Editorial
Does Obesity Prevention Cause Eating Disorders?

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The Importance of Creating Consistent Public Health Messages

Eating disorder and obesity prevention efforts have the potential to be complementary. However, as noted by Neumark-Sztainer,2, 3 we need to reconcile our public health messages. There is general agreement on promoting frequent family meals, enjoyable physical activity, a positive body image, and decreasing media exposure. Below, we address some of the more controversial issues.

There are no Good or Bad Foods, and Everything is OK in Moderation

The message that there are no good or bad foods seems reasonable at first, but this mantra interferes with making real changes to the obesogenic environment. Policies that set nutrition standards for foods sold in schools, nutrition standards for foods companies can market to children, or even foods that should be taxed must first identify the target foods. We believe it is reasonable to call a food “bad” if it predominantly consists of ingredients associated with disease (such as sugar, trans

Children Should Never be Encouraged to Diet

The question of whether obesity prevention leads to dieting, what dieting is, and whether it is a good or bad thing deserves closer attention and clarification. The research on dieting, binge eating, and weight gain has yielded inconsistent results. First, a body of prospective research shows a positive link between dieting and risk for bulimic symptoms and weight gain, and this is cited frequently as evidence against the practice of recommending caloric restriction to overweight youth.1 In

Children are Going to Become Obsessed with What They are Eating

Another construct that is not well understood by the public is overconcern or preoccupation with food and eating. Some worry that removing vending machines from schools or placing calories on restaurant or school menus may lead children to become obsessed with eating only healthy foods. Like other behaviors, vigilance in monitoring food intake occurs on a continuum. Whereas individuals with eating disorders have a preoccupation with food, eating, and calories that interferes with their ability

Trust Internal Cues for Hunger and Satiety

Neumark-Sztainer2 writes that both eating disorder and obesity professionals can agree on the message that people should use internal cues for hunger and satiety. We agree it is desirable to rely on internal hunger and satiety cues, but our current environment drowns out these cues. People may not be intentionally ignoring internal cues as much as they are unable to distinguish them from external cues, such as the amount of food in a serving or television commercials for food. We believe that

Obesity Prevention will Increase Body Dissatisfaction

Body dissatisfaction rates are high; one study found that 40% of 9- to 11-year-old girls are worried they are fat or will become fat. Although disturbing, the truth is that many of them may be right. We must simultaneously encourage children to engage in health-promoting behaviors while also protecting their positive feelings about their bodies. Promoting dietary changes in school or community policies may be less likely to make individual children feel stigmatized or punished.6 Early evidence

Childhood Obesity is the Main Problem

Obesity prevention efforts exist because of the striking increase in childhood obesity; however, the root problem is poor diet and inactivity among American children. We suggest reframing the current public health efforts of obesity prevention into health promotion for all children. This would address one of the key obstacles to implementing new policies—the belief that children who are not overweight do not have to worry about improving eating or activity levels.

Continued open dialogue is

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There are more references available in the full text version of this article.

Cited by (33)

  • Ethical Considerations for Food and Beverage Warnings

    2020, Physiology and Behavior
    Citation Excerpt :

    Body image and disordered eating. Researchers have raised concerns that obesity prevention interventions, including nutrition labeling, could worsen body image and increase risk of disordered eating.30,69,70 One experimental study has examined warnings’ effects on body image.

  • Dr. Kaliebe replies

    2014, Journal of the American Academy of Child and Adolescent Psychiatry
  • Ethical aspects of obesity prevention

    2014, Best Practice and Research: Clinical Gastroenterology
    Citation Excerpt :

    Furthermore concern exists that programs to prevent overweight may increase the risk of eating disorders. Further research is necessary to examine this [22,23]. Negative health effects may also occur indirectly, due to the negative and problem-based focus of prevention programs on overweight which may discourage overweight people to visit health services or to be physically active, or encourage unhealthy weight-loss methods [24].

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This article was reviewed under and accepted by Associate Editor James J. Hudziak, M.D.

Schuyler W. Henderson, M.D., served as assistant editor for this editorial.

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