Childhood Obesity: Lose Weight, Gain Health, or Evade?
The Kurbo kerfuffle has revealed a lot about how grownups are dealing with childhood obesity. Because mostly, they’re not. In fact, most of them are totally out of touch with the reality of childhood. But in sharp contrast, Michelle Cardel and Elsie Taveras bring a refreshing dose of reality and balance with a new commentary in Childhood Obesity.
Let’s Not Merely Dismiss Kurbo
With their commentary, Cardel and Taveras explain both good and bad aspects of the Kurbo app. It’s based on a well-documented tool – the traffic light system – for promoting healthier eating patterns. That’s good. But in this app, they find too much focus on calories and weight loss. Not so good.
In an ideal world, they say, we wouldn’t be relying on apps to help kids with obesity. They’d be getting help from an intensive, multi-specialty program. Dietitians, physicians, exercise professionals, and psychologists would all be pitching in.
But nope. Nothing like that is even close to happening right now. So five million kids with severe obesity mostly have no access to appropriate care. Fewer that 40 centers in the U.S. are even equipped to provide the kind of specialized care they need.
So we need scalable and sustainable options that will be effective for treating and preventing obesity, they conclude. Something like Kurbo might be part of that.
Honey, Let’s Shrink the Kids
From detractors, you get a very different picture. Christy Harrison, a HAES® dietitian, says Kurbo is just an ineffective tool for “attempts to shrink a child’s body.” Not only is it likely to be ineffective, she says. It’s probably quite harmful.
You see, one of the core beliefs of HAES is that obesity is not such a big deal. “‘Obesity’ is not the health risk it’s been reported to be.” You’ll find that on the HAES Fact Sheet. Obesity – if it’s even mentioned – gets scare quotes.
Harrison presents her dire warnings about Kurbo in a New York Times op-ed. You will find no mention of obesity anywhere in her 1,296 words on the subject. Irrelevant in this worldview.
Regardless, she has good points to make about cruelty and bias against larger people. Parents, teachers, and peers heap stigma upon kids who are big. Much of what is done in the name of “fighting childhood obesity” is indeed ineffective and too often, quite harmful. Presumptions prevail over facts.
A False Dichotomy: Harm or Evasion
However, Cardel and Taveras are precisely right. We cannot accept a false choice between doing harm in childhood obesity or evading the subject. We need less stigma, bias, and subjectivity. Children need unconditional love from friends and family. They need unconditional, positive care from professionals. They need tools for self help.
Elbert Hubbard tells us that there is only one way to escape criticism. Do nothing, say nothing, and be nothing. On the subject of childhood obesity, this is unacceptable.
Rather, we must be thoughtful, speak kindly, and act carefully.
Click here for the commentary by Cardel and Taveras, and here for further reporting on it. For excellent perspective on teaching kids about healthy eating, click here.
Natasha in Childhood, painting by Pyotr Konchalovsky / WikiArt
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August 27, 2019
August 27, 2019 at 8:00 am, Traci Malone said:
Thank you for sharing the Parenting article on teaching kids about eating. Nowhere is there a discussion about weight loss. In fact, Dr. Jerica Berge is quoted as saying “any discussion about eating vegetables or exercising can become harmful when it’s suggested in the service of losing weight.” The overall theme of the article focuses on the role of parents in shaping their children’s health and habits, and that is a huge gap right now, especially when just putting food on the table is nearly impossible for millions of families. So instead of an app that clearly prioritizes weight loss and creating right vs. wrong foods, how about an app that helps connect kids and parents, helps parents learn the tools to guide their children. Or, perhaps an app or program to support food insecure families, or maybe something that targets improving infrastructure like safe sidewalks. Nope, instead, lets keep doing the same thing (jumping straight to body weight being the problem) which hasn’t worked and has only created more harm for millions. And now, let’s really dig in and start the process even earlier.
August 27, 2019 at 8:33 am, Ted said:
Traci, thanks for sharing your views. I’m not sure your characterization of the Kurbo app being primarily about weight loss and wrong foods is an accurate or objective assessment. I also think that in the real world, kids are talking about their weight. Like it or not.
We do need less focus on weight and more on health. I think Kurbo could be improved in this regard. But to achieve that, we have to start with realistic ideas about what kids face. And they face a lot of weight talk.
Again, thanks for sharing your views.
August 27, 2019 at 2:04 pm, Allen Browne said:
I had to speak up on this one. So I put the following in the NYT comments:
Obesity is a disease. It has over 230 complications. Denying children treatment for this disease is wrong. It is a chronic, incurable disease in most cases – spontaneous remission is rare. It is the body’s energy regulatory system gone awry – mostly subconscious and frequently resulting in the defense of an unhealthy body composition. What causes the energy regulatory system to malfunction is not known for most people. It is not a voluntary, behavioral problem. We treat children with cancer, appendicitis, pneumonia, etc. We prevent diseases like polio, tetanus, and measles. We need to take the same approaches with the disease of obesity.
August 28, 2019 at 4:19 am, Mary-Jo said:
I so agree with Michelle Cardel and Elsie Taveras on this. And Allen Browne. The KURBO program is imperfect but it’s a step up from nothing and, in the least has brought attention to the baffling gap in treatment and access to effective care for childhood obesity. Much more investment in time, talent, and, of course, funding has to happen now for childhood obesity. It’s unconscionable to wait longer to provide help for families and children to get the timely intervention needed to properly assess and treat so that affected children will be less likely to have their disease pathology further exacerbate for the next 20+ years, if not consume them for life. Money invested early will save billions later.