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A weight-loss app for kids sends the wrong message

Opinion by Holly Thomas

Updated: Sat, 24 Aug 2019 21:38:09 GMT

Source: CNN

Editor's Note: Holly Thomas is a writer and editor based in London. She tweets @HolstaT. The opinions expressed in this commentary are solely those of the author. View more opinion articles on CNN.

The first thing you see when you go to the new WW site is the price. The second, when you scroll down, is your choice of weight loss plans. For all its rebranding as a "wellness" resource, along with claims that the company no longer just focuses on weight loss, WW -- the company formerly known as Weight Watchers -- still makes its priorities very clear.

So when WW recently released a new app -- Kurbo -- for children ages 8-17, its claim that the app aims to help kids "build healthy habits" was already built on shaky ground. But as parents, eating disorder sufferers, dieticians and health care professionals have pointed out since, not only might the app fail to encourage healthy habits, it might actively increase the chance that children will develop destructive and even dangerous behaviors.

This isn't to say that there aren't high levels of obesity among young people in America and elsewhere. But the reasons for this have social and economic roots which run far deeper than individual lifestyle choices. The privilege individuals have to change their lifestyle -- be that buying or preparing different foods, or spending time on exercise, varies hugely, and depends a great deal on their social background, wealth status and where they live. People living in poverty are more likely to become obese for a number of reasons including lack of access to affordable healthy produce and a lack of time and resources for meal planning and other necessary components of a healthy diet. The solutions to these problems are not to be found in an app designed for children and adolescents at an age when they are most emotionally and psychologically vulnerable.

One woman even started a petition to have the app removed. "As somebody who has lived with an eating disorder for 14 years, I was absolutely horrified when I found out about Kurbo," Rachel Egan told me. "Some of the behaviors that Kurbo encourages such as tracking your food intake, categorizing foods as good or bad and compensating for what you have eaten [with exercise] are all behaviors which fueled my anorexia and made it harder for me to recover."

When Kurbo launched, WW tweeted a video of a slim 12-year-old girl, slicing vegetables and talking about how she had been "so tired and so sick," but after using Kurbo, she says "her [running] mile time has dropped by three to four minutes." This video outlines how the app groups foods by color, like a traffic light: red for foods to eat sparingly, yellow for foods to "watch your portions" with, and green for foods to "eat lots of." Other weight-loss apps, like Noom, also use this kind of structure -- but for adults. The Kurbo site features a page of "success stories" -- before and after stories of teens alongside a graphic showing the number of pounds they've lost.

The message is obvious: the larger "before" shot is bad; the thinner "after" shot is good. Thinner is presented as aspirational -- and most sinister of all, "healthy." For Kurbo kids, weight loss and success -- weight loss and health -- are one and the same. The reality for many people is vastly different.

As Natalie Muth, a pediatrician and spokesperson for the American Academy of Pediatrics, told the Atlantic to explain her wariness about Kurbo, "Children are not 'little adults'...Interventions that focus on weight as the main target can trigger disordered eating patterns, low confidence and self-esteem when goals are not met and an unhealthy preoccupation with looking a certain way."

A tragedy of encouraging children to listen to an app, rather than their stomachs, is that it robs them of weight-regulating tools they already had. And while it's up to parents — the ones who have the resources to do so -- to try to ensure their kids' access to good food, regular meals and plenty of exercise, offloading that responsibility onto a weight-loss app administered by non-professionals whose first interest is not in the health of these kids but in the health of its bottom line is quite possibly setting them up for an eating disorder.

"Dieting is a risk factor for eating disorders, and for future weight gain in adulthood," nutritionist and author Pixie Turner told me. "Eating disorders are on the rise, and being diagnosed at younger and younger ages. Children whose parents put them on diets are more likely to have unhealthy attitudes towards food, which can last well into adulthood."

"Babies and children are natural intuitive eaters - when you feed a baby they will suddenly turn their head when they've had enough," explained Turner. "They don't need an app telling them how much is enough food, and yet Kurbo is actively encouraging children to turn away from their body's natural hunger signals to rely on external cues instead, to rely on an app that knows next-to-nothing about that child's life."

The consequence of repeatedly ignoring these signals can be both physiological and psychological. "When children lose that ability they are at higher risk of weight gain in the future, as they aren't easily able to recognize when they're full and so are more likely to overeat," Turner said.

The potential psychological toll of early dieting is evident. But it can also wreak havoc from a physical perspective. It is a developmental necessity for children to put on weight, and to accumulate fat at certain stages. This allows for teens to reach their height potential -- the classic growth spurt -- and is critical for girls to produce enough estrogen to reach menarche. The average age of menarche -- the point at which girls start to menstruate -- is 12-13, but it can occur at any age between 9 and 15. This is almost the exact age range targeted by the Kurbo app.

"Weight gain is a normal part of childhood," said Turner. "In focusing on weight, we are ignoring how complex health is. Health is far more than just a number." Tellingly, not all the reasons Kurbo prompts children to consider for losing weight are even health-related. "The app allows children to state their primary motivation for being on the app is 'making parents happy,' " Turner points out. "That is heartbreaking. Parents should love their children unconditionally, not on the condition that they're thin."

For a fee of $69 per month Kurbo kids can get one-to-one "coaching." According to a statement WW made to HuffPost, Kurbo requires only that coaches do six to eight hours of initial training, followed by three and a half hours of continuing education. Managing children's health -- and especially manipulating their behavior around food and exercise -- is assuming a level of responsibility which would be more appropriate to people who were guaranteed to have specific, qualified expertise.

Now, well-meaning parents might argue that it is because they love their children that they are encouraging them to lose weight. Indeed, it is more likely for a child to be obese than have an eating disorder. According to the US Centers for Disease Control and Prevention, about 18.4% of 6- to 11-year-olds and 20.6% of 12- to 19-year-olds in the US are classified as obese, and a near-constant barrage of media warns of the obesity epidemic.

But -- besides the fact that having a "high" BMI does not disqualify anyone from suffering any form of eating disorder, and a higher weight doesn't automatically connote ill health -- for those who do fear obesity or face ill health because of it, dieting is almost certainly not the answer. Intuitive eating, which could help children learn to listen to their bodies and understand their hunger, would be a much better option. As Christy Harrison, a registered dietician pointed out in the New York Times, a host of studies show that intuitive eating is linked with better health outcomes than dieting.

According to the CDC, between 2013 and 2016, almost half of Americans were on a diet. Yet obesity is rising - standing at nearly 40% of adults in 2015-16. And diets may well be making the situation worse. As Traci Mann, professor of psychology at the University of Minnesota puts it in her 2018 article, "Why do dieters regain weight:" "It appears that weight regain is the typical long-term response to dieting, rather than the exception." She continues: "Calorie deprivation leads to changes in hormones, metabolism,and cognitive/attentional functions that make it difficult to enact the behaviors needed to keep weight off."

A common risk of dieting is weight cycling. Weight cycling -- more commonly referred to as yo-yo dieting -- is the repeated loss and gain of weight as opposed to steady maintenance over time. The Journal of Exercise Science highlights that this actually increases the likelihood of eventual weight gain and heightens the risk of other health complications including cardiovascular disease or type 2 diabetes to a greater extent than remaining at a stable, "obese" BMI.

The focus on dieting—especially with children-- also ignores other factors that might contribute to a person having a higher weight. These include time for parents and caregivers to buy and prepare food, their access to, and education about, nutritious food, or their socioeconomic status. If a parent hasn't got much money or time to spend on preparing the family meal, they're unlikely to opt for vegetable-rich casserole rather than fries, if they know their kids will eat the fries.

Many of the factors which will prove most influential to a child developing a healthy relationship with food will be completely out of that child's hands. But children model what they see. If they notice a parent fretting about weight and food -- and this includes being presented with a weight loss app -- it is likely that they will do the same. This, in turn, is more likely to harm their health than improve it.

In a culture that overwhelmingly stigmatizes fat and celebrates thin, the last thing a child needs is the reinforcement of a message they already hear every day: that losing weight will make them better.

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