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Fat phobia feeds kids' eating disorders

Sharon Kirkey, Canwest News Service
Published: Saturday, January 19, 2008

Fears about obesity are feeding so much "fat phobia" that experts worry of an increase in healthy kids obsessing about weight and more parents projecting irrational fears about fat on their children.

Some are questioning whether the obesity "epidemic" is even real and whether schools have any business trying to fight obesity.

"It seems like whenever we decide there is an epidemic people run around helter-skelter trying to solve the problem without really thinking about it in an organized fashion," says Dr. Leora Pinhas, a child psychiatrist and psychiatric director of the eating disorders program at Toronto's Hospital for Sick Children.

"I'm not convinced that telling kids that they're fat, or that they might get fat, is a way of solving the problem."

The hospital has seen pre-teens and teens who attended school-based obesity prevention programs, "who then decide they're going to be the best kid at not getting fat, who then end up losing so much weight that they put themselves medically at risk," Pinhas says.

"They're little kids. They don't have to lose a lot of weight to get sick."

"We have had kids who have been weighed in the gym and then had to deal with how they felt about their weight, and these may have been kids who never weighed themselves before and it hadn't been a concern before," Pinhas says. Children are being taught in nutrition classes how to cut all fat from their diet.

But, "who buys food, who makes the meals? It's not the eight-year-old," Pinhas says.

"All we seem to do is keep placing more unreasonable expectations on children that can be confusing for them."

Children are hearing that fat is bad. Period. And where anorexia and bulimia before adolescence was once unheard of, hospitals are now seeing eating disorders in children as young as seven.

Children are social sponges, Pinhas says. " How many times does a kid have to overhear a conversation like, 'wow you look great, you lost weight,' or 'look at my butt, it's really fat,' 'I should cut down on what I'm eating,' or 'all that fat is going to give you a heart attack'."

Susan Willard says a lot of the pressure to be thin is now coming from home.

"It's not infrequent that we see patients who have families who are over-invested in body shape and weight," says Willard, clinical director of the eating disorders treatment centre at River Oaks Hospital in New Orleans, where many patients come from Canada.

Families where one or both parents "are very involved with their own bodies and with what they're putting into their bodies" so that calorie counting, fat gram counting and exercise "become a primary focus in the home and at the table."

"Kids who grow up in families of that sort believe that it is of very primary importance that they eat 'right' and stay fit and healthy and that ultimately can turn out to be extremely unhealthy," says Willard, a professor of psychiatry and pediatrics at Tulane University School of Medicine and co-author of the book, When Dieting Becomes Dangerous.

But parents also live in a culture that says what matters most is to be thin. "They're being told over and over again that if their kid is fat, it's like a death sentence. They're being told they're not good parents," Pinhas says.

"I think we should stop worrying about whether someone is fat or not because it's not necessarily an indicator of poor lifestyle or imminent mortality or morbidity."

Dr. Ahmed Boachie says many healthy weight teens believe, wrongly, that they're overweight. Even campaigns to rid schools of snacks can lead to negative messages and neurosis about food.

"And when they feel that way they're more likely to be dieting," says Boachie, clinical director of the eating disorders program at Southlake Regional Health Centre in Newmarket, Ont. But a study of nearly 15,000 girls and boys aged nine to 14 showed that dieting not only doesn't work, it actually leads to weight gain. Kids severely restrict their diet, then lose control and binge or overeat, and the cycle continues.

What's more, dieting is considered a risk factor for eating disorders such as anorexia nervosa or bulimia nervosa - "very chronic and difficult illnesses with often fatal outcomes," Boachie says. Most people who develop eating disorders were never overweight or obese to begin with, he says.

"Eating disorders are illnesses. If any parent has any weight concerns, instead of listening to the street definition of obesity contact the experts," Boachie says.

A recent study found that girls who eat at least five meals a week with their family are less likely to be preoccupied with dieting.

Signs a child or teen might be engaged in extreme dieting or have an eating disorder include coming home from school and saying they have already eaten, separating themselves from family at mealtimes, and complaining of being cold and tired all the time.

Younger children often don't stop eating completely, but they eat less, or complain their stomach hurts or they're not hungry.

"Don't forget, they're small to start with. Losing a few kilos is enough to lose a significant proportion of their body weight," says Pinhas, of Sick Kids in Toronto.

"What we end up seeing sometimes are kids who just stop growing."
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