|
    
Working with
Fat Children in Schools
By Michael I.
Loewy, Ph.D.
Illustrations
by Doug Dworkin
From Radiance
Fall 1998
 Sandy
McBrayer, the 1995 national Teacher of the Year, tells of visiting an
elementary school that was proud of its ethnic diversity and the
integration achieved within the school’s social milieu. The principal
walked her to the newly built multipurpose "cafetorium" and
ceremoniously pulled open the doors to reveal children of all colors
eating, talking, and laughing together.
As she entered, a contrasting scene
near the door caught her eye. Separated from the rest of the student
body were two large children who sat at a table eating their lunches in
silence, staring directly ahead. They were not laughing. They were not
talking. They were just bringing their forks to their mouths and down
again, trying to be inconspicuous and to finish quickly. This day, they
were too slow.
As other children finished their meals
and exited the cafetorium, they threw their uneaten food at the two
children. The fat children appeared oblivious as food hit their table
and slid to the floor or hit their hands and fell onto their plates.
They just kept eating and staring directly ahead. They behaved as if
they did not know what was happening or as if this was a normal
occurrence and they expected nobody to intervene.
The ridicule and torment of fat
children by others is a story told again and again by fat children and
by adults who were fat children. What effect does such ridicule—often
accepted and endorsed by society—have on its young victims? How can
educators and counselors intervene to support fat children?
Prejudice and
Its Effects
 The
literature on prejudice reveals that fat children are the target of
ridicule and disgust both by their peers and by the adults in their
lives, such as teachers, counselors, and parents. This is no small
problem in schools: according to the Centers for Disease Control (1994),
21 percent of people ages twelve to nineteen are overweight. As early as
preschool age, children have accepted the stereotypes about and
developed prejudice against fat people. Given the opportunity to play
with fat or thin dolls, all children, even those who could correctly
identify that the fat dolls looked more like them, preferred to play
with thin dolls (Dyrenforth, Freeman & Wooley, 1978; Rothblum,
1992). Given pictures of children who were in a wheelchair, missing a
limb, on crutches, facially disfigured, or obese, most children said
they would least like to play with the fat child (Rothblum, 1993).
By elementary school, children
describe fat children as lazy, sloppy, dirty, stupid, and ugly (Levine,
1987). Fat children are less likely than other children to receive “best
friend” ratings from their classmates (Rothblum, 1992). When shown
silhouettes of fat and thin males and females, nine-year-old children
rated the fat figures as having significantly fewer friends, being less
liked by their parents, doing less well at school, being less content
with their appearance, and wanting to be thinner (Hill & Silver,
1995). A group of six- to ten-year-old boys rated fat children as most
likely to be teased (Staffieri, 1967).
By adolescence, the subjective importance
of physical appearance is particularly great among girls (Wadden &
Stunkard, 1987). A longitudinal study of one thousand high school
students revealed that more than 50 percent of the girls wanted smaller
hips, thighs, or waists. Of ninth-grade girls, 63 percent wanted to lose
weight. This figure rises to 70 percent for tenth- and eleventh-grade
girls (Huenemann, Shapiro, Hampton & Mitchell, 1966). Canning and
Mayer (1966) found lower acceptance rates into prestigious colleges for
fat high school students, compared with average-weight students, even
though the two groups did not differ in high school performance,
academic qualifications, or application rates to colleges.
Teachers and counselors are subject to
the same stereotypes and biases as parents and children. In a study of
more than two hundred teachers, it was found that for such
characteristics as attractiveness, energy level, leadership ability,
self-esteem, and the ability to be socially outgoing, large children are
consistently perceived by teachers more negatively than average-weight
children (Schroer, 1985). In another study of education professionals, a
picture of an average-size teenage girl received higher ratings on
scholarship, while the picture of a fat girl was rated highest on risk
for personal problems and recommendation for psychological referral
(Quinn, 1987). A study of fifty-two mental health professionals
indicated that counselors have the same biases as the general public:
they tend to stereotype fat people negatively and thin people positively
(Loewy, 1994).
Parents have a strong impact on
children’s self-image and self-esteem. One study found that girls were
less likely to receive support from their parents for college education
if they were fatter than average (Crandall, 1991). Controlling for
income, ethnicity, family size, and number of children attending college
did not change the results. Further examination found that reluctance to
pay for large daughters’ educations is a matter of parental choice,
not ability (Crandall, 1995).
According to a 1994 article by Ronald
Kleinman, M.D., chief of the Pediatric Gastroenterology and Nutrition
Unit, Massachusetts General Hospital, and associate professor of
pediatrics at Harvard Medical School, “Many parents are unnecessarily
concerned with their children’s weight. They badger their
high-achieving, happy kids for generally unfounded reasons. We need to
communicate to parents [and other responsible adults] that a fat child
does not have any more medical problems than other children the same
age.”
Parents and educators often project
their dissatisfaction with their own bodies on the children over whom
they have influence. It cannot be stressed enough that adults must deal
with their own negative body image and fear, loathing, and disgust of
fat before they can stop teaching children to hate their bodies.
The cultural obsession with thinness
and the stigma attached to being fat take a toll on the mental health of
large people. Although they show no greater disturbance on conventional
measures of psychopathology, many fat people suffer from poor body image
(Wadden & Stunkard, 1987). Fat people characteristically view their
own bodies as grotesque and loathsome and believe that others view them
with hostility and contempt (Stunkard & Mendelson, 1967). Because
poor body image is an internalization of parental and peer criticism
(Wadden & Stunkard, 1987), only a cultural shift in parental concern
and acceptance of fat children by peers and adults can alleviate fat
children’s internalized self-hatred.
What Is Wrong with Common
Strategies?
Several perceptions encourage
well-meaning parents and teachers to be
concerned with childhood obesity. First, it is commonly believed that
being fat is a health hazard. Second, it is generally accepted that fat
children grow into fat adults (Stunkard & Berkowitz, 1990). Third,
parents don’t want their children to be the target of oppression and
discrimination. Fourth, we know that being fat during adolescence has
important social and economic consequences. For example, large
adolescents and young adults remain single more often and have lower
household incomes in early adult life than their average-weight
counterparts, regardless of their socioeconomic origins and
aptitude-test scores (Gortmaker, Must, Perrin, Sobol & Dietz, 1993).
As a result of these perceptions and
misperceptions, many parents subject their children to commonly
prescribed strategies for weight loss, including caloric restriction,
behavior modification, and commercial weight-loss programs. Most
attempts at weight loss will result in short-term success (Bennett &
Gurin, 1982). Yet current research demonstrates that for many children,
such methods result in increased frustration and lower self-esteem.
What is not generally accepted or
understood is that efforts to control or limit the food intake of
children and adults through diets (or the euphemistic term lifestyle
change) do not work in the long run. There is overwhelming evidence
that obesity is primarily genetically determined (Price et al., 1990;
Stunkard et al., 1986; Stunkard, Harris, Pedersen & McClearn, 1990).
In a study of same-sex, identical and nonidentical twins, estimated
heritability of obesity was 88 percent (Borjeson, 1976). Price, Cadoret,
Stunkard & Troughton (1987) found a strong relationship between body
mass index (BMI) of adoptees and their biological parents, whereas no
relationship was found in the BMI of adoptees and their adoptive
parents.
Research has shown that metabolic rate
has a genetic pattern. The metabolic rate of the four-year-old children
of fat parents was 10 percent lower than the rate of the four-year-old
children of parents who were not fat (Griffiths & Payne, 1976). At
three months of age, the BMIs of infants of lean and obese mothers were
indistinguishable. However, the energy expenditure was more than 20
percent lower in the infants who later became fat (Roberts, Savage,
Coward, Chew & Lucas, 1988). The findings of Ravussin et al. (1988),
who studied energy expenditure among Southwest American Indians,
indicate that, although there was no difference between fat and lean
children in caloric intake, the children of fat parents became fat later
in life.
Fat children, as a group, do not eat
more than average-size children. Withholding or restricting someone else’s
food is the same as starving that person, and it feels the same:
torturous. And when one withholds or restricts one’s own food intake,
we call it a diet. In reality, it is self-starvation.
Several reviews of behavioral and
dietary treatments of obesity have revealed the dismal failure of these
methods (Bennett & Gurin, 1982; Garner & Wooley, 1991; Wadden,
Stunkard & Liebschutz, 1988). Although almost all weight-loss
programs appear to demonstrate moderate success in promoting at least
some short-term weight loss, there is virtually no evidence that
clinically significant weight loss can be maintained over the long term
by the vast majority of people.
The most successful weight-loss
programs studied have incorporated behavior management techniques,
exercise, social influence, longer treatment duration, and continued
therapeutic contact after the end of formal treatment. Although these
strategies have been found to promote greater weight loss and improved
maintenance during the first eighteen months after treatment, long-term
follow-up studies (Garner & Wooley, 1991) show that in time, weight
is gradually regained, with many participants weighing more than they
did before the programs.
For example, in a five-year follow-up
study, Stalonas, Perri & Kerzner (1984) reported that the average
participant had gained 11.9 pounds since the end of treatment, making
him or her 1.49 pounds heavier than when treatment began. Researchers
studying 114 men and 38 women who had successfully completed a
fifteen-week behavioral weight-loss program reported that less than 3
percent maintained their post-treatment weight loss after four years
(Kramer, Jeffery, Forster & Snell, 1989). Weight rebound seems to be
almost as reliable a consequence of treatment as initial weight loss
(Garner & Wooley, 1991).
Not only do such methods fail to
produce lasting results, but there is strong evidence that continued
attempts at dieting result in increased biological resistance to weight
loss. Young people are often advised to lose weight now because it gets
harder to lose as one gets older. However, the earlier one starts this
cycle of losing and regaining, the heavier one will be as an adult.
Teachers, parents, and other
caregivers who lack understanding of the variations in growth patterns
that occur during childhood may do more harm than good. Poor role
modeling and attempts to limit children’s food intake are ineffective
and can even be harmful in dealing with children’s body-size issues
(Ikeda & Naworski, 1992). The more pressure we put on children and
adolescents to conform to the ideal body type, the more we perpetuate
the myth that this ideal can be achieved by everyone. Furthermore, we
are sending children the message that they are damaged and need to
change in order to be acceptable.
In reality, it seems that body weight
is regulated by physiological mechanisms that oppose the displacement of
weight caused by either over- or underfeeding. This concept, known as
“set point,” accounts for the data from human and animal studies
showing that there is a remarkable stability and homeostasis of body
weight over time (Bennett & Gurin, 1982). Set point accounts not
only for the difficulty people have in losing weight, but also for the
extreme difficulty some people have in gaining weight and maintaining
that weight gain.
In essence, as body weight is reduced,
the resting metabolic rate is also reduced. Therefore, it takes
increased restriction of caloric intake to maintain any weight loss.
Furthermore, when food intake is normalized after a period of food
restriction, there is a tendency for energy to be redeposited
preferentially as body fat (Dulloo & Girardier, 1990).
In sum, a small percentage of children
will slim down as they physically mature, and for some very few,
weight-loss programs may have long-term benefits. However, the vast
majority of children and adolescents who attempt to artificially control
their weight will experience failure and frustration, leading to lower
self-esteem.
Recommendations for Supporting
Fat Children
Counselors, psychologists, physicians,
and other experts suggest that a
strategy more beneficial to the social and emotional well-being of fat
children would be to accept them at any size and support them in
building self-esteem and positive body image (Ikeda & Naworski,
1992; Kleinman, 1994; Loewy, 1994/1995). I believe this is possible by
adopting an attitude of admiration, appreciation, and nurturance of fat
children.
Fat children should be admired because
being fat in our society takes tremendous strength. For fat children to
face teasing, rejection, and discrimination on a daily basis and still
thrive takes great strength of character. It is amazing that so many fat
children survive adolescence, given the hatred and meanness directed at
them. Indeed, some do not make it, as evidenced by the fifteen-year-old
high school student in Alabama who shot and killed himself in the
classroom in 1997 because he could no longer take the torment.
To appreciate fat children is to value
the diversity of people and to see fat children as a valid part of that
diversity. When we think of diversity in the classroom, we usually think
in terms of race, ethnicity, and gender. Some of us may include physical
ability and sexual orientation in our view of the diverse classroom. Fat
children often have a unique perspective on life and society. It is
important to validate that perspective and appreciate the richness that
different perspectives bring to the classroom.
Fat children need to be nurtured, not
changed. To nurture a fat child, one must see that child as
indispensable. If we see fat children as indispensable, we will view
them with genuine affection and delight. We will then be willing to
advocate for them, love them, and nurture them just as they are.
Educational materials and instruction
should be free of derogatory representations of fat people. Avoid using
materials with text or illustrations that endorse negative stereotypes
about fat people as lazy, sloppy, stupid, mean, or eating too much.
Material should not depict fat people whose problems are solved because
they lose weight. To the contrary, there should be positive images of
fat people of all ages, both genders, and all ethnicities in educational
materials. Those of us who are educators must demand that the publishers
of educational material provide us with unbiased tools.
Here are some classroom and library
materials that are supportive of fat children:
Am I Fat? Helping Young Children
Accept Differences in Body Size by Joanne
Ikeda and Priscilla Naworski (Santa Cruz, Calif.: ETR Associates,
1992). This is a book designed for teachers, parents, and other
caregivers of children up to age ten, to help them understand the
links among weight, body image, and self-esteem; a practical guide
with ideas for supporting large children and helping them and their
nonfat peers accept the diversity of human appearance. It includes
classroom activities, nutrition guidelines, and recipes. [Call
800-321-4407 to order.]
Are You Too Fat, Ginny?
by Karin Jasper (New York: Is Five Press). Written for young girls,
this small book challenges myths about fatness and dieting in
adolescents and offers the healthy alternative of self-acceptance. It
includes an introduction for parents and teachers.
Belinda’s Bouquet
by Leslea Newman, illustrated by Michael Willhoite (Boston: Alyson
Publications, 1991). A fat girl who is teased about her weight learns
about the beauty of diversity from her best friend and his parents.
This book is appropriate for kids ages four to eight and their
teachers and parents.
Fat Chance
by Leslea Newman (New York: G.P. Putnam Sons, 1994). This book is for
kids ages eight to thirteen. Written in diary form, it approaches the
topics of eating disorders, dieting, and self-esteem. It won the
Parents’ Choice Silver Award for 1994. It tells the story of
thirteen-year-old Judi Beth Liebowitz, who longs to lose weight and
gain popularity and learns about bulimia from her thin best friend.
[Contact the Naafa Book Service for
information at 916-558-6880, or http://naafa.org.]
All children deserve love and respect,
whatever the size of their bodies. By teaching children the value of
respecting fat people, and enforcing that value, we are teaching fat
children to love and respect themselves. We are also teaching
average-size children the importance of embracing and including in their
lives people who are different from them. We who are school personnel
must advocate for all youth, especially those who need our advocacy
most.
 We
do not need to single out fat children or ask them directly if they are
having a problem being fat. Chances are, they are having a problem but
will not trust anyone to be on their side. We need to speak to all
children about our appreciation for fat children. In this way, fat kids
will know that we are approachable, and trust will begin to build. At
the same time, average-size kids are learning an important lesson about
the value of people outside the dominant culture.
Our goal as child educators and child
advocates is to produce healthy children who feel good about themselves.
Let us take the focus off size, food, and eating, and put it back on
health and self-esteem. Our children can only benefit. ©
This article is excerpted with
permission from Michael I. Loewy, 1998. Suggestions for working with fat
children in the schools. Professional School
Counseling 1,4: 18–22. Published by the American School Counselor
Association, 801 North Fairfax Street, Suite 310, Alexandria, Virginia
22314, 800-306-4722, fax: 703-683-1619, e-mail: asca@erols.com,
http://www.schoolcounselor.org.
Due to space limitations, the list of references cited in this article
has not been included. Correspondence concerning this article can be
sent to Michael I. Loewy, Deptartment of Counseling and School
Psychology, San Diego State University, 5500 Campanile Drive, San Diego,
CA 92182-1179, e-mail Loewy@mail.sdsu.edu.
MICHAEL I. LOEWY, Ph.D., is
assistant professor of counseling and school psychology in the College
of Education at San Diego State University, where he teaches
cross-cultural counseling. He completed his Masters and Doctoral degrees
in counseling psychology at the University of California, Santa Barbara.
He currently serves on the Scientific Advisory Board of NAAFA, the
National Association to Advance Fat Acceptance.
back to the Kids Project |
