May 9, 2023

Telling It Like It Is

Several years ago, Wellspring received an e-mail from a parent that said:

My child has a BMI at the 92% for her height and age. While this is technically labeled as “at risk for being overweight,” I am very concerned about her happiness and self-image. I am exploring many options currently and would like more information about your program. Thank you.

Is it confusing to you that a child with a BMI at the 92nd percentile for her height and age is called “at risk for being overweight”?

It’s confusing to us. Today, nearly every country employs the same terminology to describe obese and overweight children. Children whose weight and height put them in the 95th percentile BMI (or higher) for their gender and age are classified as obese. Children between the 85th and 95th percentile are classified as overweight.

But in many countries, there is a lingering debate over terminology. Many physicians in the U.S. still use the old American classifications – “overweight” to describe children at or over the 95th percentile, and “at-risk of overweight” for children between the 85th and 95th percentile.

Just this week at our Wellspring UK summer camp, campers and families discussed the recent UK government decision to weigh school children, send letters home to parents of overweight children, but to employ the term “very overweight” instead of “obese” for the heaviest category of children.

While the UK’s National Obesity Forum accused the government of being “prissy” and “namby pamby” by avoiding the word obese, the Department of Health perceived “a danger that parents would not react to the information at all if they received a letter containing the word ‘obese’”.

This is the case with many physicians as well. Some studies report doctors are concerned about using the term “obese” or even addressing the issue with families for fear of offending parents and/or the child, thereby reducing the likelihood of weight loss and lifestyle change.

The problem with this fear is that it’s not supported by any research. In fact, research suggests exactly the opposite: the problem is not that we’re using the term “obese,” but rather that physicians and others are not “telling it like it is” to both parents and children. In one recent study, 67% of parents of obese children report that their physicians have never raised their child’s weight as an issue.

Behavioral change cannot occur unless and until the subject recognizes the need to change and makes the decision to start down a different path. As a result, Wellspring supports any initiative that “tells it like it is” with a view to setting the stage for positive behavioral and lifestyle change.

The terminology debate is over, and we should also close the door on other silly debates. For example, as reported on local news in Cincinnati, billboards sponsored by a group called The Center for Closing the Health Gap with messages like “Are we feeding our kids to death?” have been protested by the National Association for Advancement of Fat Awareness saying the billboards will subject overweight children to ridicule and shame.

We couldn’t agree more that the ridicule and shame should stop. But it will only stop by addressing the problem. And this can only begin by telling it like it is.