The Myth of the Childhood Obesity Epidemic
Virginia reads Chapter 1 of FAT TALK.
You’re listening to Burnt Toast! This is the podcast about diet culture, fatphobia, parenting, and body liberation. I’m Virginia Sole-Smith, and I also write the Burnt Toast newsletter.
And, as I may have mentioned, I’m the author of FAT TALK: Parenting in the Age of Diet Culture, which comes out in just five days. WHAT. So we have a very special episode of Burnt Toast for you today. You are all going to be the very, very first people to hear me read Chapter 1.
We are excerpting this from the audiobook, which I got to narrate. It was way more intense than I expected, more difficult than podcasting, but also very fun and one of the most rewarding creative experiences I’ve ever had.
I will also say that Chapter 1 was the most physically exhausting one to record because it’s the longest chapter in the book. (No I did not know that sitting still and talking for hours would be physically exhausting but it is!) So if you’re daunted by the length of this episode, please know that other book chapters are easy breezy! Maybe not easy breezy, but they are shorter, whether that is on paper or in your ears. But this is also the chapter I am most proud of, in a lot of ways. I’m so excited for you to hear it. (Content warning for explicit discussions of medical anti-fat bias, childhood trauma, dieting, eating disorders and some unfortunately necessary use of weight numbers and o words. Take care of yourselves!)
And of course, if you love what you hear, I hope you will order the audiobook or the hardcover (or if you’re in the UK and the Commonwealth, the paperback) anywhere you buy books. Split Rock has signed copies and don’t forget that when you order from them, you can also take 10 percent off anything in the Burnt Toast Bookshop.
Thank you so much for supporting this entire process. I give you: The Myth of the Childhood Obesity Epidemic.
Chapter 1: The Myth of the Childhood Obesity Epidemic
Anamarie Regino is a 25-year-old in Albuquerque, New Mexico, who looks a lot like every other 25-year-old on TikTok. She posts videos of her dogs and her tattoos. She lip syncs and tries out new ways to wear eyeliner. And she participates in sassy memes: “Soooo . . . this whole meme that’s going around with ‘decade challenge’?” she says in a video from 2019. “I just want to say: I think I won that.” Then Anamarie’s current lipsticked smirk is replaced by a photo of her from 2009. In both shots, Anamarie is fat. In fact, in other recent TikTok videos and Instagram posts, Anamarie proudly describes herself as fat, affectionately calls out her double chin, and uses hashtags like #PlusSize and #BBW (short for “big, beautiful woman”). But this video is also tagged #WeightLossCheck, because in the 2009 photo, Anamarie is significantly larger than her adult self. Twelve-year-old Anamarie has a half-hearted smile, but her dark bangs are swept over most of her face. It is the classic awkward “before” shot.
It’s not, however, the most famous photo ever taken of Anamarie. That photo, shot by Katy Grannan when Anamarie was just four years old, first ran in a 2001 New York Times Magazine story and is now archived in the National Portrait Gallery’s Catalog of American Portraits. Anamarie’s body became part of our historical record when she was removed from her parents’ custody by the state of New Mexico because she weighed over 120 pounds at age three, and social workers determined that her parents “have not been able or willing” to control her weight.
The case made international headlines, with Anamarie’s parents telling their story to Good Morning America and to Lisa Belkin of the New York Times Magazine, for the article that accompanied Grannan’s portrait. Anamarie’s mother, Adela Martinez-Regino, had long been concerned about her daughter’s appetite and her rapid growth, and then, her delayed speech and mobility. She sought help from medical professionals repeatedly from the time Anamarie was just a few months old, and multiple tests ruled out any known genetic cause, such as Prader-Willi syndrome, a rare chromosomal disorder that causes children to never feel fullness. But Anamarie continued to grow. And doctors grew frustrated by what they perceived to be a dangerous pattern: Anamarie would lose weight when undergoing their intensive medical regimens, including prescription liquid diets that provided her no more than 550 calories per day. But she would regain the weight when the protocol ended and she was once again left in her family’s care. To the doctors, the risks to Anamarie lay not in their use of aggressive weight loss tactics on a toddler but in what happened when her family let her eat. “They treated her for four years, doctor after doctor. Not one of them could help. Then they took her away for months, and they still couldn’t tell me what was wrong,” Martinez-Regino told Belkin. “They’ve played around with her life like she was some kind of experiment. [ . . . ] They don’t know what’s wrong, so they blame us.”
Martinez-Regino also reported that when Anamarie was taken from her parents, they had to listen to their daughter screaming for them as a nurse wheeled her away. During her months in foster care, Anamarie lost some weight and got new glasses but also stopped speaking Spanish (her father’s native language) and was understandably traumatized by the separation from her parents. The state’s decision to take custody of Anamarie was immediately controversial: “If this were a wealthy, white, professional family, would their child have been taken away?” Belkin asked in her piece, noting how often doctors and social workers perceived a language barrier with the Regino family, even though English was Anamarie’s mother’s first language. As a nation, we debated the question in op-eds, on daytime talk shows, and at water coolers: Should a child’s high body weight be viewed as evidence of child abuse?
Anamarie Regino wasn’t the first or the last child to be removed from parental custody due to her weight. In 1998, a California mother was convicted of misdemeanor child abuse after her thirteen-year-old daughter, Christina Corrigan, died weighing 680 pounds. A handful of similar cases popped up in Indiana, New York, Pennsylvania, and Texas over the subsequent decade, according to a report published in Children’s Voice, a publication of the Child Welfare League of America. And in 2021, a British case made international headlines when a judge ordered two teenagers into foster care because their parents had failed to make them wear their Fitbits and go to Weight Watchers meetings. A 2010 analysis published in the DePaul Journal of Health Care Law by a legal researcher named Cheryl George summarizes one prevailing cultural attitude on such tragedies:
Parents must and should be held accountable for their children’s weight and health. Parents can be a solution in this health care crisis, but when they are derelict in their duties, they must be held criminally responsible for the consequences of their actions.
George acknowledged the “fear and anxiety” caused when a child is removed from parental custody but quickly dismissed that as a priority, quoting an earlier article on the subject: “If a child remains with his or her parents in order to affirm the ‘attachment,’ we may be overlooking the looming morbid obesity problem,” she wrote. Never mind that removing custody in an effort to address this “morbid obesity” overlooks a child’s emotional and developmental needs, as well as several basic human rights.
A New Mexico judge dismissed charges against Anamarie’s parents after a psychiatric evaluation of Martinez-Regino found no evidence of psychological abuse. But the family was left to sort through the wreckage of those harrowing months, while continuing to seek answers that doctors could not provide to explain Anamarie’s accelerated growth. And Anamarie’s story embedded itself in our national consciousness. She became a kind of “patient zero” for the war on childhood obesity. Even Belkin’s piece, which is largely sympathetic to the family, frames Anamarie’s body as the problem. Belkin makes sure to emphasize how this toddler’s weight made her unlovable, describing Anamarie’s “evolution from chubby to fat to horrifyingly obese” in family photos, and noting that Martinez-Regino “knows that the sight of her daughter makes strangers want to stare and avert their eyes at the same time.” Having a fat child was framed as the ultimate parental failure. Anamarie’s story confirmed that our children’s weight is a key measure of our success as parents, especially for mothers.
Nowhere in the public conversations around Anamarie’s early childhood was there ever any attempt to understand what Anamarie herself thought of her body or the treatment she received because of it. Today, her social media makes it clear that she’s proud to have lost weight but also proud to still identify as fat, and maybe also still working it all out. (Anamarie—quite understandably—did not respond to my interview requests.) But in the late 1990s and early 2000s, our anxiety about the dangers of fatness in children far outstripped any awareness of their emotional health.
Today, this conversation has evolved, but only so far: We want our kids to love their bodies, but we also continue to take it for granted that fat kids can’t do that. A child’s high body weight is still a problem to solve, a barrier to their ability to be a happy, healthy child. This thinking is the result of a nearly forty-year-old public health crusade against the rising tide of children’s weight. We’ve been told—by our families, our doctors, and voices of authority, including First Lady Michelle Obama— that raising a child at a so-called healthy body weight is an essential part of being a good parent.
But when we talk about the impossibility of raising a happy, fat child, we’re ignoring the why: It’s not their bodies causing these kids to have higher rates of anxiety, depression, and disordered eating behaviors. Even when high weight does play a role in health issues, as we’ll explore in Chapter 2, it’s often a corresponding symptom, a constellation point in a larger galaxy of concerns. The real danger to a child in a larger body is how we treat them for having that body. Fat kids are harmed by the world, including, too often, their own families. And our culture was repulsed by fat children long before we considered ourselves amid an epidemic of them. “It is easy for us to assume today that the cultural stigma associated with fatness emerged simply as a result of our recognition of its apparent health dangers,” writes Amy Erdman Farrell, PhD, a feminist historian at Dickinson College, in her 2011 book, Fat Shame: Stigma and the Fat Body in American Culture. “What is clear from the historical documents, however, is that the connotations of fatness and of the fat person—lazy, gluttonous, greedy, immoral, uncontrolled, stupid, ugly, and lacking in will power—preceded and then were intertwined with explicit concern about health issues.” To understand how we’ve reached this anxious place of wanting our kids to love their bodies, but not wanting them to be fat, we have to first go backward and understand the making of our modern childhood obesity epidemic. And we need to see how it has informed, and been informed by, our ideas about good mothers and good bodies.
A SHORT HISTORY OF FATPHOBIA
Just as we think of childhood obesity as a modern problem, we often frame fatphobia as a modern response and wax poetic about the days of yore when fat was seen as a sign of wealth, status, and beauty. But when historians dig back through old periodicals, newspapers, medical records, and other historical documents, they find plenty of evidence of anti-fat bias throughout Western history. The ancient Greeks celebrated thin bodies in their sculptures, art, and poetry. By the 1500s, corsets made from wood, bone, and iron were designed to flatten the torsos of the European aristocracy. And early novels like Don Quixote and the plays of Shakespeare are full of fat jokes and fat characters played as fools. For the purposes of understanding our modern childhood obesity epidemic, it’s most helpful to see how Western anti-fatness intensified at the end of the late nineteenth century and then strengthened in the early decades of the twentieth century. This happened in response to the end of American slavery and increasing rights for women and people of color, as Sabrina Strings traces in her seminal work, Fearing the Black Body. In Fat Shame, Farrell notes that for much of the nineteenth century, fatness was attached to affluence and social status “and as such, might be respectable [ . . . ] but also might reveal gluttonous and materialistic traits of specific, unlikeable, and even evil individuals. By the end of the 19th century, fatness also came to represent greed and corrupt political and economic systems.” Around the same time, advances in medicine and sanitation led to a decrease in infant mortality and infectious disease death rates. This meant that by the early 1900s the scientific world could begin to consider the ill effects of high body weight in a more concerted way. And scientists brought their preexisting associations of fat with sloth and amorality to this work.
The template for our modern body mass index was first designed as a table of average heights and weights in the 1830s by a Belgian statistician and astronomer named Lambert Adolphe Jacques Quetelet. Quetelet set out to determine the growth trajectory of the life of the “Average Man,” meaning his white, Belgian, nineteenth century peers. He never intended his scale to assess health. But in the early 1900s, the American life insurance industry began using his work to determine what they called an “ideal weight” for prospective clients based on their height, gender, and age. How closely you matched up to this ideal determined whether you qualified for a standard life insurance policy, paid a higher premium, or were denied coverage. And as the medical world was connecting these first dots between weight and health, we see the unmistakable presence of anti-fat bias. “A certain amount of fat is essential to an appearance of health and beauty,” wrote nutrition researchers Elmer Verner McCollum and Nina Simmonds in 1925. “It is one indication that the state of nutrition is good. [ . . . But] we all agree that excessive fat makes one uncomfortable and unattractive.” Health and beauty were synonymous to these researchers, and many other medical experts of the late nineteenth and early twentieth centuries.
Much of the early scientific work around weight was rooted in the racist belief that fat bodies were more primitive because they made white bodies look more like Black and immigrant bodies. Black women, in particular, were (and still are) stereotyped as a “mammy” (a fat and asexual maternal caretaker of white families), a hypersexual “Jezebel,” or, more recently, a “welfare queen” (a fat, amoral, single mother whose existence endangers the sanctity of the white family). The almost exclusively white and predominantly male fields of medicine and science were eager to find “proof” of white people’s superiority to other racial groups and made broad generalizations about racial differences in body size and shape (as well as facial features, skull size, and so on) to build their case.
In 1937, a Jewish psychiatrist named Hilde Bruch set out to challenge the theory of fatness as a sign of racial inferiority by studying hundreds of Jewish and Italian immigrant children in New York City. She examined their bodies (with a particular focus on height, weight, and genital development). She visited their homes to observe children eating and playing, and she interviewed their mothers extensively. And Bruch determined that there was nothing physically wrong with the fat kids in her study—which could have been a huge breaking point in our cultural understanding of weight and health. But although she disputed the notion that fat white immigrants and fat people of color were biologically inferior to thin white Americans, Bruch still framed fatness as a matter of ethnicity: “Obesity occurs with greater frequency in children of immigrant families than in those of settled American background,” she declared in a 1943 paper. And instead of blaming physiology, Bruch blamed mothers. Her papers on childhood obesity explain the children’s fatness as “a result of the smothering behavior of their strong willed immigrant mothers,” writes Farrell. “These mothers simultaneously resented and clung to their children, trying to make up for both their conflicting emotions and poor living conditions by providing excessive food and physical comfort. Bruch described the fathers of these fat children as weak willed, often absent, and ‘yearning’ for the love that their wives devoted to the children.”
Bruch’s description of immigrant parents of fat children is a neat precursor to the treatment the Regino family received during Anamarie’s custody case. Anamarie’s father, Miguel, goes unquoted in the New York Times Magazine feature and most other media, while her mother is required to defend herself as a parent and assert herself as an American repeatedly, in the media and with doctors and social workers who assume she can’t understand them. “There were so many veiled comments which added up to, ‘You know those Mexican people, all they eat is fried junk, of course they’re slipping her food,’” the Regino family’s lawyer told Belkin. The social worker’s affidavit recommending that Anamarie be placed in foster care concluded by saying, “The family does not fully understand the threat to their daughter’s safety and welfare due to language or cultural barriers.” Martinez-Regino said such comments showed her that “they decided about us before they even spoke to us.”
So anti-fatness, racism, and misogyny have long intersected with and underpinned one another. Even when a researcher like Bruch set out to challenge one piece of the puzzle, she did so by reinforcing the rest of our cultural biases. The immigrant children she studied weren’t diseased—but their weight was still a problem, and their mothers still held responsible. It would be decades before anyone thought to question either assumption. In 1969 the nascent “fat acceptance” movement took off with the establishment of the National Association to Advance Fat Acceptance (NAAFA). In 1973, two California activists named Judy Freespirit and Aldebaran wrote the first “Fat Manifesto” for their organization, the Fat Underground: “We believe that fat people are fully entitled to human respect and recognition,” they began. A later clause specifies:
We repudiate the mystified “science” which falsely claims that we are unfit. It has both caused and upheld discrimination against us, in collusion with the financial interests of insurance companies, the fashion and garment industries, reducing industries, the food and drug establishments.
These early activists created spaces where fat people could find community and support and begin to understand the way they were treated as a form of chronic oppression. Along with disability rights activists, they operated on the fringes of feminism and queer activism, and their ideas were far from any mainstream conversations about weight.
But around the same time, a handful of researchers began studying fat stereotypes as a way of understanding how we learn and internalize biases. In several studies from the 1960s, researchers showed children drawings of kids with various body types (usually a disabled child, a child with a birth defect, and a child in a larger body) and found that they consistently rated the fat child as the one they liked least. In a 1980 experiment, a public health researcher named William DeJong found that high school students shown a photo of a higher-weight girl rated her as less self-disciplined than a lower-weight subject unless they were told her weight gain was caused by a thyroid condition. “Unless the obese can provide an ‘excuse’ for their weight [ . . . ] or can offer evidence of successful weight loss, their character will be impugned,” he wrote. In 2012, researchers revisited the picture ranking experiment from the 1960s with a group of 415 American fifth and sixth graders and found that anti-fat bias had only intensified. They noted, “The difference in liking between the healthy and obese child was currently 40.8 percent greater than in 1961.” So, the farther we come in claiming to understand and care about the health of fat children, it seems, the less we like them. As Anamarie’s mother said in the New York Times Magazine story: “They decided about us before they even spoke to us.”
THE MAKING OF THE MODERN OBESITY EPIDEMIC
In 1988, Colleen was ten years old, living in Highlands Ranch, Colorado. She had never heard of fat acceptance or the Fat Manifesto or early research on anti-fat biases. But she experienced fatphobia every day. At home, family members would make comments like “You look like you’re going to have a baby with that belly” and remind her to suck in her stomach and stand “like a lady,” with her hands clasped in front of her middle, especially when she went up to receive Communion at church. At school, kids teased her mercilessly, calling her “Tank” when she played four-square at recess. When everyone got weighed in her gym class, Colleen recalls stepping on the scale in front of all her classmates and then having to put her weight on an “About Me” poster that was hung in the school hallway. Highlands Ranch is a mostly white, affluent suburb of Denver also known as “The Bubble,” and Colleen thinks its’ lack of diversity played a role in her experience. “There was a sense of perfectionism and I didn’t fit that ‘perfect’ or ideal body type.” When the bullying reached a breaking point, her parents called a psychologist—and put Colleen on the popular ’90s weight loss plan Jenny Craig. “I remember my mom saying, ‘You need to nip this in the bud right now,’” says Colleen, who is now a forty-two-year-old physician’s assistant, still living in a larger body, and still living in Highlands Ranch, with her husband and eleven-year-old son. “I think she felt that if I was fat at that age, I’d be fat for the rest of my life, and live this horrible life where everyone would make fun of me, and I’d never be accepted.” There was no discussion of consequences for the kids bullying Colleen at school. Her family is white and now upper middle class, but having a fat child still subjected Colleen’s parents, who grew up working class themselves, to stigma and scrutiny. Colleen’s weight was their problem to solve, and her mother, especially, was determined to fix it.
Indeed, by the 1990s, fixing everyone’s weight had become a national project. In 1997, a Boston pediatrician named William Dietz, MD, PhD, joined the front lines of the fight, as director of the Division of Nutrition, Physical Activity, and Obesity at the Centers for Disease Control and Prevention. “I took the CDC job because I thought that obesity needed to be a national concern, and I couldn’t really do that much about it in an academic setting,” he tells me. Dietz and his colleagues had been warning about a rise in body size for both children and adults since the mid-1980s, based on data collected in the National Health and Nutrition Examination Survey, known as NHANES, which is executed every two years. Data collected beginning in 1971 showed that just 5.2 percent of kids aged two to nineteen met the criteria for obesity then. By the survey begun in 1988, that percentage had nearly doubled, and the 1999–2000 NHANES showed a youth obesity rate of 13.9 percent. That rate has continued to climb, reaching 19.3 percent in the 2017–2018 NHANES. A similar rise in body size was documented for adults: Data collected from 1976 to 1980 showed that 15 percent of adults met criteria for obesity. By 2007, it had risen to 34 percent. The most recent NHANES data puts the rate of obesity among adults at 42.4 percent.
The statistics alone were startling, but Dietz wanted to find an even more effective way to communicate to Americans the scale of the obesity epidemic. One day early in his CDC tenure, while chatting with staffers in a hallway, Dietz suggested they plot the NHANES findings across a map of the United States, to designate which states had become “obesity hot zones,” using a green to red color-coded system. “Those maps, more than anything else, I think, began to, well, transform the discussion of obesity,” Dietz tells me. “Nobody argued thereafter that there wasn’t an epidemic of obesity because those maps were so compelling.”
Dietz’s maps, which are updated every year, and the NHANES numbers are dramatic, unprecedented, and, to some extent, indisputable. Americans are, on average, bigger than we were a generation ago. And our kids are bigger, on average, than we were as kids. We’ll look more at explanations for this rise in body size in Chapter 2. But what I want to note about these numbers now is how they continued to climb even as public health officials were printing their maps and assembling this evidence of their epidemic; even as weight loss became our national pastime. One conclusion we can therefore draw: The weight loss industry and public health messaging have failed, quite spectacularly, in their quest to make anyone smaller. They may even have had the opposite effect. But it’s also worth looking at these statistics in a little more detail, to see what else they tell us.
The NHANES researchers determine our annual rate of obesity by collecting the body mass index scores of about 5,000 Americans (a nationally representative sample) each year. BMI is a blunt tool, never developed to directly reflect health. But it’s useful for tracking populations in this way because it’s easy to calculate by dividing a person’s weight in kilograms by the square of his or her height in meters. From there, researchers can sort people into the categories of underweight, normal weight, overweight, or obese, depending on where they fall on the BMI scale. This entire project of categorizing people by body size— and determining that there is only one “normal” weight range—is flawed and loaded with bias. And to make matters more confusing, the cutoff points for those categories haven’t stayed fixed over the years. A major shift happened in 1998, when the National Institutes of Health’s task force lowered the BMI’s cutoff points for each weight category, a math equation that moved 29 million Americans who had previously been classified as normal weight or just overweight into the overweight and obese categories. The task force argued that this shift was necessitated by research. But just a few years later, in 2005, epidemiologists at the CDC and the National Cancer Institute published a paper analyzing the number of deaths associated with each of these weight categories in the year 2000 and found that overweight BMIs were associated with fewer deaths than normal weight BMIs. (Both the obese and underweight groups were associated with excess deaths compared to the normal weight group, but the analysis linked obesity, specifically, with less than 5 percent of deaths that year.)
Rather than revisiting the cutoff lines for BMI weight categories after this research came out, many researchers objected to that study being published at all. “There was a lot of criticism that our finding was very surprising,” the study’s lead author, Katherine Flegal, MPH, PhD, told me in 2013. “But it really wasn’t, because many other studies had supported our findings.” These included studies that the Obesity Task Force had reviewed while debating BMI cutoffs—so many studies, in fact, that in 2013, Flegal and her colleagues published a systematic literature review of ninety-seven such papers, involving almost three million participants, and concluded, again, that having an overweight BMI was associated with a lower rate of death than a normal BMI in all of the studies that had adequately adjusted for factors like age, sex, and smoking status. They also found no association with mortality at the low end of the obese range. This review was also met with criticism and fury by mainstream obesity researchers. The Harvard School of Public Health held a symposium to discuss all the ways that Flegal’s work made them mad. “I think people will be endlessly surprised by these findings,” is how Flegal put it to me then, while she was still employed by the CDC and presumably felt required to be circumspect about the criticism her work received.
But in 2021, years after retiring, Flegal published an article in the journal Progress in Cardiovascular Diseases that details the backlash her work received from obesity researchers:
Some attacks were surprisingly petty. At one point, Professor 1 posted in a discussion group regarding salt intake that JAMA had shown a track record of poor editorial judgment by publishing “Kathy Flegal’s terrible analyses” on overweight and mortality. Similarly, again using a diminutive form of my name, Professor 1 told one reporter: “Kathy Flegal just doesn’t get it.”
After her paper was published, former students of the obesity researchers most outraged by Flegal’s work took to Twitter to recall how they were instructed not to trust her analysis because Flegal was “a little bit plump herself.” The most depressing part is how well these personal attacks, rooted in fatphobia and misogyny, worked: For years, Flegal’s findings have been all but ignored by doctors and other healthcare providers, for whom using BMI to determine health has remained accepted practice.
Doctors use BMI to determine health for kids, too, using a similar calculation, and then plotting that number as a percentile on a BMI-for-age chart, which shows how they are growing compared to same-sex peers of the same age. BMI doesn’t take a child’s muscle mass or level of pubertal development into account, both of which influence body composition. And the BMI-for-age chart used in most doctors’ offices today is based on what children weighed between 1963 and 1994. “It’s true that the demographics of the population have changed,” says Dietz, noting that obesity rates differ dramatically by racial identity. Black kids, especially, tend to be bigger than non-Black peers and start puberty earlier, which impacts their growth trajectory. But Dietz stops short of acknowledging that maybe we should use a different scale to assess the weight/health relationship of these kids, pointing to research done by the World Health Organization, which found the growth curves of upper- and middle-income, healthy children in six different countries to be similar. “You know, you need to draw the line somewhere,” he says.
Dietz drew that line in 2010, when categories on the pediatric growth charts were renamed. Kids who were previously identified as “at risk of overweight” were relabeled “overweight,” and kids who had been classified as overweight were now designated as “having obesity.” This decision, along with the earlier 1998 reshuffling of the adult BMI scale, was controversial. “There was a feeling at the time, from a conservative faction, that obesity was too drastic a diagnosis [for kids],” says Dietz, who pushed hard for the change. He stands by it a decade later, though he does acknowledge that the “overweight” range, defined as the 85th to 95th percentiles on the growth chart, is more of a gray area. “There are a lot of misclassifications there because you find kids who just have a large frame or are very muscular,” Dietz says. “Whereas body weights in excess of the 95th percentile are almost invariably fat.”
I want to point out here that there is anti-fatness even in how Dietz (and Flegal, in her work on adult BMI categories) make allowances for bodies who are “just overweight,” or on the low end of obesity versus the higher end. Such distinctions still rank different kinds of fatness in ways that silo and stigmatize people at the top of the scale and ignore that they have just as nuanced and complicated a picture of health as anybody else. Or would, if anybody bothered to study their health in non-stigmatizing ways. In fact, kids’ body weights above the 95th percentile vary tremendously in composition—we just don’t have a good tool for measuring them. A child in the 99th percentile might have a BMI of 29 or 49, but they’re plotted along the same line because the chart doesn’t go any higher.
The debates within research communities over how to define obesity rarely make headlines—only the resulting scary statistics, which is how those numbers bake into our collective subconscious as truth, even though they cannot tell the full story. A particularly dangerous one is the claim that “obesity kills 300,000 people per year!” This figure is used by doctors, the media, and for years by Jillian Michaels, the celebrity personal trainer and host of the TV show The Biggest Loser. But where did we get this number? From a 1993 study by researchers at the United States Department of Health and Human Services titled “Actual Causes of Death in the United States.” These scientists combed through mortality data from 1990 and attributed 300,000 American deaths due to heart attacks, strokes, and other medical issues to “diet and activity patterns.” The only contributor with a higher death toll was tobacco (400,000). The researchers made no mention of weight, and they also analyzed data for only one single year. Nevertheless, in 1994, former surgeon general C. Everett Koop joined forces with then First Lady Hillary Clinton to kick off their “Shape Up America” campaign, citing that 300,000 figure as proof of the need for a “war against obesity.” Other researchers also referenced the figure often enough that in 1998, the study’s authors published a letter to the editors of the New England Journal of Medicine saying, “You [ . . . ] cited our 1993 paper as claiming ‘that every year 300,000 deaths in the United States are caused by obesity.’ That is not what we claimed.” But the “epidemic” was already underway.
What motivated researchers and public health officials to hype their “war on obesity” in this intense way? Many operate from a place of deep concern for their fellow humans. Dietz, for example, struck me as personable and passionate about helping children during both of our conversations. But he has also been financially entangled with the weight loss industry for much of his career. After his tenure at the CDC, Dietz served on the scientific advisory board of Weight Watchers. And even before joining the CDC, Dietz was a member of the group then known as the International Obesity Task Force. Now known as the World Obesity Federation, this task force began as a policy and advocacy think tank “formed to alert the world to the growing health crisis threatened by soaring levels of obesity,” according to the organization’s official history. The task force was framed as an independent alliance of academic researchers—but many of these researchers, including the organization’s founder, a British nutrition scientist named Philip James, were paid by pharmaceutical companies to conduct clinical trials on weight loss drugs; James even hosted an awards ceremony for the drug manufacturer Roche. In 2006, an unidentified senior member of the task force told a reporter for the British Medical Journal that the organization’s sponsorship from drug companies “is likely to have amounted to ‘millions.’” And in the years around that first shift in the BMI cutoffs— the one that resulted in twenty-nine million more Americans in the overweight and obesity categories—the Food and Drug Administration approved a flurry of weight loss drugs: dexfenfluramine (sold as Redux) in 1996, sibutramine (sold as Meridia) in 1997, and orlistat (sold as Xenical and Alli) in 1999. More overweight and obese Americans meant a larger potential market for the makers of those drugs. In America’s “war on obesity,” the weight loss industry had just negotiated its arms deal.
While both Redux and Meridia were later recalled due to concerns about heart damage, the FDA approved several more weight loss drugs in 2012, 2014, and 2021. Today the US weight loss market is valued at over $70 billion. Dietz is now the director of the Strategies to Overcome and Prevent (STOP) Obesity Alliance at the Sumner M. Redstone Global Center for Prevention and Wellness at George Washington University. Like IOTF before it, the STOP Obesity Alliance looks like an academic think tank but actually comprises “a diverse group of business, consumer, government, advocacy, and health organizations dedicated to reversing the obesity epidemic in the United States,” according to its 2020 annual report, which further discloses that in that year alone, the alliance received $105,000 from corporate members including Novo Nordisk, a pharmaceutical company that manufactures liraglutide and semaglutide, two recent weight loss drugs to get FDA approval, and WW, the brand formerly known as Weight Watchers. They also received an additional $144,381 from Novo Nordisk to sponsor a research project on primary care obesity management.
Dietz is perfectly upfront about all of this when I ask him about the role of corporate sponsorship in obesity research. “We would not have been able to do this work without that kind of support,” he tells me. “Does that bias my judgment about medication? I don’t think so. But, you know, that’s an external kind of thing.” It doesn’t feel problematic to Dietz to be funded by drug companies because he views weight loss medication as “the biggest thing that’s been missing in obesity care”—a silver bullet that’s going to transform people’s lives—because he doesn’t question the premise that fat people must need their lives transformed. “Companies and practitioners have the same goals. And that’s to treat obesity effectively and to be reimbursed for that care,” he tells me. “Those go hand in hand. So, there’s no way of avoiding that conflict of interest.” The bias is baked in.
Almost thirty years later, Colleen can’t even remember if she lost weight on that first diet, though she does recall going to her brother’s Cub Scout camp out in the mountains of Colorado and watching all their friends eat hot dogs while she ate her Jenny Craig meal. “It was always, ‘Come on, Colleen, you know that French fry is not on your diet,’” she says. Dieting became an ever-present feature of her tween and teen years. Colleen gave up on expecting her body to fit in; she channeled all her energy into being “the smart one, the sweet one, the people pleaser,” as she puts it. “I had a lot of friends, I was part of the ‘popular clique,’ but I felt like I had to conform in those ways,” she explains. “Everyone else was the same physical body type, and pretty soon they were all kind of going out with each other. But boys weren’t interested in me.”
So, Colleen excelled at being a good friend and being good at school. When she got to college, she decided to major in nutrition. “I was so, so sick of people telling me what to eat, how to eat, how to do anything,” she explains. “I wanted to go find out for myself what the truth is behind all of this.” But Colleen studied nutrition from 1999 to 2003, the same years when the 300,000 deaths figure and the state maps were making headlines. “It was a very weight-centric education, to say the least,” she says. When a guest lecturer came to campus to give a talk on how we can be both “fat and fit,” Colleen recalls her professors telling students to completely disregard it. They were sure it couldn’t be true—after all, our own government research had told them everything they needed to know about weight and health.
MODERN MOTHER BLAME
Elena, forty-one, grew up in New York City and New Jersey and has her own list of childhood diets prescribed during the war on obesity’s early years: Richard Simmons’s Deal-a-Meal, Weight Watchers, and “Get in Shape, Girl!” a workout video series marketed to tween girls, which involved a lot of pastel leotards, ankle weights, and side ponytails. “I remember my mom taking me with her to this twelve-week weight loss group she was doing, and at the end of it, we all went out for pizza to celebrate, which seems so absurd now,” says Elena. Her mom dieted steadily, but it’s Elena’s dad who took it even further. “He was in the Air Force Reserves and he’d have to hit certain weights every so often, so I remember him, like, not eating or eating and puking and eating,” she says. Nobody suggested this was a good idea, but it certainly communicated to Elena that her own “chubby” body was not okay.
Her extended Afro–Puerto Rican family reinforced that narrative: “My grandmother would make comments, and I remember one of her friends would always say, ‘You’re fat!’ to me. But in Spanish, so she would say, ‘Ahhh, gordita!’ and it’s like, a term of endearment and a term of criticism all in one,” Elena says. “You were not supposed to be fat. But also, my grandmother would fry a chicken for me, for like, a snack. It was very convoluted.” Elena isn’t sure if her grandparents and their friends were measuring her by Puerto Rican or white American beauty standards, but she knows which metric she used on herself. “I compared myself to the typical teen and fashion magazines of the 1980s and 1990s, which were very white and thin,” she says. “My friends were of varying races, but they were almost all thin, so I also compared myself to them. I knew my weight was different from what was mostly around me. And I hated that.”
Like Colleen, Elena was also teased constantly at school and didn’t date in high school. But some of her most intense trauma came from pediatricians. “I remember one doctor just berating me in front of my mother, telling me, ‘You have to stop eating fast food!’” Elena says. She was nine years old. She liked fast food but ate it only rarely. “Getting to go out to eat at all was kind of special,” Elena says. “She made all these assumptions about me, and remember being so crushed.” Elena told her mother she’d never go back to that doctor. “And probably from the time I was twelve, until I needed a physical for college, I just didn’t go.” Elena is now a public health nurse—finding her way into a version of the profession that so stigmatized her, just as Colleen did with nutrition—and lives with her husband and two children in Philadelphia. She spends her workdays making home visits to low-income, expecting, and new mothers. Elena weighs the babies after they’re born, but she never asks a mother to get on a scale. “I never talk about my clients’ health through the lens of weight. Never,” she says. “The health impacts they face are due to racism and poverty, not weight. So, I approach it that way: How can we get you money and resources? How can I radically listen to and accept you? That’s my role.”
Elena parents carefully around weight, too; her kids never hear her discuss diets or body size. If they hear someone described as “fat,” Elena never says, “Don’t say that!” because she doesn’t want to reinforce that fat is bad. “I say, ‘Yes, fat people exist, and I am one of them, and there’s nothing wrong with being fat. But we don’t need to comment on everyone’s body because that might make people uncomfortable,’” she explains. “But none of this has stopped my brain from saying, ‘Oh my God, please don’t let my kids be fat.’” And even while she speaks so positively about bodies to her children, Elena has also done everything she can to prevent their early weight gain. “I breastfed each of them for three years; we eat vegetarian, rarely drink juice, and never set foot in McDonald’s,” she reports. “The motivation for all of this was ‘no fat kids.’”
And yet. When her now-eight-year-old daughter reached kindergarten, Elena noticed her “chunking up a little.” The same thing has happened in the past year for her five-year-old son. “It was just this realization of, ‘Oh man, genetics are real,’” she says. “I’ve never said anything about this to my kids. I would never say that to anyone. But I think about it every day.” Part of what Elena is struggling with is the intense desire to spare her kids the anxiety she felt around weight as a child. She’s already told their pediatrician not to discuss weight loss in front of them. But she also worries how their weight reflects on her as a mother. “All of their friends are stick thin. Like, it’s a striking difference. And so, I wonder, do people look at them and think I’m a bad parent?”
When I follow up with Elena more than a year after our first conversation, that fear of being a bad parent, of being to blame for her children’s bodies has escalated. “My son gained forty pounds over COVID and has high cholesterol and fatty liver,” she writes in an email. “I really fucked him up. And it’s really awful. I feel terrible.” We’ll talk more about the links between weight gain and health in the next chapter, but whether Elena’s son’s bloodwork is related to his body size or not, I know one thing is true: Elena did not fuck him up. She loved her child and kept him safe during a global pandemic, which has left scars on all of our bodies, hearts, and minds in complex ways. Subjecting him to the same kind of perpetual weight anxiety that Elena experienced as a child is unlikely to help, as we’ll see in Chapter 3. But I am not surprised that this is the solution she reaches for: “We’re going to a healthy weight clinic in January and I’m back on Weight Watchers.”
Elena is responding to the same cultural narratives that judged Anamarie Regino’s mother before her, Bruch’s Italian and Jewish immigrant mothers before both of them, and Black mothers from the time they were enslaved. These narratives predate the modern obesity epidemic, which is to say, they’ve also shaped it. As the first data on the rise in children’s body size was unfolding, doctors, researchers, and public health officials immediately turned the conversation to parental responsibility: how to make parents “aware” of their children’s weight, and how to get parents to make better decisions about the family’s food and activity habits. “The researchers in this camp suggest that we need to educate mothers about how to determine whether their children weigh too much,” noted Natalie Boero, PhD, a sociologist at San Jose State University, in an essay for The Fat Studies Reader published in 2009. “Implicit in this critique of American culture is a blame of working mothers for allowing their children to watch too much television, for not having their eating habits more closely monitored, and for relying on convenience foods for meals.”
“Implicit in this critique of American culture is a blame of working mothers for allowing their children to watch too much television, for not having their eating habits more closely monitored, and for relying on convenience foods for meals.”
Research began to pile up pinpointing links between children’s higher body weights and these kinds of poor parenting decisions. And this has resulted in tangible limitations on how fat people, especially fat women, are allowed to parent. As comic storyteller Phoebe Potts explores in her 2021 one-woman show Too Fat for China, many countries ban fat parents from adopting. In addition to China (where Potts was rejected for having a BMI of 29.5), BMI has also been a deal breaker for adoption proceedings in South Korea, Taiwan, and Thailand as well as parts of Australia, the United Kingdom, and the United States. And, as I reported for the New York Times Magazine in 2019, it has become a common practice for infertility clinics to deny in vitro fertilization and other treatments to mothers above a certain body weight.
It’s easy to classify stories like Anamarie Regino’s as rare and exceptional, the sad, salacious stuff of daytime talk shows that blow up in brief Twitter storms and then become memorialized in internet memes but don’t factor into our everyday lives. But every time we put a mother on trial for making her child fat, we put all mothers on trial for the size and shape of their children’s bodies. For moms like Elena, it’s nearly impossible to separate out her fear of judgment from her fear of fat because we’ve always dealt with these as one and the same in our culture. It’s also incredibly difficult to separate her experience of anti-fat bias from her fear for her child’s health, because what we know about kids, weight, and health has been informed and shaped by that same stigma. This is why, in almost every interview I do with someone who has lived with an eating disorder, they tell me about what their mother said or did about their weight and how it contributed to their struggle. The “war on childhood obesity” of the past forty years has normalized the notion that parents, but especially mothers, must take responsibility for their child’s weight, and must prioritize that responsibility above their own relationship with their child as the ultimate expression of maternal love. And almost nobody pushed that message more fervently than the most famous mother ever to take on this fight: former First Lady Michelle Obama.
DIET CULTURE IN THE WHITE HOUSE
In November 2008, it was then president-elect Barack Obama who gave an interview to Parents magazine where he explained how “Malia was getting a little chubby.” He described how he and Michelle got serious about the problem and made changes to the family’s diet. According to Michelle, the result “was so significant that the next time we visited our pediatrician, he was amazed.” When the Obama family arrived at the White House, First Lady Michelle Obama made fighting the war on childhood obesity her central mission, perhaps at least in part because it felt like a safe issue for the nation’s Mom in Chief to take on as she battled extreme levels of scrutiny and misogynoir as the first Black First Lady. She told the story about Malia and the pediatrician repeatedly when promoting her “Let’s Move” initiative, which ran from 2010 to 2016. “The thought that I was maybe doing something that wasn’t good for my kids was devastating,” she said of that doctor’s appointment, in a 2016 speech to a group of parenting bloggers. “And maybe some of you can relate, but as an overachiever, I was like, ‘Wait, what do you mean, I’m not getting an A in motherhood? Is this like a B-? A C+?’”
In another speech, Obama spoke more directly to parents’ failings, saying, “Back when we were all growing up, most of us led lives that naturally kept us at a healthy weight,” before describing her own idyllic childhood as full of healthy habits like walking to school, playing outside, eating home-cooked meals with green vegetables, and saving ice cream as a special treat, all because her parents imposed such policies whether kids liked it or not. “But somewhere along the line, we kind of lost that sense of perspective and moderation,” implying that kids’ weights are rising because parents have become too lax and indulgent. Obama also painted a grim picture of what kids’ lives had become, thanks to this loss of parenting standards: “Kids [ . . . ] are struggling to keep up with their classmates, or worse yet, they’re stuck on the sidelines because they can’t participate. You see how kids are teased or bullied. You see kids who physically don’t feel good, and they don’t feel good about themselves,” she said in a 2010 speech to the School Nutrition Association. Later in the speech, she added: “And by the way, today one of the most common disqualifiers for military service is actually obesity.” References to military readiness are sprinkled throughout Obama’s “Let’s Move” speeches, reinforcing the “war” rhetoric around weight first popularized in the 1990s by Koop and Clinton, but this time placing kids on the battlefield.
By 2013, Obama was putting the responsibility for childhood obesity even more squarely on parents:
When it comes to the health of our kids, no one has a greater impact than each of us do as parents. [ . . . ] Research shows that kids who have at least one obese parent are more than twice as likely to be obese as adults. So as much as we might plead with our kids to “do as I say, and not as I do,” we know that we can’t lie around on the couch eating French fries and candy bars and expect our kids to eat carrots and run around the block.
The “Let’s Move” campaign often portrayed the physical activity part of fighting obesity as fun; Obama hosted dance parties at public schools and went on TV for a push-up contest with Ellen DeGeneres and to dance with Big Bird. Nutrition activists were frustrated that Obama often seemed more interested in dance parties than in holding large food corporations to higher standards. “‘Move more’ is not politically loaded. ‘Eat less’ is,” wrote Marion Nestle, PhD, a professor of nutrition, food studies, and public health at New York University in a 2011 blog post. “Everyone loves to promote physical activity. Trying to get the food industry to budge on product formulations and marketing to kids is an uphill battle that confronts intense, highly paid lobbying.”
Meanwhile, although anti-hunger activists mostly supported Obama’s goals of reforming school lunch programs, there was some quiet resignation in that community that she had chosen to focus on childhood obesity, which accounted for 19.7 percent of kids aged six to seventeen when Barack Obama was elected in 2008, instead of food insecurity, which was arguably the bigger issue, impacting 21 percent of all American households with children. But the relationship between hunger and fatness has long been fraught with stigma: In the early 2000s, conservatives began to argue that the United States Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps) and other federal food programs should be abolished because, they claimed, poor Americans couldn’t be hungry when so many of them were fat. “We’re Feeding the Poor as if They’re Starving,” ran the headline of a 2002 Washington Post column by Douglas Besharov, director of the American Enterprise Institute’s Social and Individual Responsibility Project. “Today the central nutritional problem facing the poor [ . . . ] is not too little food, but too much of the wrong food,” he wrote.
In fact, as we’ll see in Chapter 3, it’s possible to be both fat and not eating nearly enough food. But rather than clarify this misconception, anti-hunger organizations, pediatric health, and nutrition organizations, as well as journalists like Michael Pollan and Eric Schlosser, and public health researchers like Nestle, set out to document how our modern “toxic food environment” represented an immediate threat to the health of all children. Very quickly, fighting childhood obesity became a progressive cause deeply intertwined with protecting SNAP and other social safety net programs. But when Obama had to pitch a legislative agenda, she needed to pick an issue that would spark outrage among liberals and conservatives alike. And framing kids’ weight as a matter of good parenting and personal responsibility was easier to sell across the aisle. “I do think the administration cared about fighting hunger, but it’s definitely not what they led with,” one anti-hunger advocate told me. “I’m not sure what political calculations they made around that. Part of it is that I think people just have a really hard time understanding the intersection of obesity and hunger.”
Obama did talk openly about the fact that poor children of color tended to weigh more than wealthier white children. But by zeroing in on their weight, she steered the conversation away from dismantling oppression or shoring up social safety net programs. Instead, Obama championed an in-depth overhaul of school nutrition standards, which culminated in the Healthy, Hunger-Free Kids Act of 2010. That piece of legislation is now hailed as a centerpiece of Obama’s progressive legacy; it’s the reason you see whole grains on school lunch menus and fewer vending machines in schools. It also expanded after-school programs’ supper offerings around the country and brought free school lunch and breakfast to over thirty thousand schools nationwide, both of which were huge wins for the anti-hunger community. But what progressives discuss less often is the fact that those school initiatives were paid for by pulling funds from SNAP, ending a temporary increase in food stamp funding five months earlier than expected. The original bill took money from a different pot, but when the Senate Committee on Agriculture, Nutrition, and Forestry marked up the bill, they quietly shifted the funding source. Money that low-income families had been using to pay for dinner now covered their kids’ tab for lunch.
Over a decade later, the question of the Healthy, Hunger-Free Kids Act funding is still a sore spot with many food and hunger activists, all of whom declined to go on record to discuss what happened. “We believe that kids deserve the healthiest meals possible. There are lots of good things in that act, but paying for it through SNAP just didn’t make any sense to us,” an anti-hunger activist who worked on the bill told me. Indeed, over 50 percent of SNAP recipients are children, and several studies have shown that when you cut a household’s food budget, the nutritional quality of family meals drops fast. Anti-hunger groups lobbied Democrats to block votes on the bill for several months, leading to bitter disagreements with the child nutrition organizations they had previously considered allies. The anti-hunger groups worried about families falling off a financial cliff, but the nutrition groups were focused on achieving their nutrition standards overhaul. “An additional five months of the temporary increase in SNAP funding is a price worth paying for a lifetime of reforms and ten years of resources to address childhood hunger and obesity,” argued Margo Wootan, who was then director of nutrition policy at the Center for Science in the Public Interest, in a piece by TheHill.com. “This bill wasn’t a Sophie’s Choice. It was more like choosing between your child and your pet fish. Like the temporary increase in SNAP funding, goldfish never live long anyway.”
However Michelle Obama herself felt about the funding decision, the Obama administration sided with the nutrition advocates to get the bill passed. And it’s clear that Obama’s own passion for nutrition and health meant she viewed dieting as a necessary evil for both parents and kids. “I have to tell you, this new routine was not very popular at first,” Obama told the parenting bloggers in 2016. “I still remember how the girls would sit at the kitchen table and I’d sort out their lunches, and they would sit with their little sorry apple slices and their cheese sticks. [ . . . ] They’d have these sad little faces. They would speak longingly of their beloved snack foods that were no longer in our pantry.” Obama also spoke longingly of her own beloved, banned foods: “I could live on French fries,” she told the New York Times in 2009, explaining that she doesn’t because “I have hips.” Instead, she follows a strict diet and exercise routine.
I want to stop here and note just how much scrutiny Obama has faced personally about her body size and shape. In her latest book, The Light We Carry, she talks about becoming aware of her “differentness” as a tall Black woman when attending Princeton, and that experience only intensified during her husband’s first presidential campaign and throughout their time in the White House. I remember watching her wave on television from some early campaign stop and noticing that her upper arms jiggled a little; a few months later, the jiggling had stopped, and it seemed like everyone was talking about Obama’s sheath dresses and toned biceps, which were nicknamed “Thunder” and “Lightning” by New York Times columnist David Brooks, who thought she should “cover up.” And much of the public discourse about Obama’s body was racialized, because she was our first Black First Lady and therefore was in a position “to present to the world an African-American woman who is well educated, hardworking, a good mother, and married,” noted the feminist historian Amy Erdman Farrell, PhD, in Fat Shame. Obama’s job was to reject the mammy, the welfare queen, and every other derogatory stereotype about Black women, and thinness was a part of how she did that. Depriving her kids and herself of French fries was “an ideological lesson, teaching the girls how to survive in a world that will scrutinize their bodies unmercifully for signs of inferiority and primitivism,” writes Farrell. “Fatness is one of those signs, this lesson teaches, one too dangerous to evoke.”
It’s impossible to say how conscious Obama was (or is now) of the potential downsides of taking such a restrictive, even authoritarian, approach to food for herself and her children. She acknowledges in The Light We Carry that her “fearful mind” “hates how I look, all the time and no matter what,” and recalls envying smaller girls like the cheerleaders at her high school: “Some of those girls were approximately the size of one of my legs.” But she also makes frequent casual references to the joys of vigorous exercise and bonding with friends through “spa weekends” that include a punitive schedule of three workouts a day. And while she argues that the way out of anxiety and fear is to celebrate our differentness as a strength, Obama never names a larger body as one of hers.
In terms of her public agenda, it’s worth noting that her speeches also frequently included disclaimers that “this isn’t about how kids look, it’s about how kids feel.” But her office ignored the lobbying efforts of fat activists and even mainstream child nutrition experts like Ellyn Satter, a therapist and nutritionist who developed the “Division of Responsibility” framework for feeding children that we’ll discuss in Part 2. “Don’t talk about childhood obesity,” she implored in an open letter to Obama. “Research shows that children who are labeled overweight or obese feel flawed in every way—not smart, not physically capable, and not worthy. [ . . . ] Such labeling is not only counterproductive, it’s also unnecessary.”
Satter also wrote an opinion piece for the New York Times, which ran alongside several other critiques of “Let’s Move,” including one from Alwyn Cohall, MD, a professor of sociomedical sciences at Columbia University and director of the Harlem Health Promotion Center, who argued, “Public health interventions that address the real reasons why people gain weight and suffer from chronic diseases will not ostracize or discriminate because they are not focused on the surface level symptoms, but rather on the more profound reasons why they occur.”
Obama never appears to have addressed this criticism directly, though she did begin to add lines like “I don’t want our children to be weight-obsessed,” to her public talking points and in her 2021 Netflix show Waffles + Mochi, she takes the focus off weight entirely to instead teach kids how to have fun trying new foods (mostly vegetables). But the “Let’s Move” rhetoric around parents taking responsibility for their kids’ weight tied in nicely with our larger cultural narrative of weight as a matter of personal choice. And the way she downgraded herself as a mom when Malia’s weight became a problem made Obama relatable to other mothers taught to judge themselves by this same standard.
Today’s generation of parents grew up embedded within the war on childhood obesity. Some of us were its direct victims, like Anamarie, Colleen, and Elena. The rest of us represent a kind of collateral damage— even if we were thin kids, even if we didn’t feel pressure to diet ourselves, we still internalized its key lessons: Fat people can never be healthy. Fat people can never be happy. Fat children are less lovable. And parents, especially mothers, of fat children, are doing something wrong unless they are fighting that fatness relentlessly with apples, cheese sticks, and a “take no prisoners” mindset. “To her mother, she is beautiful,” Lisa Belkin wrote of four-year-old Anamarie in the 2001 the New York Times Magazine piece, before hastening to add that “Martinez-Regino is not so blind that she does not see what others see.”
Reading that, I paused to consider how much harm happens when parents must define their children, and their own parental success, by body size in this way. What was lost, in those three months of forced separation but also throughout Anamarie’s childhood, and Colleen’s, and Elena’s, and those of so many others? What if Anamarie’s mom had just been allowed to see her child, and love her for who she was? What if all parents got to do that with and for our kids?
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