Late last year, actress Ginnifer Goodwin, 32, made headlines after revealing she joined Weight Watchers when she was 9. Though critics said she was too young to diet, Goodwin defended herself and the program: "I went to weekly meetings, got counseling, and would exercise with my peers who were my size," she told People magazine. "It was the first time I saw a proper children's portion size, and it wasn't two burgers, it was one."
Indeed, children as young as six and eight hate their thighs, bemoan their chubby bellies, and long for leaner legs. Nearly half of boys and girls in grades three to six want to be thinner, research suggests, and about 37 percent have already dieted. Often, they’re spurred by mocking at school or parents who push weight-awareness at an early age.
"Fat has become the boogieman of our time," says British Columbia-based eating-disorder counselor Sandra Friedman, author of When Girls Feel Fat: Helping Girls Through Adolescence. "Kids are counting calories before they even have any idea what a calorie is."
Most pediatricians plot a child's body mass index on a growth chart, starting at birth, because of the health consequences of weighing either too little or too much, says Seema Kumar, a pediatric endocrinologist at the Mayo Clinic. Obesity in childhood, for example, is linked to diabetes, heart disease, hypertension, asthma, and sleep disorders. Those kids, Kumar says, are typically directed to approaches like supervised diets, behavior modification, and intensive exercise.
But if health isn't an issue, most experts warn that the word "diet" shouldn't be used with children or teens; the emotional and physical consequences are too risky. In one study, researchers asked normal-weight middle school students if they intended to diet in the future—and when they followed up a few years later, those who had said "yes" weighed more than the non-dieters did. "The act of dieting, for the most part, leads to further weight problems," says registered dietitian Melinda Johnson, a lecturer in the nutrition program at Arizona State University. "It's not appropriate for the vast majority of kids to go on a weight-loss diet."
Dieting in childhood can lead to physical problems that may prove difficult to reverse, even years later. One of the most common issues is vitamin and nutritional deficiencies. Stunted growth, delayed puberty, and osteoporosis become real concerns when kids follow restrictive diets that don't meet their nutritional needs. Bones grow rapidly during childhood, for example, typically reaching peak mass by age 20. Kids who skimp on calcium are inviting brittle bones that break easily.
For children, almost every dieting approach can be problematic:
- If it supplies too few calories, even a balanced diet can stunt growth and development; for girls, that could mean delaying or temporarily stopping menstruation.
- A diet that skimps on protein may hamper muscle growth, while too little fat can block absorption of vitamins A, D, E, and K, says Melina Jampolis, a physician and nutrition specialist in California.
- Underweight children with a low percentage of body fat may have weakened immune systems, leading to more frequent and persistent illnesses.
- Low-carb diets discourage foods like potatoes, which provide iron, potassium, B vitamins, and vitamin C—all essential for the body to work at its maximum ability. And some studies suggest that low-carb diets may affect learning, concentration, and school performance, since carbs provide energy and help people think clearly.
- Early dieting can also promote chronic body image problems, yo-yo dieting, and eating disorders. Anorexia or bulimia can both stunt growth and cause serious illness, even death. What's more, nutrition experts worry that restrictive or fad diets don't teach children healthy eating skills they can rely on for a lifetime. "They're not learning how to integrate healthy foods into their daily menu," Johnson says. "They're just going on a diet, and when they go off it, they're going to return to their original eating patterns."
Some popular commercial diet programs exclude kids. Weight Watchers no longer accepts children under 10, and older children up to age 16 need a doctor's referral before being considered. "The methods deemed most appropriate for adults cannot simply be assumed to be appropriate for all children," chief scientist and global director Karen Miller Kovach has written in program materials. "I challenge anyone who currently says they have a safe and effective weight-loss program for children to back up their claims with long-term data." Nutrisystem is off-limits to anyone under 18, and Slim-Fast products are intended only for those 18 and over. Jenny Craig dieters must be at least 13.
The most effective way to keep children at a healthy weight, say experts, is to adopt a whole-family approach that emphasizes a balanced diet and adequate calories. Rather than focusing on cutting calories, the emphasis should be on improving diet quality and making modest changes that can make a big difference—choosing water or nonfat milk in lieu of soda and juice, say, and eliminating processed foods. Sometimes that equals fewer calories, but that's not really the point. It's about improving the quality of those calories. Fruits, vegetables, whole grains, and non-fat dairy should always be central, with room for the occasional splurge. And physical activity is a must, whether it's joining the soccer team or simply playing in the backyard. "Children need to be taught what to eat for life," says Sarah Krieger, a registered dietician and spokeswoman for the American Dietetic Association. "These are lifelong habits we're teaching them, and we want to avoid lifelong dieters."