Apparently, “diet” is one of the most incendiary four-letter words in the English language. Just consider the case of “Maggie Goes on a Diet,” a forthcoming book about an overweight 14-year-old.
As the book opens, Maggie is called “fatty” and “chubby” by kids at school. So she decided to do something about it. She didn’t starve herself but switched to eating foods that were “healthy and nutritious” and cut way back on junk food, allowing herself a single “normal-sized treat” once a week. She also started exercising almost every day and later joined a soccer team.
The results? “Losing the weight was not only good for Maggie’s health, Maggie was so much happier and was also very proud of herself.” And: “More and more people were beginning to know Maggie by name. Playing soccer gave Maggie popularity and fame.” (Yes, the book is written in rhyme.)
This all sounds like the kind of sensible advice recommended by experts. And yet on Amazon.com, customers have tagged the book with labels like “teaching kids to self-hate,” “give your children neuroses” and “anorexia bait,” among others.
“The idea of this book makes me want to either cry or scream -- actually both,” wrote a commenter named Adrienne Ressler from Ft. Lauderdale, Fla. “It's bad enough that the messages and images in the cullture have co-opted most women into loathing their bodies, but targeting the insecurities of young girls, vulnerable to the risk of developing an eating disorder, borders on promoting high risk behaviors and attitudes that are destructive both physically and psychologically. Please take this book off the market.” Other commenters (of which there are many) have threatened to boycott Amazon if the online retailer follows through with plans to sell the book, which will be out in October.
One apparent source of their ire is the fact that, although the book is about a 14-year-old, Amazon pegs the reading level at kids between ages 4 and 8. The Barnes & Noble website says the age range for the book is 6 to 12.
“This just isn't right,” wrote a poster with the handle “Alexia561” on a blog called Pen and Paper. “Little girls shouldn't even know what a diet is, much less be encouraged to lose weight!"
Many online critics have also pointed out that the author and self-publisher, Paul M. Kramer, has no expertise in child health (and isn’t exactly slim himself).
Defending himself in an interview on Fox News, Kramer said the book is not aimed at the preschool set. He continued:
“I’m not advocating, never did, that any child should go on a diet. First of all, this is a change of lifestyle. This is not meant to be to go on a diet.”
However, just seconds later, he acknowledged that Maggie did indeed go on a diet, as the title of the book clearly indicates.
Kramer also took issue with critics who said the book sends the message that being thin will make you happy. In Maggie’s case, her source of happiness is the fact that she achieved her goal through hard work. “If one is obese, and one loses a bunch of weight, and one becomes fit, I think the rewards of just accomplishing that is good enough,” he said.
So what do the experts have to say about kids and dieting?
Girls who followed a sensible diet like Maggie’s that focused on eating healthful foods weighed less (as measured by body mass index) than girls who didn’t, according to a study published in June in the journal Archives of Pediatrics and Adolescent Medicine. The study involved 2,327 girls who were tracked for 10 years starting at age 9. Those who most closely followed the DASH (Dietary Approaches to Stop Hypertension) diet had an average body mass index of 24.4 (in the healthy range), while those who veered the most had an average body mass index of 26.3 (which is considered overweight). The DASH diet emphasizes fruits and vegetables, lean meats, low-fat dairy and whole grains and doesn’t include strict portion controls.
In an editorial accompanying the study, two experts wrote that it makes sense for pediatricians to recommend the DASH diet to their patients to combat the “epidemic levels” of childhood obesity. “The law of thermodynamics applies in that, when energy in (dietary intake) exceeds energy out (energy expenditure, including physical activity), weight gain occurs,” they wrote.
Girls who focus on eating less won’t necessarily lose weight. A study published in May in the American Journal of Clinical Nutrition found that kids who switched from whole to low-fat daily foods did not consume fewer calories overall, though they ate and drank less saturated fat and had lower levels of LDL cholesterol (the “bad” kind) after 24 weeks.
Another study published in the June issue of the journal Obesity found that swapping SlimFast shakes for regular meals helped obese teens lose weight in the short-term. But by the end of the year-long study, drinking shakes instead of eating meals did not help them continue or maintain their initial weight loss. The study, conducted by researchers at Children’s Hospital of Philadelphia, included 113 teens whose average age was 15.
The key – as Maggie discovered – is not only to eat healthier foods but to exercise. In a study of 174 obese children between age 8 and 16, those who spent 12 months in an “intensive lifestyle intervention” that focused on exercise and nutrition not only reduced their body mass index, body fat and cholesterol but maintained those gains over two years. The study was published online in February by the journal Pediatrics.