TW: Mentions of eating disorders, dieting, and suicide.
“We cannot solve anti-fat bias by making fat kids thin. Our current approach only teaches them that trusted adults believe the bullies are right — that a fat body is just a problem to solve. That’s not where the conversation about anyone’s health should begin” (Sole-Smith, 2023)
This week I read two texts. The first was a guest essay published in the New York Times. While this was not on my original list, it was published at the end of week 3 and I felt it fit perfectly with what I had lined up for weeks 4, 5, and 6. Entitled “Why the New Obesity Guidelines for Kids Terrify Me” by Virginia Sole-Smith, this article responds to the comprehensive guidelines for evaluating and treating children and adolescents with obesity published by the American Academy of Pediatrics in January. Having had first-hand experience with being a fat child and adult in the American medical system, I was curious to see what the guidelines now were for a child or teenager.
My first eye roll, although not a surprise, was discovering that they are still using the B.M.I scale, even for children. This scale has been debunked many times, and for reference, I used to register as obese, although no medical professional considered me such, I was overweight. So with so much evidence that it is not an accurate measure of health, why is it still so commonly used? We will come back to that.
The American Academy of Pediatrics guidelines start for children as young as two years old, with different suggestions of what can be offered as the child gets older. Starting at two with “intensive health behavior and lifestyle treatment”, a vague and ominous idea. What could intensive lifestyle treatment possibly look like for a two-year-old? And how will this kind of treatment affect their long-term relationship with food? Teaching children from a young age to be so conscious of what they’re eating can’t be healthy. As someone whos studying food, is it reasonable to say that perhaps we are looking too much at our food?
Moving up to twelve and older they introduce the option of weight loss pills, and at thirteen, weight loss surgery. I wrote a pretty personal annotation on this section that I would like to share, although I would like to add an additional content warning as it contains specific memories and ideas from my childhood that were signs of disordered eating.
“This is a direct pipeline to increased eating disorders in kids. Not only is the B.M.I scale incredibly outdated and many times debunked, but using it on a child as young as two seems barbaric. Offering a 12-year-old weight loss medication could go so many ways depending on the child, but I cannot imagine any of them have a healthy future. I would have taken it, 100%, but now that I have experienced sudden weight loss I know that it is never what you really want. There is no number on the scale that equals happiness and this feels as though we are teaching kids from a very young age that their health and worth are able to be measured on a chart. And I don’t even want to think about what I would have done if I had been offered weight loss surgery when I was 13. I used to dream of waking up with a “perfect” body, I promised myself if it happened I would never do anything to risk losing it. And those thoughts came from trying to decide what my genie wishes would be in the 5th-grade production of Aladdin, the option was never actually put in front of me.”
My experience is not everyone’s, but I know that I was not an outlier for these thoughts, and I can’t imagine that there aren’t hundreds of thousands of 5th graders across the world that could attest to having realized in that late elementary to early middle school time that they were not happy with their bodies. Now imagine that you have been feeling this way since 5th grade and in 8th grade, your doctor offers weight loss surgery. As I said, we are teaching happiness comes from something you can quantify in a single number.
This brings me back to the earlier question, with so much evidence that it is not an accurate measure of health, why is B.M.I being used? Sole-Smith sums it up well in this article. The American healthcare system is waging a war on obesity by focusing on weight loss. The B.M.I scale is easy for doctors to quantify a healthy range of weight and not much else, streamlining essentially. But this combats moderate and severe weight gain as the problem, and not as what it normally is, a side effect or a symptom of another health condition or life change. Instead of villanizing weight gain, we need to view it as both a normal and natural part of life, our bodies changing as our lives change, but also as a potential symptom instead of as the problem needing to be treated. Sole-Smith summarizes a solution much more eloquently than I do.
“What should the obesity guidelines say instead? Stop classifying kids and their health by body size altogether. This would involve a paradigm shift to weight-inclusive approaches, which see weight change as a possible symptom of, or a contributing factor toward, a larger health concern or struggle.”
The second text I read was entitled “Food Sovereignty and Farmer Suicides: Synthesizing Political Ecologies of Health and Education in Karnataka, India” by David Meek. It was a photo essay, and much more focused on business practices than I expected. It did not truly fit with the work of the ILC so I will not say much but I did enjoy it, and it left me with many questions about the idea of farm ownership and a farmer’s access to the means of production.
As it is mid-quarter I will also be writing and uploading a midquarter summary/evaluation of my work, and next week instead of new readings I will be focused on drafting the first half of my summative writing piece. I am in the process of reworking what it will look like as I plan for my Spring 23 ILC.