As a long-term fan of The Daily, several clients and friends sent me this podcast as soon as it was aired to get my response. This blog is in no way meant to fully address the issues of fatphobia, eating disorders, or BMI. Nor is it intended to drag The Daily through the mud, as much of the work they do is hugely beneficial to the community and the world. I understand that they are reporting on information, not creating information, but without a follow up and/or response episode to today’s episode, The Daily is perpetuating the inordinate levels of fatphobia, with potentially deadly consequences.
My name is Abbey Griffith and I own Clarity Fitness, Georgia’s first weight inclusive, fat positive, eating disorder informed fitness center. Clarity offers people in eating disorder recovery, people in larger bodies, as well as the general Decatur community and our virtual friends, a safe and empowering place to move regardless of the number on the scale. We work with many eating disorder informed therapists, dietitians, general practitioners, activists, and eating disorder survivors to educate the world on the discrimination and harm done by diet culture. We cannot stay silent after hearing this podcast.
To start our response, it is essential to bring an understanding to “fatphobia”. Well described by Butterfly, fatphobia “describes the negative attitudes and stereotypes surrounding and attached to people with larger bodies. Fatphobia can also manifest as an abnormal and irrational fear of being fat or being around fat people” (Bradbury, 2021). Fatphobia is a systematic, oppressive, insidious world-wide issue, and the depths of it cannot be captured through any blog. Please learn more about fatphobia in the resources linked from my friend, scientist, activist, and athlete Ragen Chastain here [https://weightandhealthcare.substack.com/p/the-research-post]. I am an able bodied, smaller, white woman who does not have lived experience in a bigger body to be able to speak to the trauma resulting from fatphobia. However, the resources Ragen cites are a treasure trove of input from amazing people who truly get it.
My lived experience as an eating disorder survivor calls me to speak to this podcast. I know first-hand that undoing the brainwashing by society of fearing weight gain is a lifelong journey. We live in a society where body shape and size is equated to health, “obesity” is demonized, and people believe that thinner is better at all costs. This is a breeding ground for body image struggles, eating disorders, disordered eating, exercise addiction, and low self-worth, not to mention the documented discrimination, mistreatment, and shaming of people in bigger bodies. The prevalence of eating disorders has increased significantly, especially since COVID, and eating disorders are among the most deadly, if not the most deadly, mental illness (South Carolina Department of Mental Health).
The Daily’s “An Aggressive New Approach to Childhood Obesity” serves to perpetuate a fear of weight gain. The information they’re spreading from The American Academy of Pediatrics encourages frighteningly invasive and traumatizing treatments in children as young as 2 years old, and calls into question the life-saving work of the HAES and weight inclusive communities and advocates. The biased and one-sided presentation of these positions is not only dangerous; it can have life-altering and life-ending consequences (Barbaro, 2023).
Let’s start with the title. “Obesity” as defined by the CDC is “weight that is higher than what is considered healthy for a given height” or a BMI of 30.0 or higher (CDC, 2022). This brings about the questions how credible is BMI? What data is being used to determine what weight is “healthy for a given height”? What data do we have to show that the shape and size of someone’s body alone can be an unwavering determinant of their health? In another article by the CDC, the organization states that “the clinical limitations of BMI should be considered… Factors such as age, sex, ethnicity, and muscle mass can influence the relationship between BMI and body fat. Also, BMI does not distinguish between excess fat, muscle, or bone mass, nor does it provide any indication of the distribution of fat among individuals” (Department of Health and Human Services).
In short, “obesity” (now a word more used to shame individuals in bigger bodies than simply a clinical medical descriptor) is based on a metric ridden with inadequacies, mathematical uncertainty, and exceptions to its relevance. If BMI has issues (it does), then so does the term “obesity”, generally determined simply as a reference to BMI measures. Every time the word “obesity” is used in this podcast, by The American Academy of Pediatrics, and in the world, let it raise a red and discriminatory flag.
The podcast states “when they have a child who has obesity, they say ‘you have to be aggressive’” (Barbaro, 2023).
As someone who was in a larger body in my adolescence, I remember being bullied, shamed, and sent to camps such as “Health Kids Healthy Weight”. I learned from family, friends, teachers, and doctors that there was something “wrong” with my body. As a child and into my adulthood I had trouble separating the “wrongdoing” of my body from my character and self-worth. I was told that because I was in larger body, I had done something “wrong”, when in fact no body shape or size can ever be a moral or ethical failure of a person. I came to learn that this messaging was a huge part of the development of my eating disorder, as it is for the millions of others who have struggled and are struggling. I would equate every approach described in this podcast to “prevent obesity” among children and/or adults as equally damaging and harmful.
Regardless on if we agree on the issues of BMI, weight loss, and diet culture, we must agree that the consequences of shaming, scaring, and traumatizing children about their body from a young age can have huge and negative consequences on their mental health for the rest of their lives.
The means of “preventing obesity” are already ubiquitous and damaging. Bullying kids in school about their weight is not taken as seriously as bullying based on other social justice issues. Calorie counts are marked on many-a-menu. “Red lights” on “bad foods” and “green lights” on “good foods” throughout school lunchrooms can be found everywhere. Physical Education teachers being encouraged, if not required, to record the weight of their students and send home letters of concern to family if the weight measurements fall in the category of “obese”. Being more “aggressive” will only further traumatize children, sending them on a direct path for deadly eating disorders, body hatred, and low or nonexistent self-esteem.
Furthermore, less than 6% of people with eating disorders are considered “underweight”. Again, the standard that determines “normal weight” is flawed and does not accurately assess health. This fatally flawed statistic suggests that there are significantly more people struggling than we realize, especially if the way we determine physical and mental health is limited to assessing the shape and size of the body.
The podcast states “just to remind us of how wide spread a problem this is, and how many people are likely to be impacted by these bold new guidelines”…“14.4 million children and adolescents, 1 in 5. A lot of children” … “20% of American children.” (Barbaro, 2023).
Clarity’s response: “28.8 million Americans will have an eating disorder in their lifetime” and a recorded “57% of adolescent girls engage in crash dieting, fasting, self-induced vomiting, diet pills, or laxatives” (ANAD 2022).
The podcast states “for children 13 and older with severe obesity they might want to consider bariatric surgery” (Barbaro, 2023).
Among the other “professional recommendations” for children as young as 2 years old stated on this podcast, bariatric surgery is not to be taken lightly, and has serious health risks as does any surgery. While I stand firmly behind everyone’s individual right to choose what to do with their body, we urge people to recognize that fear-mongering a 13-year-old into getting such a traumatizing and invasive surgery before they are developmentally able to mentally consent to it themselves is unfair and irresponsible (NPR, 2011).
For more information on bariatric surgery and risks thereof, Lindo Bacon breaks down concerns in their book Health at Every Size in this excerpt: https://www.lindobacon.com/HAESbook/pdf_files/HAES_Bariatric-Surgery.pdf
The podcast breaks down all the diet drinks and foods that exploded to “prevent” the “obesity epidemic”
Statements such as “Diet Pepsi won’t go to your waist” sung in a jingle serves as a perfect illustration of how much society fears weight gain, and how blatantly society will address the ever-constant attempt to lose weight (Barbaro, 2023). This is textbook fatphobia.
Encouragement of “move more, eat less” completely negates the impact genetics, cultural background, medical conditions and disability, mental health, medications, eating disorders, access to nutrient-dense (and any) foods, the media, stress and trauma from discrimination, sleep, work, financial wellbeing, and so many more factors play into body shape and size (Barbaro, 2023), (Australian Government Department of Health and Aged Care, 2022). According to an Article by Harvard Medical School, genetics alone can account to up to 80% of body shape and size (Harvard Health, 2019).
The podcast states “after studying thousands of kids for years… there was no difference in the kid’s weights”
This study is case in point the point addressed directly above. At minute 8, Gina Kolata addresses how big of a role genetics play in body shape and size (yay)! She says, “it’s not all under your control… you don’t have absolute control over what you weigh, even if you want to” (Barbaro, 2023). Now that we recognize that weight is largely out of a person’s control, we should be able to see the injustice in blaming anyone for their body shape and size, and how forcing “aggressive approaches” upon our children and the population at large is said to help this perceived “problem”.
The podcast states “in fact, it is written in law that Medicaid and Medicare cannot pay for obesity medications” (Barbaro, 2023).
Now that we’ve gotten all of these “aggressive new approaches” on the table, we come to learn that a huge majority of the American population will not be able to pay for them. This information has essentially loaded the gun of fatphobia, pulled the trigger, and said “best of luck” to anyone standing in its way. Since only people with the means of paying for these medications out of pocket will have access, fatphobia is now even more heavily fueled by people believing there is a so-called “treatment” for being in a bigger body, with few people being able to access said “solution”. Instead, we should be challenging the societal belief that being in a bigger body is a problem to begin with.
The podcast states “and then there are people who for a lot of reasons would say ‘how ‘bout health at any size, how ‘bout body positivity, how ‘bout accepting me for what I am and stop trying to make me into some ideal of what you think a child or person should look like,’ and not everybody with obesity has problems” (Barbaro, 2023).
I am very happy that The Daily addressed that people in all shapes and sizes of bodies can be healthy. This has been shown through countless studies, only some of which can be found in Ragen’s treasure trove of resources [https://weightandhealthcare.substack.com/p/the-research-post].
The speaker Gina Kolata also discussed the discrimination and the suffering of children and adolescents (and adults) in bigger bodies. Michael Barbaro brought up that “hyper-focus on obesity in kids could make it, in a sense, a defining feature of their lives”. This portion of the podcast was well articulated. I hope in a future episode The Daily further calls into question the “aggressive approaches” recommended by The American Academy of Pediatrics.
Michael Barbaro says, “So is the thinking, Gina, that recommendations like this are liberating and cathartic for children and for their families because it says to them all ‘we know how hard this is, and we know that this is a disease, and we know that the only real solution is to act early and aggressively,” and that in a sense unburdens people?” Gina Kolata responds, “That’s my hope”
At this point in the podcast, we lost any forward momentum of the brief and previous address of body positivity and issues of discrimination.
The phrase “obesity is a disease” is essentially saying that “an illegitimate marker of health dictates that there is something wrong with your body, and for that you are diseased”. Furthermore, adding additional fuel to the fatphobic fire, enforcing these “aggressive approaches” to “mitigate ‘obesity’”, and further shaming children and their families for a perceived aesthetic shortcoming will never promote physical or mental health. The only health the approaches from The American Academy of Pediatrics will improve is the financial health of the weight loss companies making billions ($3.8 billion in predicted revenue in 2023 alone) feeding off American’s insecurities and an illegitimate fear of their own bodies (Ibis World, 2022).
This blog is not meant to cover every single issue in the podcast, nor is it meant to fully describe the issues of fatphobia, eating disorders, discrimination, diet culture, or risks of these approaches. I hope it identifies the tip of a very dangerous iceberg and serves as a call to action for change in the medical system.
Thank you to the countless other individuals and organizations who have spoken up about The American Academy of Pediatrics approaches. Please continue to learn and learn about the incredible people and organizations who have been doing this work for decades such as National Association to Advance Fat Acceptance and Association for Size Diversity and Health.