I read this article in The Philadelphia Inquirer.
It made me more than a little frustrated and angry.
The headline is great and I had high hopes.
And it starts out well – talking about how teens pinpoint the start of their eating disorder to comments about their weight from doctors, coaches or (health) teachers.
Yeah, when talking to teens about weight – watch what you say.
In fact, when talking to anyone about weight – consider carefully what you say (some of us could hurt you).
And then things start to go horribly wrong.
They start talking about how many fat teens there are and that the “guidelines” recommend these teens lose weight through diet and exercise.
Because you know fat teens must be made into thin teens because, you know, fat = unhealthy.
And then they complain that teens try to lose weight in unsafe ways.
The point they miss is: Diets, unsafe or not, don’t work.
Don’t work for 90% + of humans – and that includes teens.
Also, exercise – good for the body – not so great for losing weight.
And then the they say:
“Teens who diet have lower self-esteem, feel less connected to their families and schools, and feel less in control of their lives.”
Since there is no qualification there – I’m assuming they are talking about the effect of ALL diets.
Yay! They at least recognize how dieting can cause mental / emotional problems.
But the next paragraph blames “bad” diet behavior and exercise for the eating disorders.
I’m thinking “bad” dieting and exercise behaviors may be associated with eating disorders – but I’m also thinking, the authors should refer back to the beginning of the article where the they say – kids are pointing at what amounts to weight and body-shaming from adults – as the start (dare I say, cause?) of their eating disorders.
Then somehow, this whole wonderful section on the HAES (“Health At Every Size”) approach appears.
It’s great! Discussing and recommending weight neutral, health-centric care from healthcare professionals.
AND IT WORKS!
“Randomized controlled clinical trials in adults have shown that a HAES approach improves blood pressure, cholesterol, self-esteem, body image, and health behaviors around eating and activity. HAES achieved these health outcomes more successfully than treatments focused on weight.”
Well, fuck me.
There’s your answer!
End of article, right?
Now the authors revert and say
“some teens do need to lose weight due to problems … and some teens may even need bariatric surgery …”
Yeah, somehow, someway (which these authors know currently does not exist) these kids NEED to lose weight and they might even need to have a healthy vital organ fucked with – because, you know, they are, when all is said and done, FAT.
But while proceeding with these ineffective and barbaric treatments, you should be “nice” about it.
Because you don’t want to cause the kid “significant harm” mentally, while you are causing them significant harm mentally and physically.
The authors are Rima Himelstein, a pediatrician and adolescent-medicine specialist and Kidian Martinez, a licensed clinical social worker and clinidcal coordinator. They both work for Nemours (a pediatric health system).
If I had a kid, I would put Dr. Himelstein and Ms. Martinez on my don’t go near them list.
They are healthcare professionals dealing with children; children who already have eating disorders.
They have heard about HAES and seem to understand why it’s good and that it works, but they just can’t change their ingrained fatphobia to accept that the biggest problem kids have with their weight is what other people think about their weight.
I am sure they believe in the concept of “First do no harm” – except they don’t seem to believe it applies to their fat patients.
If these professionals can’t lose their weight-centric attitude and embrace a health-centric attitude, how the fuck do they expect their patients to do so?