Let's Move, Part II

[Trigger warning re: disordered eating and sexual assault.]

Part One is here.

Something else I wanted to point out about First Lady Michelle Obama's "Let's Move" initiative—and I felt it deserves its own, separate, discussion thread—is that there doesn't appear to be any strategy at all for discerning whether the "obese" children being targeted have disordered eating.

The evident assumption is that "obese" children (and I'm putting obese in quotes here because BMI is a crock for kids, too) are fat because of some combination of not having been taught to eat right, not having access to healthy food, not getting enough exercise, etc. And for many kids, this may be true.

For other kids still, who are being ignored by the "Let's Move" initiative, they are fat because of disability, or treatment of disability—many drugs prescribed to treat mental illness, including childhood depression and bipolar disorder, have a side effect of weight gain.

But there are also children who compulsively overeat as an emotional salve. Children (for the most part) cannot access on their own the appropriate tools adults use to process trauma, like therapy.

They can't access inappropriate tools adults use to cope with trauma, either; they don't have access to drugs or booze, but they do have access to food—and children in emotional distress can use food to self-medicate.

Several studies have found associations between childhood sexual trauma and childhood and/or adult obesity, especially in girls and women (example). Even a child thought to be overeating out of "boredom" may really be eating out of loneliness or abandonment.

That we know children may self-medicate with food to fill a void left by neglect or abuse means one of our primary concerns for any "obese" child is the potential that trauma is underlying disordered eating.

To ignore this possibility is to risk subjecting children not merely to the secondary trauma of indifference, but also to deepening wounds, by piling shame about their only coping mechanism on top of the original trauma.