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Preventing Childhood Obesity Will Not Reduce Bullying



sharma-obesity-bullyingRegular readers will be well aware of my concerns about weight bias and discrimination as well as the problem of weight-based bullying. In fact, there are few patients I see in my clinic, who do not recount traumatic bullying about their weight as one of their most vivid childhood memories.

I am therefore happy to see mention of bullying in the Ontario Healthy Kids Panel’s report, released earlier this week.

Indeed, the report quotes parents, who express their concern about this issue,

“If their weight is not proportionate with their friends, then they feel different, they look different, they may even behave different or be treated differently, and feel like they won’t fit in. If they’re on a team, then they’re not performing the same. Then they look in the mirror and feel like there is something wrong with them.”

And,

“My son tells me that he didn’t see anything wrong with himself until his first day of school when he saw that he looked different than everyone else. As he went through elementary school, he was mercilessly bullied and he bullied back. When he reached high school, he had to wear a uniform but the company didn’t even make them in my son’s size. So, I found a similar shirt and sewed the school decal on it. That made [the bullying] worse.”

It is important to note that the report does point out that,

“Many of the severe physical problems associated with being overweight or obese as a child – such as heart disease – may not appear until adulthood, but the social and emotional problems start early.”

This is not something that obesity prevention programs can address – indeed, the greater the focus on the problem of childhood obesity (in media, through schools, parents, social media, or anyone else), the worse the consequences for the kids, who happen to carry a few extra pounds.

Thus, unfortunately, there is little talk in the panel’s recommendations about promoting “size acceptance” and cautioning government and others to not discriminate against those, who do happen to be larger.

Personally, I would have loved to see a cautionary word or even a specific recommendation to address weight-based bullying as one of the first recommendations or even as a preamble to the entire document (and not simply stuck in one of the last few pages, almost as an afterthought).

While I fully support the fact that we need to take the issue of childhood obesity seriously and make every effort to prevent it (and provide treatments where necessary), let us also make sure that we do not throw out the baby with the bath water.

AMS
Edmonton, AB

4 Comments

  1. Is childhood obesity really a health problem or not?

    If childhood obesity really IS a health problem, then the public health professionals are going to have to learn to stand up to the bullies. The bullies should not control the debate. Are we going to let kids continue to be unhealthily obese because we give in to the playground name-calling?
    Don’t kid yourself, ignoring obesity as a health problem won’t shelter kids from bullying, pop culture provides more than enough fuel for bullying. Helping kids get to a decent weight won’t expose them to any more bullying (they’re already getting it for being obese). Neither will becoming a good weight stop the bullying – if someone’s weight is ordinary a bully will find something else to torture the victim with.

    If a bully was making fun of your child’s glasses, would you tell the child to stop wearing them? Even though the child wouldn’t be able to see the blackboard or the softball? True, you’d be stopping the bullying, but at what cost to the child?

    If your child had a nut allergy and was getting sarcastic comments from classmates (yes, it happens), would you tell him to hide his condition and eat risky food, figuring that fitting in with the crowd was more important than avoiding an attack?

    If your child had diabetes, same question – would you want your child to eat cakes and cookies and sweets just to avoid nasty comments that she was too “stuck-up” to eat what everyone else eats?

    If obesity really is a health problem, not dealing with it because of bullying is giving in to the bullies.
    “Size acceptance” when it concerns obesity (not just variations within a range of healthy weight), is like “wheelchair acceptance” – it means accepting people with health problems, not denying that there is a health problem.

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  2. If obesity really is a health problem, not dealing with it because of bullying is giving in to the bullies.
    “Size acceptance” when it concerns obesity (not just variations within a range of healthy weight), is like “wheelchair acceptance” – it means accepting people with health problems, not denying that there is a health problem.

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  3. @Anonymous: Apparently, for the sake of argument, you offer 3 scenarios involving bullying; you also present 3 categories of victims as potential targets (children who wear eyeglasses, children with food allergies, and children diagnosed with “diabetes”); and you give each of your imaginary targets 2 behavioral options from which to choose.

    According to these scenarios, it appears, we should teach our children to cope with bullying as best they can—as a pragmatic strategy for reducing health risks (perhaps rationalizing that bullying is an inevitable childhood right of passage and “hey, life’s unfair” anyway).

    Or, to borrow Anonymous’s rationalization, bullying just happens—because even “… if someone’s weight is ordinary a bully will find something else to torture the victim with.”

    Evidently, then, we should advise victimized children accordingly: “Put up with bullying so you can keep choosing to wear eyeglasses when necessary for clear vision, so you can keep avoiding foods that cause allergic reactions, and so you can keep averting a diabetic coma (for instance) by choosing to monitor blood glucose levels and sugar intake.”

    And we wonder why so many children are diagnosed with (and need medical treatments and pharmaceutical interventions for) mental health problems.

    Children aren’t stupid. On some level, sooner or later, they sense the distorted social values and priorities which legitimate children’s victimization. No matter what the adults claim (and employ as rationalizations), many children must of course realize that bullying is not truly unavoidable or inevitable; they see with their own eyes that children must endure bullying because adults in positions of responsibility, authority, privilege, and power neglect to implement effective bully-prevention protocols, fail to consistently model compassionate behavior, refuse to provide crucial empathy-enhancing educational activities/opportunities, and pathologically deny children’s critical needs for protective environmental safeguards.

    Children may not think about bullying in quite such complex terms, but they still confront (see and hear) the enormous disconnect and contradictions between the rhetoric of being valued and loved as children and the reality of living with social conditions in which the impacts of bullying are systematically minimized and denied, in which bullying continues year after year because the adults in power act in ways that support and reinforce (rather than subvert) social norms which help to perpetuate (status quo) conditions of social inequities, social domination and social control.

    During childhood years, bullies (it would seem) help provide important assistance with the reinforcement of social norms, including norms that legitimate social privilege, bias and social stigma—including fat stigma.

    Anonymous’s apparently typical bullying scenarios reveal a culture in which innocent children become repeat victims of injustice, oppression, and even violence at the hands of other children (labelled “bullying”, a rhetorical distortion which minimizes and discounts the severity of harmful consequences in contrast to more accurate labels, such as harassment, assault, and battery.)

    All too frequently, children are forced to choose between the 2 options which Anonymous presents as if these accurately reflect the inevitable human condition…Option (1): enduring unsafe, painful and harmful conditions (aka “bullying” at school) or Option (2): sacrificing one’s basic human needs and rights in hopes of preventing option 1.

    Also, btw, “obesity” is not a behavior. Thus, your indirect attempt at argument by analogy fails because you compare behaviors (wearing glasses, etc) with a non behavior (having a particular body size). Perhaps you assume that people can choose their own body size–their weight–based on professional recommendations, as if one’s body weight is a kind of behavior that one can choose to perform; or maybe you assume there are actual behavioral strategies which have been proven to be effective in controlling and/or managing the body weights of obese children. If that’s what you mean by “dealing with it” rather than “giving in to the bullies” then I would love to see some evidence to support that claim.

    In addition, Anon, your definitions of “size acceptance” and “wheelchair acceptance” are certainly unique and distinctively different from most “acceptance”-related definitions I’ve encountered. 🙂 Perhaps you also underscore a significant idea (albeit inadvertently) because I hate to contemplate the full implications of NOT “accepting people with health problems.” That notion is utterly horrifying.

    Finally, perhaps we can agree—maybe it’s not always so wrong to feed the trolls? 😉

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  4. Hopeful&Free, interesting comments

    I certainly didn’t mean that a child should have to put up with bullying – I agree totally that adults in positions of responsibility, authority, privilege, should do all the things you mention to stop bullying. (That includes bullying for any reason, not just obesity.)

    In the examples I gave, of course there are many steps that can be taken to stop the bullying. My point was that to stop the bullying, whatever action you did take, you would not expect a child’s health problem to be ignored in an attempt to make the bullies be nice.

    Adults should not deliberately ignore a health problem, hoping that if they don’t mention it the bullies will never think of adding that to their usual insults.

    Concerning my imperfect analogies, I guess the kid wearing glasses one is the most accurate, because that child will be teased both for the condition (being unable to see/being obese) and for doing something to make things better (wearing glasses/eating better). “Damned if you do and damned you don’t”.
    (Here I’m thinking of a particular teen, who did get teased both for being obese, and also for dieting – the teasing didn’t stop until he moved away to college, where no one knew he had once been obese.)

    I disagree that “having a particular body size” is a “non-behavior”.
    When it comes to their body, everybody gets a set of “givens”, however, what people do with their “givens” varies greatly. Check out dancers and athletes – they don’t see the state of their body as permanent – it’s just a starting point which they will train until they change it to what they want, as far as possible within their limitations.
    A normal range of weight, plus the buffer zone of overweight gives lots of latitude to include the natural variety of body types.
    To get to the extreme of obesity the person has to eat a lot, just like to get to competition a bodybuilder has to pump a lot of iron. Those are behaviors. Obesity, like huge biceps, doesn’t just happen. We all have fat and muscle, what gets developed depends on what we do.

    Whether or not a person has a “choice” in behavior is another matter. A child in an obesogenic culture hardly has a choice, unless the adults in the school and at home teach the child to recognize and avoid obesogenic traps. If the adults don’t explicitly confront this obesogenic culture the poor children are left ignorant, and in danger of becoming obese.

    I disagree with you in that I think obesity really is a health problem, whereas you see obesity not as a health issue but as “fat stigma”.
    In other words, the “fat” is not bad, but the “stigma'” is bad because it’s one of “social norms which help to perpetuate (status quo) conditions of social inequities, social domination and social control.”
    If something has a “stigma” attached to it, does that mean any negative aspects of it should never be discussed because to do so would be to perpetuate social inequity, domination, control?
    Should one assume that if the ruling class frowns upon a particular “stigma”, then of course, the rest of us should embrace it as a matter of principle, even if it is damaging to our health?
    Ironically, it’s mostly the lower classes who are made unhealthy by obesity, and if the health problems of obesity are denied for fear of invoking “stigma”, the damage will be to those lower classes.

    I don’t understand the “feeding the trolls” reference. Perhaps some childrens fairy tale I am unfamiliar with, but which has to do with children and eating habits and obesity?

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