Policy and the Childhood Obesity Stigma

Government Bullies

Earlier this year, one of the many writers who answered Slate magazine’s call for ideas on childhood obesity was Daniel Engber, who unfondly recalled his days as a “husky” boy. When his weight reached the 95th percentile, it was hard to ignore. Though he was rescued by a growth spurt that helped him “grow into” his weight, Engber carried the memory of being a fat kid.

He says,

You can change a child’s habits when he’s still impressionable, the argument goes, when his body is still in flux. That’s one of the theories behind Michelle Obama’s Let’s Move! program… What sort of difference you’ll make isn’t so easy to figure. It’s nice to imagine there’s some critical period of development when our physiologies can be reprogrammed for thinness.

The problem is, this writer believes, a well-intentioned intervention on a little kid can “metastasize into a deep-seated anxiety.” What adults might consider a tough-love approach can seem to a child nothing but tough. A little bit of stigma, the writer says, can go a long way and be very detrimental to children’s health. Engber mentions a number of studies supporting the notion that drawing attention to a child’s weight doesn’t do a bit of good.

He also mentions instances where school programs have seemingly done no harm to the emotionally volatile kids who are being asked to cope with their overweight. But a lot of things don’t show up right away.

The writer asks,

How do we know what it’s like for the husky kid who has to run a gauntlet of anti-obesity flyers on his way to class? Even if our efforts to prevent obesity don’t turn children into bulimics or pill-poppers, we might still be helping to create a new generation of kids who worry over every pound, or must endure a lifelong fear of muffins. Why risk it, especially when we don’t know if these interventions work at all?

Sure, thousands of children reach their teens unable to fit into clothes or even cars because of obesity, but a frontal attack could be doing more harm than good. Like many others, Engber recommends dropping the emphasis on weight and the concentration on at-risk kids, and doing more to promote optimal health in every kid.

Another point of view, from Paul Campos, refuses to equate childhood obesity prevention efforts with fat-shaming. He makes a comparison with height, another physical factor that greatly affects people’s lives. He says short people, and especially short men, are discriminated against, just like the obese.

What if lots and lots of kids were born with the genetic potential to be acceptably tall, but couldn’t to it because they didn’t have the right nutrition at the crucial age when it would make a difference? Would it be so bad for the government to step in and try to make sure all children get the nutrients they need to reach their genetic potential for height? Campos suggests that it’s perfectly natural and right for the government to be concerned about such a fixable problem, and the same goes for obesity.

He writes,

As a short person, I would not regard a nutritional supplement program to prevent growth stunting as short-shaming or short eliminationism… If the government acted to prevent unhealthy shortness, I wouldn’t feel like the government was telling me that being short is inherently unhealthy or shameful…

Your responses and feedback are welcome!

Source: “Leave the Fat Kids Alone,” Slate’s The Hive, 03/10/11
Source: “Preventing Childhood Obesity is Not Fat-Shaming,” The American Prospect, 03/16/11
Image by didbygraham (Graham Richardson), used under its Creative Commons license.

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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