The Children’s Hospital at Westmead is recruiting for its Fast Track to Health Trial. It is a 12 month study looking at the effect of 2 types of low calorie eating plans for children between 13 – 17 years of age. All participants will undergo 4 weeks of a Very Low Calorie Diet (3 – 4 meal replacements such as shakes, soups, bars and one small meal per day). Participants will then follow either a modified alternate day fasting (4:3 plan) or a reduced calorie plan. The website states that the study aims to compare eating plans that have had success with adults, and to assess their effectiveness with adolescents with severe obesity. It also claims both plans are nutritionally balanced to meet the needs of growing adolescents. The Sydney Children’s Hospital are defending their study. However, here are my concerns with this planned trial:

a)    Success
The study aims to replicate eating plans that have provided ‘success with adults.’ Success? What success? As far as I’m aware, there aren’t any.

b)    Nutritionally balanced
The website states that both plans are ‘nutritionally balanced.’ However, food is more than nutrition. Just like health is broader than nutrition.  To simplify food to quantitative measures such as meal replacements and calories is to ignore the qualitative aspects of food in a child’s life. Food is interaction with family, socializing with friends, mental well-being, culture, religion, and so much more. Food, and eating, is vital to everyone. Adolescents are no exception.

c)    Health
The study has a narrow view of health. It focuses on better outcomes to heart health and diabetes, however, there is no regard for deterioration in other areas of health, or the risk of creating additional health problems. Yet there is evidence to support that restrictive eating can lead to metabolic, hormonal and mental health problems (such as poor self esteem and disordered eating).

d)    Children’s rights
Another flaw is the study’s disregard for children’s rights. This year commemorates 30 years since the Convention on the Rights of the Child. It outlines the basic human rights of all children. The four core principles of the Convention are:

•    non-discrimination;
•    devotion to the best interests of the child;
•    the right to life, survival and development; and
•    respect for the views of the child.

In many ways, the study is counterproductive to protecting the rights of children:

•    Discrimination
The study discriminates against larger children. How can it be deemed ethical to put larger body children on a Very Low Calorie Diet, a 4:3 plan or a reduced calorie plan, but not thinner body children, when we know that body size is not the only predictor of heart disease and diabetes? Are we fostering health in all, or judging and punishing children with larger bodies?

•    Best interests
When it comes to larger body adolescents, we are quick to blame food. Yet, there are so many other factors involved. Kids learn to feel guilty for their hunger and anything that they eat. The study will make participants question their right to eat food like their peers and may exacerbate their already poor relationship with food. It will also deteriorate their already poor relationship with their body. If food is an integral part of connecting with friends, family and the community, how is restricting food in the best interests of the child?

•    Development
How does restricting children of food help them to develop self-respect, teach them to nurture their body, and give them a sense of pride, dignity and empowerment in their physical and mental development?

•    Respect
Children will be pressured to go into the study because society has already labelled their bodies as a problem. Participants are voiceless before entering the study and even more powerless during the length of the study. Its way to ‘fix’ larger body adolescents is to ignore other factors, reinforce their doubts about their bodies and eating habits, persuade them to ignore their innate body cues, and to rein in on their eating.

Will the affect of starving our teens be … satiating harm?

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