Not A Simple Fix

In recent years teenage eating disorders have emerged as a mental health issue of epidemic proportions. The harsh reality is that anorexia accounts for the highest mortality rate among all mental health issues. While public schools have been increasingly burdened with more responsibilities, the delicate subject of anorexia often has been neglected in the wake of another plight—obesity. It is undeniable that childhood and adolescent obesity rates in the United States continue to remain at an all time high. However, the solution to this epidemic must not be the relentless encouragement to restrict caloric intake and the glorification of a thin physique, as this merely fuels the anorexia epidemic—the deadliest of all mental health issues. Proponents of the belief that a public health education should prioritize the war against obesity, which undoubtedly continues to plague our youth, are sorely mistaken. In order to teach “healthy” dietary habits to children, it first must be acknowledged that obesity can stem from a plethora of circumstances beginning early in a child’s life. Advocating for a low calorie diet to battle obesity will certainly have a negative impact on the emotional health of these children, and a possibly deadly impact on those struggling in the opposite direction. It must become sound teaching practice to teach children that all foods fit, and personal caloric intake greatly varies among individuals.

Helen Skouteris highlights the Nurturing Care Framework from the World Health Organization, in regards to properly addressing childhood obesity issues. This framework suggests that emphasis on caregiver nurturing during the developmental years is key to preventing childhood obesity. It explains that “…child[hood] obesity prevention must be based on a deep understanding of the layers of influence surrounding the child as they transition across the ages and stages of development that occur in the first 2,000 days.” It seems unlikely that an overweight child sitting in a health education classroom surrounded by judgemental peers will be significantly impacted by an isolated lesson on “proper” caloric intake. According to the World Health Organization framework, childhood obesity stems from a deeply rooted lack of nurturing that occurs early in a child’s life. Perhaps the child has grown to depend on food as a source of comfort that was not provided by their caregiver. Surely, simply telling these troubled youth to limit their caloric intake will not “cure” them of their need to seek refuge in food. With this knowledge that the lesson will not be beneficial to its intended audience, it is foolish to expose children who are susceptible to restrictive eating disorders to this toxic dietary advice that could result in tragedy.

Another contributing factor to childhood obesity emphasized in the World Health Organization’s framework is the impact that socioeconomic status has on the prevalence of obesity in children. Skouteris explains the relationship between high obesity rates that are common among low-income minority groups. The lack of access to healthy food options and quality healthcare, aggravated by negative childhood experiences often result in the inability to maintain a healthy weight. It is abundantly clear that a child in such a circumstance would not benefit from a health class lecture, as their issues stem from substantial burdens that cannot be remedied from limiting their caloric intake. Rather, a thorough understanding of each child’s unique experiences throughout their developmental years is necessary to even begin to help them address their obesity issues. Clearly, this is not a realistic goal that can be achieved in a classroom setting, and therefore the subject should not be incorporated into the curriculum. 

Furthermore, children in these low socioeconomic situations tend to spend more of their leisure time engaged in screen activities. This can be attributed to various reasons including the inability to afford participation in organized activities or the need to keep children from being exposed to dangers in an unsavory neighborhood. This further exacerbates the obesity problem. In a study conducted by Joost Oude Groeniger, it was revealed that “[s]creen media exposure may affect body weight by increasing food consumption and exposure to food and beverage advertisements, lowering energy expenditure, and reducing sleep duration.” Obviously, when children are sedentary for extended periods of time in front of a screen, they are not using the amount of calories that would be expended when engaging in virtually any other activity. If circumstances out of their control are contributing to their obesity, it is both useless and detrimental to their emotional well-being to suggest an “easy fix” to their problem—eat less calories.   

Angela Golden, owner of NP Obesity Treatment Clinic in Arizona, maintains the harsh reality that genetic predisposition accounts for approximately 70% of all incidents of obesity. “Genes can predispose individuals to having obesity by affecting appetite regulation, food consumption, metabolism, body-fat distribution, and body mass index (BMI), as well as influencing food preferences, [and] response to exercise…” The role of genetics is an extremely powerful force working against any efforts that an obese child may attempt. The recommendations presented by health educators may be futile and ultimately create an even deeper degree of frustration and depression. For example, a child may have every intent to limit their calorie intake, but their genetically predisposed larger appetite may prevent them from comfortably doing so. Likewise, genetic makeup that controls food preferences combined with a hyperfocus on only consuming low calorie foods, may create another issue. In a child’s effort to only eat low calorie foods, the pool from which they can choose the foods they like and have access to becomes even more limited and may result in an accidental deprivation of much needed nutrients. 

The logic that teaching children to consume less calories in order to combat the obesity that afflicts many seems reasonable. However, these misguided teaching practices ignorantly disregard the true origins that may be responsible for a child being overweight. The issue typically stems from much deeper roots such as an emotional dependence on food for comfort, their socioeconomic status, and their genetic makeup. Addressing a child’s obesity is a highly individualistic process and cannot be done en masse. The damaging words of health educators will not reduce childhood obesity, but rather pose the threat to harm not only the mental health of these children, but encourage restrictive eating disorders among others.

References

Golden, A. & Kessler, C.  (2020).  Obesity and genetics.  Journal of the American Association of Nurse Practitioners,  32 (7),  493-496.  doi: 10.1097/JXX.0000000000000447.

Oude Groeniger, J. , de Koster, W. & van der Waal, J.  (2020).  Time-varying Effects of Screen Media Exposure in the Relationship Between Socioeconomic Background and Childhood Obesity.  Epidemiology,  31 (4), 578-586.  doi: 10.1097/EDE.0000000000001210.

Skouteris, H. , Bergmeier, H. , Berns, S. , Betancourt, J. , Boynton-Jarrett, R. , Davis, M. , Gibbons, K. , Pérez-Escamilla, R. & Story, M.  (9000).  Reframing the early childhood obesity prevention narrative through an equitable nurturing approach.  Maternal and Child Nutrition,  , doi: 10.1111/mcn.13094.