Anti-obesity campaigns are counterproductive, according to Kathy Kater, a psychotherapist specializing in eating disorders. She thinks the focus should be on good health, not on size.
Kater, who will address parents, teens and health care workers at Temple Emanuel of South Hills, Monday, March 24, as part of its Jacob’s Ladder Fund, has been making it her mission to combat weight stigmatization since the 1990s. That’s when she was shocked to discover that even little girls are fixated on being thin.
Kater got her dose of reality one day when her daughter, then in the fourth grade, asked why her playmate Callie would call herself “fat” and want to go on a diet.
“She was genuinely confused; I remember this vividly,” Kater said. “I was just stunned that this would be something my daughter would encounter at such an early age.”
This premature exchange about body image reminded Kater of her own friend, Joanne — one of “the skinniest girls in the class” — who, in seventh grade, announced that she needed to go on a diet.
“As the weeks and months went by, I wondered, ‘If Joanne thinks she’s fat, what about me?’ ” Kater recalled. “I spent years of feeling fat, and thinking I needed to go on a diet.”
This, despite the fact that Kater was healthy.
So Kater decided to see how she could help prevent children from being preoccupied with thinness before they even hit puberty.
Kater went to the health director of her school district and made her case for the importance of teaching children, that weight and size is not necessarily commensurate with good health, and that comparing one’s body to that of others actually can be harmful.
The health director agreed, but there was one problem: such a curriculum for the pre-pubescent crowd didn’t exist.
So, Kater created her own. Today, “Healthy Bodies; Teaching Kids What They Need to Know” (formerly “Healthy Body Image”) is in its third edition, and has been used by schools, health professionals and treatment facilities around the country.
Kater is particularly concerned with society’s current emphasis on obesity prevention.
“There is a growing movement of people who are both practitioners, like myself, and researchers, realizing the problems inherent in promoting size prevention,” she said. “Instead of promoting behavior, they are eliciting profiling based on size, which leads to bias. When we start talking about it with the language of size prevention, there is a bias of weight stigma, and that causes more problems, and causes the problems to be worse.”
Kater is part of a group of about 20 individuals nationwide who have been tapped as “weight stigma prevention stakeholders.” The group is providing feedback to First Lady Michelle Obama’s “Let’s Move” campaign, whose mission is to solve the “problem of obesity within a generation,” according to letsmove.gov.
“We are providing feedback to the ‘Let’s Move’ team about how their messaging could be changed to keep the good stuff and eliminate the language that leads to weight stigma,” Kater said.
For 35 years, Kater has been treating the spectrum of body image disorders. She is keenly aware of the potential dangers of anti-obesity campaigns, including what she believes is an unhelpful focus on BMI (Body Mass Index), and “alarming headlines.”
In 1998, former U.S. Surgeon General C. Everett Koop declared a “war on obesity”; by 2002, newspaper and magazine headlines stigmatizing obesity increased 1,000-fold, Kater said. But instead of helping to combat obesity, the campaign had the opposite effect.
“We saw simultaneously a 66 percent rise in weight descrimination,” she said.
There are many professionals who believe that, in some cases, a stigma is necessary to prevent obesity, Kater said, but studies have shown that to be false.
“Most people in fat bodies know that the outside world is looking at them and making assumptions that aren’t very nice,” she said. “Even if you engage in positive eating and fitness habits the culture will still look at you like that. So you will say, ‘why bother?’ ”
For most people, the biggest motivator for healthy eating and fitness habits is aesthetic, and if a certain look cannot be achieved because of genetics or other reasons, they often throw in the towel.
“People will say, ‘I did all the right things, eating well and exercising, and getting fit, and all I get is health?’ When we feel that way, it is a recipe for becoming complacent,” she said.
While she finds anti-obesity campaigns to be unhelpful, Kater stressed that her message should not be construed as being pro-obesity.
“Sometimes when people hear that I’m very concerned about the stigmatizing efforts of obesity prevention, they turn that into I’m promoting fatness and just letting people do what they want,” she said. “But that’s not what this is about. It’s about weight neutrality and putting the emphasis and directing our focus on behavior that enhances health in everyone regardless of size.”
(Toby Tabachnick can be reached at firstname.lastname@example.org.)
Want to go?
What: Kathy Kater
When: Monday, March 24
First session: 4 to 5:30 p.m.
Second session: 7:30 to 9 p.m.
Where: Temple Emanuel of South Hills
1250 Bower Hill Road
Call 412-279-7600 for tickets.