We are especially concerned with what some teachers and schools are doing in an effort to “prevent obesity”. Stigmatizing, pathologizing, and othering the fat kids’ bodies is not health promoting, for any body, and likely impacts the size based bullying that is rampant in school yards and on playgrounds. Shame – the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging (Brene Brown) – is associated with poorer self-care behaviors. Shame encourages kids to sneak food and eat in secrecy.
Clinicians who specialize in treating eating disorders see the private and isolated pain that children internalize in response to trying to “get it right” and uphold the thin ideal from a young age. In this blog post below, psychologist and Certified Body Trust® Provider Rachel Millner generously shares her own story and professional wisdom about “what happens when you put a kid on a diet”. We hope you share this story widely to increase awareness of the harm caused by introducing children to dietary restriction and fatphobia.
By Rachel Millner, Psy.D, CEDS-S, CBTP
I have recently heard a lot of conversations about different attempts to find ways to get kids to lose weight. I have heard this in the context of research studies that are being done that starve, limit, or restrict kid’s eating. I have heard it in the context of discussions about higher weight kids in schools. I have heard it in the context of healthcare providers talking about higher weight kids and ways to promote weight loss. I have heard it from other parents who are concerned with one or more of their kids being in larger bodies. I have heard it from weight loss companies that are targeting children to become members. One of the things that stood out to me during all of these conversations was the short sightedness of the discussion. In each situation, the children involved were talked about as if they will only be impacted during the time they are trying to lose weight. Every time I hear plans to put children on diets I wonder if the adults involved realize that the impact on these children will likely be life-long. While the diet itself may end, the physical and emotional toll of dieting is ongoing.
I am a psychologist and certified eating disorder specialist, but I am writing this blog as someone who has not only recovered from eating disorders, but has a history of having my food restricted as a child and adolescent in efforts to get me to lose weight. I want to be clear here that this is not about blaming my parents. Even the most loving, caring, supportive parents internalize diet culture. My parents didn’t put me on diets because they were bad parents. They put me on diets because they thought they were doing the right thing. They put me on diets because they were put on diets. They put me on diets because medical providers told them to put me on diets. They put me on diets because they believed the messages from diet culture that it is possible to make fat kids into thin ones and they believed that if I could be a thin kid and thin adult my life would be better. They put me on diets and even though their intent was good, I was harmed.
Infants and toddlers are completely embodied and in love with themselves. They are endlessly fascinated with all of their new parts. They are excited to discover what their body can do and the ways they can move. They can spend long periods of time just looking at their hands and taking in that that hand belongs just to them. It is heartbreaking to think of kids being restricted of the food they need and taught that their bodies are not to be trusted. Kids learn this young, they learn it quickly, and the lesson has a devastating and lasting impact.
I was put on my first diet as an infant. In my baby book, my mom writes about how the pediatrician advised her to cut back on the amount of formula she was giving me. My mom writes “poor, Rachel” in my baby book following that pediatrician appointment. The reason the pediatrician told my mom to do this is because they felt my weight was too high. They didn’t want me to gain weight as quickly. As a mother myself, it is hard for me to imagine what it must have been like for my mom not to give me formula when I was asking for it. I remember when my own kids were babies and how intuitively they knew what they needed (and still do). They couldn’t use words, but they communicated so clearly what they were needing on any given day. Having gone through my own eating disorder recovery and learned about Health at Every Size® and intuitive eating, I was able to trust their bodies entirely. I can’t imagine what it would have been like for them if they had cried out and I did not respond by giving them a bottle. They would have learned that not only were their most basic needs not going to be met, but that they couldn’t trust me and they couldn’t trust themselves, which is exactly what I learned when I was a baby.
Being restricted as an infant was the first in a very long list of weight loss attempts and messages that my body size was not ok, my hunger was not to be trusted, and weight was something I should be able to control. I learned to fear and dread appointments with healthcare providers because I knew they were going to tell me that my weight was too high and scold me for not losing weight. I learned that there were a different set of rules to follow based on the size of your body. My thin friends were permitted to eat whatever they wanted and there seemed to be some trust that their bodies knew what to do around food. They were often looked at with admiration by adults because they seemed to have cracked some secret code that even the adults hadn’t figured out. I knew there must be something very wrong with me when all the other students in our elementary school were allowed to take whatever the cafeteria was serving and my lunch had to be packed by my mom and the lunch monitor was keeping their “eyes on me” to make sure I wasn’t eating anything except for what was packed in my bag. I realized everyone knew that my body was wrong and a problem to be solved when my middle school teacher suggested I go to weight watchers and the other students made fun of me. I knew that kids weren’t supposed to look like me when there were no softball uniform pants in my size for our township team so I had to wear something different than everyone else. I heard that I wasn’t as good of a tennis player as I could’ve been when my tennis coach let me know how much faster and better I would play if I just lost a little weight.
I tried to lose weight. I tried eating less and exercising more. I tried not eating all the foods that I learned were “bad” and off limits to kids like me. I tried to make “good” choices. I tried to learn to tolerate being “just a little bit hungry” as I was told I would need to do to lose weight. I tried “not eating snacks in front of the TV” as my healthcare provider suggested I do. I tried every weight loss plan and every diet suggested. I knew what food in the house was for my younger, thinner siblings and that I was not supposed to be eating that food. I tried harder throughout my childhood to lose weight than I tried at anything else I did during those same years. Sometimes I would lose some weight and everyone would compliment me on how great I looked including the time a friend’s parent said it was “worth it” that I had the stomach bug because at least I had lost weight. The weight loss would last for a few weeks or a few months, but I always gained it back. I didn’t need a scale or tight clothes to know when I was gaining weight back. It was obvious on the faces of everyone around me.
What I want anyone involved in trying to find ways to get kids to lose weight to know is that what you are doing is not benign. The harm inflicted does not end when your study ends. While the experience of each person is unique, there are some common themes that happen for kids and adolescents who are told they need to lose weight and who are given directions to diet and restrict food to do so. Each one of these children are being taken further and further away from trusting and knowing what their body wants and needs. This kind of trust is not easy to rebuild. The trust we all come into the world with can be taken from us so quickly, and can take the rest of our lifetime to find again. I am still rebuilding it and I am in my 40s and have had years of therapy and support. Every time I was on a diet as a kid, I would eventually sneak food and eat as much as I possibly could while I had access. I would hide food in my room. I would eat as much of the forbidden foods while I was at friend’s houses because I knew I would get in trouble if anyone in my own house saw me eating it. My body was doing what it needed to do to keep me alive. It was saving me from starvation and making sure I had what I needed while I could. My body was doing the hard work of protecting me from the famine these diets were inducing. And each time my body overpowered my resolve to stay on my diet, I felt more hopeless, more wrong, and more like a failure. No one ever said to me “look at what your amazing body is doing for you,” what was said was that I didn’t have enough “willpower.” I didn’t try hard enough. I didn’t “care” enough about being thin. I wanted to be thin more than anything. I dreamt about being thin every night, and still I learned that I was too weak.
I also learned that my hunger and fullness signals could not be trusted. I learned I should ignore my hunger signals and when I would finally eat I would be so hungry it was hard to stop. I learned that fullness signals would come too late and I should stop before feelings of fullness came. I learned that I should try to “cheat” my hunger by doing things to “trick” my body into thinking I was full when I wasn’t. I learned that it didn’t matter how boring or painful a particular exercise was, I should be doing it because it might help me lose weight. The effects of all of this continue until this day. I still have to remind myself every day that my body can be trusted. I still have to remind myself that the foods that were once off limits are no longer so and that I can have them when I want them and don’t need to eat them all now. I still have to remind myself that there was never anything wrong with me or my body- that it was diet culture and the messages I received that taught me my body was a problem to be solved.
Even after years of therapy and strong eating disorder recovery, eating can still be complicated and difficult for me. It is in many ways the emotional toll of those early diets that has the greatest impact, because learning that my hunger and eating was not ok taught me that I was not ok. The same is happening for children placed on diets today. They learn that their worth has limits and their value is less when they are fatter and more when they are thinner. They learn that they should be quiet and find ways to take up as little space as possible. They learn that if the adults around them think there is something wrong with them- there must be something wrong with them- and everyone can see it. I cannot say for sure that every single child being signed up for a weight loss diet is going to end up with an eating disorder or disordered eating or that every single child is going to hate themselves for years to come, but I can say with absolutely certainty that every single child being told they need to lose weight or their body cannot be trusted is being put at risk.
If you are an adult putting kids on weight loss diets, restricting their eating, or telling them they can’t trust their body, you are an adult who is saying that the risk of a lifetime of struggle- a lifetime of self-hatred, a lifetime of disordered eating, a lifetime of not trusting oneself- is worth the possibility of a brief moment of thinness. We don’t know what size any child is ultimately meant to be. We do know that we are not going to make the kids who are meant to be larger into kids who are meant to be smaller. Their bodies are way too smart for that. Let’s put our energy and resources into helping kids learn to be resilient, to build community, to love themselves and each other, to find joy, to speak up for those who are being harmed. Let’s teach kids that their bodies are so wise and can be trusted. Let’s teach our kids that we are not all meant to be the same size and that having a world of different size bodies is a beautiful thing.
Bio: Rachel Millner (she/her), Psy.D., CEDS-S, CBTP, is a psychologist, certified eating disorder specialist and supervisor and certified body trust® provider in Philadelphia, PA. Dr. Millner works with children, adolescents, and adults who are struggling with all forms of eating disorders and disordered eating. Dr. Millner practices from a Health at Every Size®, fat positive, trauma informed perspective. She speaks locally and nationally on topics related to weight bias, HAES, and eating disorder recovery. She has shared her own story of recovery from eating disorders on popular podcasts such as Food Psych and the Eating Disorder Recovery podcast as well as in talks she has given to professionals and the public.
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