Is She Considered Fat or Fit?
Courtney Wright is 10 years old, 4 foot 11 inches tall and weighs 140 pounds. Last year, at her yearly well-child check-up, her mother, Rennie Davidson, got a look at Courtney's chart and saw that the doctor had noted that she was obese. Davidson was furious.
"I confronted him and asked what he meant by obese," says Davidson. "I explained that Courtney is very active; she can ride her bike for 2 miles, swim 1 mile and walk 2 miles. He just said she'd probably grow out of it, but I could tell he thought I was feeding her a bunch of junk and letting her lay around and watch television, and that simply isn't the case."
In fact, there's very little TV watching in Davidson's house. Junk food and candy are a rare treat, and Davidson is careful about serving the entire family a healthful diet. What Courtney does have that Davidson can't do anything about is a father who is 6 foot 5 inches and went through a chubby period as a youngster himself.
According to Gail Woodward-Lopez, associate director of the Center for Weight and Health at the University of Berkley, the primary component of what we, as a society, perceive as overweight is a result of genetics. In other words, parents who are large will have large children, regardless of the eating and exercise habits of those children.
"Our whole society needs to recognize that our size has a very significant genetic component," says Woodward-Lopez. "We can never assume that the bigger child has worse eating or exercise habits than a smaller or thinner child."
In addition, Woodward-Lopez adds, society needs to become more accepting of the difference in people's shapes and sizes. Because the images a person sees from a very young age are primarily thin and beautiful, we are imprinted with these images as what our culture defines as beauty. Therefore, any deviation from that imprint is perceived as unattractive.
The net effect is that perfectly healthy, active children, such as Courtney, are being branded as fat when, in fact, they're merely big kids with big parents who still have a lot of growing to do before they reach their final adult proportions. In the meantime, Courtney is discriminated against in ways that would be completely unacceptable if she were being judged by her appearance for a different reason – such as being a member of a minority race.
A recent study published in the April 2003 issue of the Journal of the American Medical Association found that obese preteens rated their quality of life as low as that of young cancer patients on chemotherapy. While this particular interpretation of the study has been criticized as being cavalier toward cancer patients who are fighting for their lives, the point was merely to illustrate the depths of despair suffered by obese children in our appearance-oriented society. Their perception of their suffering is so severe that only children undergoing chemotherapy came even close in the depth of emotional desolation they feel.
Davidson understands how that can happen. Although Courtney's an excellent athlete and excels in three sports, she's often teased by other children about being fat. Even adults treat her differently because of her size, as if she's too big to sit on mom's lap, get special privileges her thin relatives of the same age get or acting as if she just isn't quite as bright as the other children. In fact, Courtney's a straight-A student.
"If everyone in the United States ate well and became more physically active, we would all be thinner," says Woodward-Lopez. "However, there would still be a great range of weights and body sizes. There would be thin healthy people and heavier healthy people. Some people are just naturally prone to being heavy, just as there are people who it seems can't gain weight no matter what."
The Critical Years
Woodward-Lopez says that the preteen years are particularly hard on overweight children for a couple of reasons. The first is a matter of perception. As children, they observe prejudice, but don't necessarily internalize it. As they begin to go through early puberty, they become much more self-conscious and critical – both of themselves and of others.
The second is a matter of physiology. Children often get plump right before puberty and then get thinner as they grow taller. However, the positive effects don't last long – and it happens a bit earlier for girls. With girls, growth speeds up just before menarche (first menstruation) and then slows down until total growth is complete about four years after menarche. In America, the average age of menarche is 12 1/2, and it's not unusual for girls as young as 10 to begin menstruating. As a result, they stop significant upward growth rather early on.
For boys this process happens a little later, which explains why middle school girls are often so much more mature looking than their male peers. Regardless of gender, by the time our children reach high school, their bodies are dealing with weight issues as adult bodies.
Complicating the issue is that girls typically become less active as they get older. Beginning in middle school, it is estimated that girls decrease their physical activity by 7 percent per year. This is at the same time that their diets tend to be filled with more junk food and their growth has slowed.
An Early Start
Adolescence can be a tough time for a variety of reasons. Children want to be more independent, and there are often clashes with parents over issues such as clothing, curfews, grades and anything else a volatile preteen or teen can think to push the envelope on. Needless to say, this is not the best time to begin talking to them about healthy eating and body image issues. In addition, because of the slowing of growth, if they're near puberty and are still quite heavy, it can be difficult for them to lose weight.
Woodward-Lopez says the ideal time to start talking about body image and healthy eating is the preschool years. This is when they are still under parental control, food-wise, and are amenable to physical activity. The more they see their parents promoting healthy eating and physical activity as a way of life, the more likely they are to remain at a healthy weight and to continue healthy practices.
However, it's never too late to start a healthy lifestyle. What Woodward-Lopez cautions against is the parent who, maybe having one or more thin children and one heavy child, treats the heavy child differently.
"On a parental level there needs to be the same rules of eating and exercise for all the children," says Woodward-Lopez. "If you allow the thin child to have cookies, but not the heavy one, he will soon get the message that it's not my health, it's my weight. Parents may be a very small piece of the child's environment, but to a child the parent's acceptance is most important and this acceptance equips them to go out into the world."