Pierre Dukan is a French diet guru. He thinks that, in their last two years of high school, students should be awarded extra exam marks if they maintain an acceptable Body Mass Index (BMI). He makes no mention of the vast shortcomings of BMI (including that it does not, in any way, measure health). He makes no mention of what would happen to students who are very tall or very muscular who would be punished academically for their strength and height.

He claims that it will be “a good way to sensitise teenagers to the need for a balanced diet.” I think it is just as likely that it will sensitize them to the ability to use dangerous behaviors to try to “make weight”. It’s not like he’s suggesting an education program about a balanced diet (one that, were it evidence-based, would likely denounce the low carb high protein diet that has made Pierre millions.) He doesn’t want to measure kids’ health, or the health of their diet (which would be problematic in and of itself). He wants weigh kids and grade them on their weight. That’s not educational, and it’s not about health, it’s punitively punishing fat kids.

Pierre says that it would not punish fat children: “There is nothing wrong with educating children about nutrition. This will not change anything for those who do not need to lose weight. For the others, it will motivate them.” It sounds an awful like what he’s saying is that it won’t punish thin kids or kids who manage to get thin. Of course it punishes fat kids – that is the point.

Those aren’t my biggest problem with this however. My biggest problem with this is the same as my problem with the Georgia child-shaming billboards and all of the campaigns whose goal is to end “childhood obesity”:

Where is the evidence? Where the frickity fricking frick is the evidence?

Where is the evidence that punishing fat kids with poor grades “motivates” them and makes them healthier or thinner in the short or long term? Where is the longitudinal study with the statistically significant sample, and the controlled variables? What is he basing this on…rectal pull?

Where is the proof that nutrition education leads to kids eating more nutritiously? Where is the proof that eating more nutritiously will make them thin?

Where is the evidence that billboards that shame kids under the guise of making their parents “aware” that they are fat lead to them becoming healthier or thinner? Where are the studies to back up this method?

Where is the evidence that sending home a BMI report card from school will positively affect kid’s health?

Where is the damn evidence?

The current “logic” that we’re working under seems to be “Fatness is such a horrible problem that we can’t stop to prove that it’s a problem or see if our intervention will make things worse before we start solving it!” And that’s just dumb.

I would call this a grand social experiment but it’s not. An experiment would be way better than this. First because they would need to get IRB approval. This might be difficult since they’re messing with the physical and psychological health of kids. But let’s pretend that they get this approval. They would then have to do all the scientific method stuff that’s apparently just too much trouble for these people – form a hypothesis, design an experiment, institute controls, blah blah. It’s just science, how important could it be?

But here’s the kicker: Let’s say the hypothesis was “punishing fat kids with bad grades will make them thin”. (Now, it would probably also behoove them to prove that that making kids thin would cause them to be healthier but that’s a different deal.) At the end of the experiment, they would evaluate the results and if kids didn’t get thin they would say “this intervention doesn’t work. Our hypothesis was wrong.”

But that’s not what happening. Anybody and their French brother can apparently say “I think this will work” and then treat their brainchild as if it’s a proven intervention and foist it onto children. Then when kids don’t get thin they don’t say that the idea failed, they say that the kids failed. And that’s unacceptable. You can file it under T for “Things that are total bullshit”

We need to stop letting people do this to kids, and while we’re at it we could stop doing it to ourselves. There is not a single study of a weight loss method that works for more than a small fraction of participant long term, not one. So when we don’t succeed at losing weight and we blame ourselves, it’s like putting a roast in the microwave and blaming ourselves if it doesn’t brown. If there is absolutely no evidence that something will work (and in fact a mountain of evidence that it won’t) why would we blame ourselves when it doesn’t work for us?

We, and our kids, deserve access to evidence-based health interventions. I believe that the burden of proof is on the person who wants to implement the intervention. First they have to prove that there is a problem, then they have to prove that they can solve it, then they have to be honest about the pros/cons/side effects of the solution. Then, and only then people get to choose if they want the solution. You’ll notice there is no step where someone gets to force other people to implement their best guess of a health strategy. I think if people really cared about kids health, they would take the time to find out what works before risking irreparable physical and psychological harm.

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