unless we do something about [obesity], the magnitude of the dilemma will dwarf 9/11 or any other terrorist attempts.” 

In 2010, Michelle Obama started the Let’s Move! campaign to end childhood obesity, declaring at the launch, ​“The physical and emotional health of an entire generation and the economic health and security of our nation is at stake."

In 2012, a series of billboards in Georgia depicted fat children saying “I’m scared” and “My fat… is killing me.” This was “intended to shock” parents into taking action: "It has to be harsh,” said the head of the children’s hospital running the campaign. “If it's not, nobody's going to listen.” 

the way we treat fat children in the name of health looks an awful lot like abuse

To this day, it’s common in many states for parents to receive BMI “report cards” for their kids, sent home as warning—nevermind the fact that the obesity threshold dropped sharply in the 1990s, vaulting thousands of Americans into the “obese” category overnight. Or that the BMI, our chief measurement of weight and health, was devised over 200 years ago by a non-physician using white European men as the ideal, and was never intended to assess the health of an individual. 

(It should be noted that this is not a uniquely American phenomenon. In one disturbingly extreme example, children deemed fat in the UK, for instance, have been removed from their parents’ care and placed with foster families.)

Leave fat kids alone

This approach—berating, bullying, scaring, and policing our kids into slimness—is not only counterproductive (we’ll get to that in a minute), it’s also actively causing the kind of damage that should horrify us. Take a step back, the way we treat fat children in the name of health looks an awful lot like abuse. 

Forcing exercise and diets on your children is an attempt to punish them for their (perceived) fatness and that is abuse.

The constant messaging at home, in school, and in public that being fat is something to fear stigmatizes and traumatizes fat kids. As researcher and author Lindo Bacon puts it, “You cannot wage war on obesity without waging war on the people who live in these ‘obese’ bodies.”

And these people we’re waging war against are kids. Author and podcaster Aubrey Gordon writes that, as a fat child, she felt she had been “declared an enemy combatant in the nation’s war on childhood obesity… Bodies like mine...represented an epidemic, and we were its virus, personified.” 

Writer and organizer Da’Shaun Harrison argues that the lasting harm caused by this is more serious than it’s treated, writing that “No one other than fat people will name this for what it is: a very targeted form of child abuse. There is no other way to put it. Forcing exercise and diets on your children is an attempt to punish them for their (perceived) fatness and that is abuse.” 

The psychological toll

Abused kids are anxious kids. In a 2008 study, nearly half of girls aged three to six reported worrying about being fat. In another, over half of six-to-eight-year-old girls said that their ideal figure was significantly thinner than their actual figure. My own sister-in-law, whose high weight as a kid was of constant concern to the adults around her, described her childhood belief that “my one job as a fat person on this earth was to lose weight.” When she finally did, the rapid weight loss caused by her anorexia nearly killed her—even as those around her congratulated her for her willpower. 

Eating disorders like her anorexia have the highest mortality rate of any mental illness except for opioid addiction. Carrie Thiel, clinical counselor and author of Surviving Disordered Eating, says that she especially worries about children in the nine to twelve range, when “it’s really normal for kids to bulk up and have more body fat in preparation for adolescence.” When parents meet their children’s growth with panic or food restriction, they teach kids to ignore their own hunger and fullness cues, paving the way for disordered eating. Of the people who come to her for treatment, Thiel says, “You’d be shocked how many people have stories of being taken to Weight Watchers as children.” In extreme cases, sending kids to “fat camps” for dramatic weight loss can cause injury or, in at least one case, death. 

That’s not all. Studies have shown that children who experience weight-based teasing are more likely to engage in binge-eating and unhealthy weight- control behaviors, even after control for variables such as BMI. Long-term, even when you control for their actual weight, people who experience the worst weight stigma have the worst health outcomes. It turns out that facing years of stress, discrimination, and harassment can take both a psychological and a physical toll. When it does, people avoid seeking care for fear of doctors who may treat them with contempt or flat-out refuse to see them.  

Committed to (counterproductive) fatphobia

Most of us consider what we’re sure we know about obesity—that it’s the result of irresponsibility or lack of discipline, that it dooms people to an early death, that it’s at a “crisis” level among children—to be self-evident rather than the result of pervasive fear-mongering. This makes it especially difficult to let go of our fears about fat even as our justifications start to slip.

Eating disorders like her anorexia have the highest mortality rate of any mental illness except for opioid addiction.

We may learn about not only the arbitrariness of the BMI, but about it’s “bizarre and racist history.” We may increasingly grasp the role racism and misogyny play in anti-fatness, thanks to research like Sabrina Strings’ book, Fearing the Black Body. We may look at the evidence produced in the last 10 years, including Katherine Flegal’s 2013 study, that seriously challenges our understanding of obesity as a killer. But many of us, perhaps even some of those reading this paragraph, can’t let it go. 

Even with evidence in front of us that calls into question everything we (think we) know about obesity, a voice inside us whispers: But still. Fat is scary.

Well, let’s say it is. Let’s say the risk of disordered eating, bullying, stress, and shame around food is justified, because remaining slim is the most important thing for a child’s health. Let’s say that the “tough love” and scare-mongering means are justified by the ends.

After decades of this messaging, of putting kids on diets, of publicly shaming them for their size, of counting every calorie and monitoring every pound—shouldn’t we see a nation of slender kids or improved health outcomes? Why is heart disease still such a looming threat?

Far from creating this fat-free utopia, the fear-mongering strategies we employ often result in weight gain. Sixty years of studies show that “fear appeal” in health messaging is counterproductive and damaging. It has been well documented for ages that between 95-97% of diets fail. And teens who diet are twice as likely to become fat regardless of their pre-diet size.

Imagine what could be done with all the energy and money that goes into dieting strategies and campaigns of fear. What if it were spent on efforts to reduce inequality? Since social determinants of health have a far greater effect on kids than which juice they choose, we could start by focusing our energies on tackling racial discrimination, paying better wages, and building a more equitable health care system. 

What if we let kids be kids? If we want our children to enjoy good health in all senses, including mental health, why not allow fat children to exist without punishing them? If we want kids to know the exhilaration of moving their bodies and feel the benefits of regular exercise, why not lengthen recess times, make sports more inclusive, and invest in more public parks, pedestrian zones, and bike paths? 

Far from creating this fat-free utopia, the fear-mongering strategies we employ often result in weight gain.

Several of the girls in that third grade classroom in New York were on diets. Statistically speaking, it’s likely that some of those girls have since developed eating disorders. Research has shown that dieting is the most important predictor of eating disorders. 

It’s also likely that John, who tried to hide his sugary drink from the critical eyes of his class, has a warped relationship to food and eating. I can’t know; I’m no longer a “nutrition educator” teaching kids to count calories. I’m a food educator. I teach kids how to cook satisfying meals that they enjoy.

It’s time to let go of our fear of fat. When we stop indulging the hysteria and start addressing what our children actually need, we can actually support their mental and physical wellbeing.