Arya M. Sharma, MD

The following is a brief commentary, I was asked to write for the Metro Newspaper on the recent decision to introduce a “self-esteem” badge for Girl Guides. It appeared in the May 15 edition of the Metro News Toronto:

Anyone interested in promoting the health of young girls is faced with a seemingly impossible challenge. On one hand, in recent years we have seen a dramatic increase in the incidence of eating disorders — now one of the most common and dangerous chronic condition in young women.

On the other hand, the obesity epidemic has also adversely affected girls and women, with unprecedented numbers developing excess weight and related health issues, ranging from polycystic ovary syndrome and infertility to Type 2 diabetes and sleep apnea.

While those concerned about eating disorders are careful to not reinforce a negative focus on body weight, those concerned about obesity are unsure how to broach this issue without further diminishing self-esteem. There is clearly concern about the unintended harmful consequences from overweight and obesity prevention initiatives, particularly those delivered in schools.

But overemphasis on weight or group weigh-ins can trigger fat prejudice, weight-based teasing, or the ostracizing of larger children, or, cause children to react to healthy eating messages by adopting extreme approaches to dieting and consequently losing weight to a degree that negatively impacts their health.

Perhaps the common ground lies in recognizing both eating disorders and obesity as psychosocial health issues. At one end of the spectrum girls and young women seek to control their weight by resorting to extreme dieting, excessive exercise and other destructive behaviours. At the other end, girls and young women turn to food to cope with negative emotions, stress, boredom, abandonment, emotional neglect and isolation.

Now, the Girl Guides of Canada have taken up the challenge of dealing with negative body image by introducing the Love Yourself Challenge badge, which girls aged five to 17 can earn by completing tasks that promote self-esteem, healthy eating and a positive body image.

Whether this initiative will indeed help to reduce the risk of eating disorders while promoting healthy weight remains to be seen. Increased self-esteem is clearly beneficial whether you are dealing with under- or overweight people.

The societal causes of eating disorders and obesity may well be the same: Media, advertising, disintegration of nuclear families, lack of role models, loss of control over an excessively demanding, stressful and fast-paced society that takes little time to play, eat or reflect on the things that truly matter in life.

Let us hope that the Girl Guides’ approach can manage to help girls walk the fine line between pathological dieting and numbing their emotions with food.

If it can help dissociate self-esteem from body weight, much will have been won.