Thursday, January 03, 2013

"First Do No Harm" and The Biggest Loser's Children

The Hippocratic oath is the oath physicians either literally or figuratively take when embarking on their careers in medicine. The original of course is rather old and is written in Greek but I found a line from its translation to be especially apropos to The Biggest Loser's inclusion of just barely teenagers on this season's show,
"I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice."
It's the latter part I'm interested in, the "harm", and, "injustice".

So there are 3 children on the Biggest Loser this year. Two 13 year olds and a 16 year old, and before I type anything else I want to make it exceedingly clear - I hope they find the healthy lifestyles that they're looking for through their involvement with the show and that the show's teachings help them to live long, happy, and healthful lives where the only outcomes of being on the show are incredibly, unbelievably and undeniably positive.  I imagine that's what they're hoping.  Probably their concerned parents too.

I just worry that they won't be.

But for a moment let's assume only the very best. That the show's incredibly gentle, ethical and evidence based. That none of the nonsense (both in terms of messaging and in terms of approach) the show typically  throws at their adults trickles down to the kids. That all of the kids lose weight, improve their self-esteem, and develop healthy relationships with food.

I'd still be worrying about the "harm" and "injustice" of their inclusion on a weight loss reality show. Having spoken to more than one adult contestant I know that simply being on the show opens them up to a world of criticism, scrutiny and unbelievable pressure. The kids may well have it worse as their worlds will include the harsh and often exceedingly cruel realities of adolescence.  Given the horror stories the former adult participants have recounted to me about the judgments and comments they experienced with adult strangers and even loved ones directly consequent to their involvement with the show, I shudder to think of the taunts, pressure and pain that the show's children will face as this season progresses, let alone if they, like the vast majority of the show's contestants, regain once it's done.

And most do regain.  According to the multiple Biggest Loser contestants I've spoken with (who keep in touch with one another through private social networks), the show's success rates for long term weight maintenance run from a low guess of 10% to a high guess of 33%.

Which brings me back to the involvement of pediatrician Dr. Joanna Dolgoff. While Dr. Dolgoff and I have publicly disagreed before on the merits of formally putting children on diets, here we're at odds on whether or not putting children on an incredibly popular and heavily watched weight loss reality show is really in the children's best interests. I'd posit that simply being on the Biggest Loser puts these kids, regardless of their short and long term weight loss outcomes, at incredible risk of harm due to the pressures of simply being so completely in the public's eye, an eye which isn't kind to adults, let alone the public eye of young teenagers - an eye that's quite frankly is too often, and in the specific case of weight regularly, dramatically and inherently cruel. Add to that the incredible statistical likelihood of regain and I'd say their involvement represents one hell of an injustice.  Consequently I think Dr. Dolgoff has failed to uphold her seminal obligation to protect her patients.

[If you're appalled by the Biggest Loser's inclusion of children - do something about it.  Visit my blog post from the other day and join the advertiser boycott]

[Stay tuned on Monday (though it may be over on the Psychology Today blog), when I'll be posting some of the thoughts conveyed to me by former Biggest Loser contestants, including at least one winner, on why they're "horrified" by the show's inclusion of children.]