Last week, many of you read this New York Post article about a 66-pound 3rd grader who was deemed overweight according to the FitnessGram that she received from her school. Please read EDIN's recommendations to our schools about this issue.
Dear Educators and School Administrators,
In the 2011-2012 school year, the Georgia Department of Education passed legislation that requires each local school district to conduct an annual fitness assessment program for all students in grades 1 to 12.(1) The assessments require teachers to measure students’ heights and weights for BMI calculations. It can be extremely stressful and even dangerous for students when the testing is not performed in a sensitive way. The focus on numbers can lead to self-consciousness, shameful feelings, and comparisons between students. These social comparisons have been shown to lead to lowered body image and self esteem. 2
It is extremely important that precautions are taken in order to safeguard students against these negative consequences. EDIN recommends that students be weighed in a private room, and not in front of other students. Ask them to turn backwards on the scale so they cannot see their weight. Do not comment on their weight, whether it is high or low. Even acknowledging a low weight in a positive way can send the wrong message. For example, a student may assume that he or she needs to stay at a low weight to be healthy or must continue to lose weight in order to receive “positive” comments.
When fitness reports are delivered, only parents or guardians should see them. Please include additional information in the reports, such as the attached letter to parents regarding Fitnessgram and recommendations to consult with a professional. Health professionals are trained to interpret BMI based on the child’s growth trend instead of looking at one weight measurement. Additionally, BMI and "growth charts are not intended to be used as a sole diagnostic instrument. Instead, growth charts are tools that contribute to forming an overall clinical impression for the child being measured."3
Parents and educators need to recognize that children grow at different rates and that this is normal, especially around puberty. Some children gain height first, and then weight. Others gain weight first, and then height. Boys and girls also grow at different rates at different times of life. Do not be alarmed if students gain weight first and then height-- this does not necessarily mean that they have bad eating habits. (See attached handout: Medical Reasons Why a Child Might Rapidly Gain Weight.) If students take good care of their bodies, they will grow into the exact size their body is meant to be. However, if they are faced with pressures to control their weight and body size, they may develop an unhealthy relationship with food, exercise, and their own bodies.
EDIN supports the Health at Every Size (HAES) campaign, which acknowledges that good health can be realized independent from considerations of size. It encourages people of all sizes to address health directly by adopting healthy behaviors. HAES accepts and respects the natural diversity of body shapes and sizes by teaching that anyone with healthy behaviors can be healthy, regardless of size. Providing this information to parents could prevent excessive concern about weight and unnecessary, harmful diets.
Please be sensitive to the feelings that fitness testing and “weight talk” may induce in students. It is not helpful, or even accurate, to base a child’s health status on a single number such as weight or BMI. Putting this pressure on students can make them feel self-conscious about their bodies and may lead to extreme behaviors or self-depreciating thoughts. This is the perfect set-up for eating disorders and other disordered eating habits.4 It is extremely important that students do not put too much stock in these numbers or measure their self-worth based on them.
1. Fitness Gram. http://www.fitnessgram.net/state-information/georgia. Accessed on 5/23/14.
2. Eyal, K., & Te’eni-Harari, T. (2013). Explaining the relationship between media exposure and early adolescents’ body image perceptions: The role of favorite characters. Journal of Media Psychology: Theories, Methods, And Application, 25(3), 129-141. doi:10.1027/1864-1105/a000094
3. Center for Disease Control and Prevention. http://www.cdc.gov/growthcharts/. Accessed on 5/23/14
4. Jerica M. Berge et al. Parent Conversations About Healthful Eating and WeightAssociations With Adolescent Disordered Eating BehaviorsParent Conversations About Eating and Weight. JAMA Pediatrics, 2013; 1 DOI: 10.1001/jamapediatrics.2013.78
It’s been about three months since I told Dina “yes” to the role of Executive Director of EDIN, the Eating Disorders Information Network. It’s already been quite a learning experience for me—running a business on top of the one that I just started for my private practice—with little business experience besides a few classes in college. Sometimes I ask myself, “What am doing?” and I’m sure my husband thinks the same when as he glances at me shuffling through the boxes, binders, pamphlets and overflowing notebooks on (and under and beside) our dining room table. However, deep down I know the reason why I said “yes.”
Before I relocated to Georgia over the summer, I worked at a children’s hospital eating disorder clinic. Working with teens with this disease was new for me. I had always worked with adults with eating disorders. So, I met with adolescents who were restricting, binging, purging, taking laxatives, and exercising their lives away. But I also regularly met with children who were 8, 9, and 10 years old with the same problems. One of my patients who struggled with restrictive eating and body image issues was 5 years old. She played with my food models in my office like they were her toys. All the while telling us her tummy was too big. Obviously, it was heart breaking.
Eventually, I discovered a positive side to kids with eating disorders: their resilience. In many cases, all they needed was some education, words of reassurance, a few sessions of therapy, and a couple rules to follow. Sometimes it would just take one or two appointments of explaining how metabolism works for kids to realize their bodies would be just fine eating three meals, snacks, and *gasp* even dessert. Now, I’m not trying to downplay how challenging it is to recover from an eating disorder. Many patients fought and struggled with their “ED” for a very long period of time, eventually requiring residential treatment. What I am saying is that there is so much POTENTIAL for prevention in the former group of children who need some simple resources to get back on track.
What if these resources –the education, reassurance, and time to talk about food and feelings—were provided to ALL kids? What if it were a requirement in schools? A law? If that were the case, I believe at least half of those children wouldn’t have needed to walk through the doors of that eating disorder clinic.
This is why I said “yes” to EDIN. Let’s not wait to act until our kids start dieting or obsessing over the scale. Let’s address these issues now with EDUCATION and AWARENESS, so that eating disorders can be PREVENTED before our children begin counting calories and cutting food groups.
Education, awareness, and prevention are part of EDIN’s mission and you can take part in this cause. I invite you to say “yes” to EDIN and to donate in support of our prevention programs. Your contribution will allow EDIN to further develop our curriculum and expand our reach to more schools in the community. Let’s fight this disease so that our children won’t have to!
Find out how you can contribute by visiting out Get Involved page.
Contributed by: Dina Zeckhausen, PhD
This past week, “The Biggest Loser” revealed its winner: 24-year-old Rachel Fredrickson, who dropped 60% of her body weight and left a mere 105 pounds on her 5’4” frame. According to Dr. Krista Casazza, a body tissue expert at the University of Alabama, such a dramatic weight loss may increase the risk of heart attack, high blood pressure, and bone fractures.
But the crowd cheered, confetti rained down and Rachel picked up $250,000.
Shortly afterwards, my Inbox filled with emails from clients with eating disorders. “She weighs less than I did when I went to inpatient treatment…and she just got paid a quarter million dollars!” Who knows how many vulnerable viewers will be triggered by Rachel, inspired by her “success.” Tweets and on-line comments from the general public revealed denial, stigma and misinformation.
Some viewers said she looked fine and were impressed by her achievement. An eating disorder is not an achievement. Anorexia is the deadliest of all mental disorders.
Some wrote that she looked “gross” or “nasty.” Although these insults are typically reserved for overweight people, public body shaming is partly to blame for this mess.
Others thought she simply needed to gain back a little weight after the show was over. If only it were that simple.
While many people jokingly wish they had the “enviable problem” of needing to gain weight, there is no journey so harrowing to an anorexic as the trip back up the scale, particularly for those who were formerly obese. The person with anorexia has experienced the power of starvation and self-denial, a high as addictive as heroin. Having endured the shame of being overweight, there is nothing so heady as the illusion of control that comes with extreme weight loss. Deep down, recovery is viewed as a failure. Every ounce gained is power lost, foreshadowing the inevitable slide back into the hell of fatness. The best and the brightest will starve to death or commit suicide because they would “rather be dead than fat.”
Many say they don’t “get” eating disorders, but they’re no mystery. We spend time, money and attention on what we value. Paying the winner of a weight loss competition $250,000 (at the price of physical and mental health) pretty well sums up current American values. Is it any wonder sensitive and talented people succumb to the belief that what makes them special and unique is their ability to deny themselves food?
Recently I overheard a group of attractive moms chatting at a restaurant, one of them sharing the secrets of her successful weight loss. “I eliminated dairy, gluten, alcohol, soy, wheat and meat…and I feel great!” I worried about her kids.
The World Health Organization defines “health” as a state of complete physical, mental and social well-being. A person whose rigid, perfectionistic food rules cause anxiety, obsession and isolation is not healthy.
During February’s Love Your Body Month a group of intrepid young women are using social media to make a change. They’re writing positive affirmations on Post-It notes and sticking them on bathroom mirrors, elliptical machines and scales all over Atlanta. If you see one, remember the message and say it to yourself. Take a picture and post it to Instagram with #atlglows. Whenever I write one and stick it on a mirror, I feel like a revolutionary. (You can do this, too!) The hope is that when a random teen (or her mom or dad) starts feeling bad about food or weight, she can scroll through positive messages at #atlglows and start to create new neural pathways in her brain.
Because negative self-talk isn’t just a nuisance. It can be deadly.
Our very first blog post comes from the very first EDIN member---EDIN's founder---Dr. Dina Zeckhausen:
Welcome to February, EDIN’s official Love Your Body Month. And isn’t this the perfect time to start trying to love your body?
We’re already one month into the year and how many of you are already beating yourself up for failing to follow through on your New Year’s diet resolutions? Have you noticed that the more times you ride the rollercoaster, the more extreme the ups and downs have become? (Weight watchers one year, Paleo the next, a 5-day juice cleanse the next…) Still holding onto the myth that the right food plan will fix your body image angst for good?
The myth (propagated by the media and the plastic surgery industry) is that if we just fix the outsides, our lives will fall into place: perfect body leads to perfect love, perfect job, perfect life, right? So why do so many of us find that, as we get older, dieting gets harder?
It’s not that you’re getting lazy. It’s that deep inside you sense (even though you may not be able to put it into words) that you are barking up the wrong tree.
Two things have happened to you.
First, you suffered.
Loss, illness and death shock us out of our fantasy about a perfect life. While we try desperately to maintain the illusion on Facebook and Instagram, if the suffering doesn’t break us it does manage to spoil our illusions. After the initial anger at the unfairness of it all, we may come to realize that the suffering helps us re-set our priorities. It teaches us what really matters. It’s harder to stick to a diet because we have discovered that the temporary high from being the skinniest girl at the party is short-lived and ultimately empty. It’s the conversations and connections with people, the moments of understanding and compassion, that make life meaningful and fulfilling.
Second, you got wiser.
Over time our sense of self broadens and deepens. As kids we compared ourselves to otherson the playground to see where we stood in the pecking order: she’s taller than me, he’s faster than me. As teens we competed in the realm of stuff: brand names and cool cars. But as we age, we shift from an outward to an inward perspective. We develop a self-image based on inner qualities. We become more giving,creative and bold. We know our minds, we speak up, we trust our instincts. As we feel wiser and more settled inside of ourselves, the superficial aspects of ourselves (e.g. fitting into our daughter’s skinny jeans) take on less meaning and emotional charge. Vanity becomes a less potent motivator.
So perhaps 2014 is not about making your body smaller but about making your body image a smaller slice of the You-Pie. It’s about shifting your perspective. That doesn’t mean throwing in the towel on eating and physical activity. It means choosing the grilled salmon because the Omega 3’s fight cancer. It means taking a morning walk because it helps you feel mentally sharp. A positive body image is about accepting that spending too much time, energy and money on trying to make yourself look perfect won’t buy you true joy or connection. It’s about appreciating that your body is simply the vessel you were given to carry your amazing spirit into the world. Honor your body by speaking to it lovingly and treating it kindly….not just this month, but every month.