Shame vs. Guilt in treating obesity…

More on childhood obesity and shaming….this morning I read a post by Jessica Gottlieb and although I agree with her premise  and a “little shame is good”, I was disturbed by the idea of using shame to change behavior.

As a social worker I know “shaming” in childhood can cause many serious problems later in childhood and in life. It is a complex emotion worth ‘unpacking’ as we say in the therapeutic setting.

Jessica said…It starts getting murky when we discuss shame and fat. Do I think that people should be shamed for being fat? As in telling them, “You should be ashamed of yourself.”? Of course not. Do I think that feeling ashamed of yourself is a natural consequence of being very fat? Yes, we all know that to be true. Recently there was an outcry about billboards in Georgia “fat shaming” kids. Anyone sensible can see that they weren’t bringing shame to children, they simply acknowledged the fact that children were feeling ashamed and that one of the many side effects of obesity is that your get ready for it self esteem takes a dive.

via Sometimes Parenting With a Little Shame is a Good Thing | Jessica Gottlieb A Los Angeles Mom.

Strong4Life began a childhood obesity campaign in Georgia earlier this year. Billboards of obese children were part of that campaign. This raised the ire of those who are opposed to “shaming” fat children which they said these billboards did. Strong4Life of course emphatically stated this was not the purpose of their billboard campaign.

This week, I am happy to report that the billboard campaign is taking a new direction and the billboards are being removed. I believe that the current rate of obesity and its longterm health effects on children is a tragedy. Almost anything that helps to educate and prevent this health epidemic should be done. I am not sure that the billboards were entirely shaming and that they gave license to bullying fat children…that is already being done without the billboards.

At the end of January 2012, Leah Segedie, a fitness blogger and founder of Mamavation, sounded the alarm about a childhood obesity campaign in Georgia that was shaming overweight kids. The Strong 4 Life campaign included a series of billboards, print ads, television ads, and social media featuring overweight children. The children talk about the negative social and health impacts of their size, including being excluded and made fun of by classmates.

via Georgias Fat Shaming Child Obesity Billboards Coming Down | Care2 Causes.

In some way “shaming” became the forefront of this Strong4Life  campaign which is not a bad thing since it seems there is some confusion between shaming and being embarrassed or experiencing guilt by one’s own behavior.

There are different forms of shame and in the extreme form shame can be very problematic. There really is no simplistic understanding of shame and what it does to a child who experiences to an extreme.

According to Alen J. Salerian, M.D., psychiatrist and medical director of the Washington, D.C., Psychiatric Center Outpatient Clinic, shame is a complex emotional response that all humans acquire during early development. “It’s a normal feeling about ourselves and our behavior,” he said, “not necessarily a symptom of an illness or pathology. In many situations, it’s abnormal if we don’t experience it.”Embarrassment and shyness, for example, are two forms of shame that seldom cause trouble — unless they’re extreme or long lasting. And humility, another of the forms shame can take, is generally considered socially desirable.But there’s mounting evidence that problems occur when shame or humiliation becomes an integral part of a person’s self-image or sense of self-worth. Over the past two decades, psychologists, psychiatrists and other mental health professionals have reported that abnormal styles of handling shame play an important role in social phobias, eating disorders, domestic violence, substance abuse, road rage, schoolyard and workplace rampages, sexual offenses and a host of other personal and social problems.

“Unlike guilt, which is the feeling of doing something wrong,” she said, “shame is the feeling of being something wrong. When a person experiences shame, they feel ‘there is something basically wrong with me.’”

Making a child feel that there is something inherently wrong with him/her for being fat is not a good thing but helping a child to understand that what he eats is important and there are healthy and unhealthy food choices is a good thing. A guilty feeling when eating large amounts of sugary foods can help a parent and a child.
By removing “shaming” from ways to deal with our children’s unwanted behavior is not disempowering us as parents…rather, it is empowering us if we remain open to learning other ways to deal with what we deem problematic behavior.

Many people are still convinced that smacking or shaming are the only antidotes for preventing antisocial behaviors in children. The suggestion of giving up shaming or smacking is misinterpreted by some as attempts to disempower parents; to turn them into guilt-laden, ineffectual and permissive wimps. Not so. The most effective and healthy boundaries can be set without resorting to violence or shaming. Being strong with children does not mean being harsh, or humiliating.There are alternatives to shaming that are healthier and more effective. Children who are shown consistent boundaries by parents who are able to express their feelings and needs in a trusting and respectful way, grow up with stronger self-worth and social awareness, free of the toxic effects of shame.

via “Good” Children – at What Price? The Secret Cost of Shame – The Natural Child Project.

“Shaming” which makes anyone feel a lack of self worth is not what I believe was the goal of the Strong4Life billboard campaign…it was an acknowledgment of how a fat child may feel embarrassed by his/her weight. He/she may have been shamed by bullies and even his /her parents. Bringing the ill effects of “shaming” into the conversation was plus in my opinion.

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Childhood Obesity…A Tragedy…


 Children, Obesity, Epidemic

Sadly, these words can all be used together to describe the plight of many youngsters today. Nearly every week there is something significant written about the obesity epidemic. It has even been related to child neglect and abuse with some states wondering if morbidly obese children should be put into foster care.

The goal is primary prevention ….prevention that starts with education of parents and preventing children from becoming overweight as infants and continuing to be overweight in childhood on into adulthood.

It has been found in some studies that a high percentage of parents do not realize that overweight children face the same health risks as overweight adults…high cholesterol, high blood pressure, heart disease and diabetes. All of these medical problems have the potential of shortening a person’s life. For some reason the message and myth that a fat baby is a healthy one is still prominent in the minds of many parents and grandparents. Back in the day this was thought to be a truth that was widely accepted. For many years, it has been scientifically known that this is a false belief.

“Obesity is likely going to limit a person’s life expectancy and increase their future health care costs,” she said. “So for us, it was a realization that we need to help parents better understand that childhood obesity does track into adulthood.”

Both parents and nonparents cited parents as the group with the greatest role in preventing childhood obesity. But parents were more likely than nonparents to endorse an “it takes a village” approach to limiting childhood weight gain. About 81 percent of parents supported requiring healthy food choices in areas with vending machines, compared with 77 percent of nonparents. Likewise, 77 percent of parents supported insurance coverage of obesity treatment, compared with 69 percent of non parents.

It is my belief that education beginning in the pre-natal period is where prevention has to begin. A healthy pregnancy and a healthy baby is first…then ongoing education and well baby care is the next step.,0,4311598.story

Here’s what the experts found, with recommendations about exercise for children under the age of five:

— Babies and toddlers spend too much time strapped in car seats and buggies. That should be reduced. Get them out more, and make them walk if they are able and move actively.

— Toddlers should be physically active and allowed to move around freely for at least three hours per day.

— Babies should be active from birth, using activity mats, swimming or through active engagement with another person

 We are currently seeing some efforts to educate parents…there is a current controversial Strong4Life campaign in Georgia to combat childhood obesity. Parent advocates are critical of the billboard and statements of obese children saying that this is a campaign based on shaming overweight children and adolescents. It is also blaming parents for not monitoring what their children eat.

Public Service Announcement on Obesity in Kids

The Strong4Life site offers “Learn,” “Ask” and “Get Started” pages for families, featuring information, resources and tips on exercise, nutrition and losing weight.

My feeling is DO “whatever it takes” to prevent the children of today from having a shorter life expectancy than their  parents.

Bring on the billboards…bring on the controversy…and the arguments…tax sugar loaded products…hold fast food companies accountable for providing healthy choices… go ahead and criticize parents for their own eating habits and the way they feed their kids…if  that’s what it will take to prevent this epidemic from spreading to the next generation…just do it.

Concurrently…develop programs to educate parents and kids to make better food choices from the get go …and if a child is in danger of death from obesity complications then unfortunately Family Services will have intervene to supervise the child’s health care. I am not in favor of taking a child from a family unless it is truly a case of child abuse and neglect with determining factors. But uncontrolled obesity in a child may soon be considered abusive and neglectful.

Nelson TF, Stovitz SD, Thomas M, LaVoi NM, Bauer KW, & Neumark-Sztainer D 2011. Do youth sports prevent pediatric obesity? A systematic review and commentary. Current sports medicine reports, 10 6, 360-70 PMID: 2207139710Share2inShare

via Weighty Matters: After School Sports Increase Junk Food and Total Calorie Consumption.

Kids menus …horrible!


Children’s diets are under the microscope and in my opinion should remain that way for some time. In many ways “we are what we eat” and our kids are what we feed them.

Oh yes… I am guilty of serving and eating “fast food” as well as “convenience foods”. Sometimes a burger from McDonald’s or Kraft’s Mac’n’Cheese just tastes good and fulfills a craving.

I  admit to  “grandparent” guilt when I take my granddaughter to McDonald’s for a “Happy Meal” and when she requests to make a stop at McDonald’s I actually cringe at what I have done to her taste buds.

Somehow, it makes me feel better if when we go out, we actually sit down in a restaurant and have a server…it seems much more relaxing and special. I enjoy sharing and she does too. But at times we fall prey to the Kid’s Menu because it’s just a kid’s kind of moment and the kiddy menu comes with crayons and characters and games printed on it.

And then… this week, I came across a post from Baby Center.

It was a discussion on Kid’s Menus...I was in shock!   Though, I have to say…I have never seen any nutritional info on a kid’s menu… but after reading the discussion from Baby Center…it is pretty obvious why the choice is made not to print this info on the menu. The information could make you sick!

Let’s face it, when we eat out we give up a lot of control…but I will look very carefully at a Kid’s Menu before ever ordering from one in the future.

Here is what was posted on Baby Center….

Outback Steakhouse    Kookaburra Chicken Fingers meal with Aussie Fries 1,030 calories 60 g fat  21 g saturated 2,052 mg sodium Fat equivalent: 12 Frosted Chocolate Fudge Pop-Tarts!

Olive Garden Fettuccini Alfredo kids meal 800 calories 48 g fat  30 g saturated 810 mg sodium Saturated fat equivalent: 1.5 full jars of Nutella!

Applebee’s Grilled Cheese with French fries 1,020 calories 54 g fat  17 g saturated 2,170 mg sodium Calorie equivalent: 400 Cheddar Goldfish Crackers. That’s 1.3 full bags!

via Restaurant kid menus: awesome or awful? | BabyCenter.

Childhood Obesity Diabetes: online discussion

Learn more about childhood obesity and join an online discussion.  This is an epidemic which will cause this generation to live shorter lives than their parents… very sad situation.

Being overweight as a kid not only creates social problems, but also sets the stage for medical problems that can last a lifetime. The concern is a growing one given that more than one third of U.S. children ages 10 to 17 are overweight or obese.

Learn what you can do to help America’s youth trim down and gain healthy habits for life. Join our online Health Chat, from 12 to 1 p.m., Wednesday, July 20, as two experts in pediatric obesity and diabetes discuss “Children, Obesity & Diabetes ¿ Reversing the Trend.”

Dr. Angela Fals, a pediatrician and medical director of Florida Hospital for Children and the Healthy 100 Kids program; and Lauren Adams, a pediatric diabetes educator and endocrine dietitian at Florida Hospital, will address your questions and share their insights.

Dr. Angela Fals is the medical director at Florida Hospital for Children and the Healthy 100 Kids program. A pediatrician who specializes in weight management for children and adolescents, Dr. Fals graduated from Loma Linda University Medical School, in California. Among her specialties is creating weight management programs for families, schools, fitness centers, medical practices and other community organizations.

Lauren Adams is a pediatric diabetes educator and endocrine dietitian at Florida Center for Pediatric Endocrinology, Diabetes and Metabolism. She works with children to help them control blood sugar and make healthy choices. Diagnosed with type 1 diabetes in 1992, Adams runs marathons and is the mother of a healthy baby boy.

via Childhood Obesity Diabetes: Addressing obesity and diabetes in children –