Labeling Children

An Associated Press article entitled 'Experts Debate Labeling Children Obese' raises a tough issue faced by professionals who deal with children. How and when do you tell a child that they are overweight? This painful issue raises a larger question of whether adults should consider societal standards at all when talking to a person about their health.

There is an obesity crisis for American youth. 17% of children fall into the category of 'overweight', defined clinically as 'greater than at least 95% of youngsters the same age and gender.' An additional 34% are in the 85th to 94th percentile and deemed to be 'at risk for overweight.'

You mathematical types might recognize the irrationality of these statistics - how can 51% of children fall into a category reserved for the most overweight 15% of their peers? The answer lies in the denominator. Young people today are being compared to statistics established in the 1960's and 70's when children were a lot less obese. By fixing the standards to a time when children were more active, the scope of our cultural problem is revealed. It is only with a slight eyeroll that I write 'this problem is increasing in size.'

If these children were adults, the same categories have different terms. 'At risk of overweight' and 'overweight' are called 'overweight' and 'obese' when physicians talk to adults. We have been reluctant to use these harsher words with young people. However, the American Medical Association (AMA) wants this to change. They say children need to be presented with the facts, just like adults. Other professionals disagree, feeling these labels are more damaging than useful.

I disagree with the AMA. I think they should drop these silly and outdated labels for all ages, children and adults. It is not the label that leads to a healthier person. Change is driven by the will of the individual. It is further encouraged by the ongoing modeling and support of those who care about them. At best, all a label does is bring about a couple of days of frightened exercise and dieting. This is not how people become more healthy.

In the privacy of a doctor's office, individuals must be told when their unique body weight is unhealthy for their unique body size - no label or percentile required. For children, parents must be given strict guidelines for the food their child eats and clear expectations for reduced screen time and increased activity. The focus must shift from meaningless societal labels to meaningful guidelines that are known to support health. Nobody gets thinner by calling them fat. All real and sustainable change begins from within.