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with Elaine Magee, MPH, RD

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Wednesday, April 7, 2010

Eating Disorders and The First Lady’s Campaign on Childhood Obesity

When I heard that First Lady Michelle Obama was waging war on childhood obesity with a team of experts at her disposal, my first comment was, “I sure hope she’s included an eating disorder specialist.” Because at the same time you are aiming to lower childhood obesity, you should be aiming to lower eating disorders. You wouldn’t want to encourage a new dangerous condition while trying to fix another.

The prevalence and seriousness of eating disorders should not be taken lightly. Here are a few sobering statistics that bring this point home:

  • Eating disorders cause more deaths annually than all other mental and emotional health conditions combined, according to the Centers for Disease Control and Prevention.
  • Eating disorders are the tenth leading cause of death in the United States, according to Chris Kraatz, PhD, author of Radical Recovery.
  • An estimated 10 to 15 percent of people who are considered obese have a binge eating disorder, according to the Weight-control Information Network, part of the NIH.

At the same time that there’s been a childhood obesity epidemic, there has also been a surge in eating disorders. In fact, body size obsession and dieting behaviors in children and teens have never been higher. This past February 21st through the 27th was National Eating Disorder Week.

“National Eating Disorder Week is just one way to wage the war on unrealistic body-perfect expectations,” explains Kim Dennis, MD, Director at Chicago-based Timberline Knolls Residential Treatment Center, which works work with women to prevent eating disorders and body image issues.

Dr. Dennis stresses that children/adults with anorexia, bulimia, or binge eating disorders might use the First Lady’s comments in the service of their diseases. She encourages parents of young girls and teens to learn about eating disorders and model a healthy relationship with food and body.

“It’s a delicate balance for parents to model a healthy relationship with food, body and exercise without feeding into the social/cultural/media pressures of being thin… Health does not equal thin, nor does it equal obese,” says Dennis.

Dr. Dennis believes young women/teens today are particularly vulnerable to developing eating disorders due to:

  • Increasing levels of social isolation/disconnectedness from friends and family associated with less face-to-face time for human interactions.
  • Increasing demands on young people today socially, athletically and academically.

Another expert in childhood eating issues, Ellyn Satter, MS, RD, LCSW, found these two factors may contribute to children being overweight:

  • Misinterpreting a child’s normal size and shape and labeling him or her overweight (some children are just naturally heavy).
  • Imposing food restrictions on a child (child is pressured to eat certain foods in certain amounts).

If your child’s weight for height plots consistently along a particular percentile over time on their pediatric growth chart, your child’s weight has a good chance of being normal for him or her (due to natural causes). A growth chart that shows quick fluctuations up or down likely indicates problems that need to be investigated and addressed.

While I’m sure the campaign has the best of intentions and seems to be promoting healthful lifestyle changes for the family, I just worry when I see things on the campaign’s website titled “healthy weight,” “calculating the BMI” or “estimated calorie requirements” that without intending to do so, might encourage restrictive behavior by parents toward children or perhaps incite negative remarks about a child’s weight or body size.

Hopefully, the campaign efforts and information will focus on encouraging a healthy lifestyle for the family and less on weight and childhood obesity. Here are some productive ways to look at encouraging healthy families (many are represented in the campaign information and some I’ve added in myself)


Admittedly, some of these are more challenging for families in lower income neighborhoods that have corner markets and fast food chains instead of a large supermarket with competitive prices. Any efforts made to change this “food desert” environment will be hugely productive for the health of entire communities and I do commend the campaign for addressing these changes in their plans.

Comment on this post and ask your questions on the Food and Cooking Exchange.

Posted by: Elaine Magee, RD at 4:41 pm

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