Erica Kenney, ScD, is an assistant professor at the Harvard T.H. Chan School of Public Health and an awardee of our “Primary and Secondary Prevention of Eating Disorders” pilot grant through our Community Engagement program.
Why did you apply for the pilot grant?
Most of my work focuses on nutrition promotion and a fair amount of it also focuses on childhood obesity prevention. One of the things that cuts across eating disorders and obesity is the issue of weight stigma. I’ve done a couple of fellowships that looked at student weight stigma in school settings and there’s not many funding opportunities in this topic area, so this seemed like a great opportunity.
My degree is also in social and behavioral sciences and I’m interested in the social determinants of health. One of the things that we know about weight is that education is an important determinant of health across all types of outcomes, and is certainly linked with obesity and chronic disease. I think eating disorders, disordered weight control, and obesity come from a similar kind of root problem; they share a lot of their determinants.
When does weight stigma start for children while in school?
We know that teasing can start even among young children. There have been some psychology studies that have found that children as young as four, if you show them pictures of larger bodies versus thinner bodies, they’ll prefer the thinner ones, and they’ll attribute negative adjectives towards something they perceive as fat.
“I think eating disorders, disordered weight control, and obesity come from a similar kind of root problem; they share a lot of their determinants.”
We published a paper a couple of years ago that looked at test scores versus teacher ratings of ability for children based on their body size. What we found was that even as young as fifth grade, if a child gained excess weight over time, their test scores usually would stay stable, but their teacher ratings would drop, so there’s some evidence that it happens, and it happens pretty young.
What about the effect on a child’s education for those who experience weight stigma?
If your educational opportunities are limited because of your weight status then you get into a vicious cycle where when you are discriminated against in your education then you aren’t able to attain as much education, and now you have a poor education, which then worsens your health over time. It’s something I’m interested in and there have been some heartbreaking studies looking at the educational trajectories and economic trajectories, particularly of women in larger bodies as they are more likely to end up in poverty, be unemployed, or earn less.
You mentioned that obesity and disordered eating and weight stigma share a root problem. What do you think that root problem is?
Well, here in the U.S. we have a dysfunctional food system and food culture, especially in terms of the types of foods that are most commonly available, and the kinds of foods that are marketed to us. This then leads to having unhealthy food that is cheap, widely available, and heavily marketed. The marketing is effective in telling you what you should be eating, or this is the fun thing to eat, or the tasty thing to eat, or this is going to make you feel good if you eat this.
Another problem is that we have this culture of personal responsibility and so if you do gain weight from eating these foods we say, “it’s your fault for gaining weight.” In the U.S., we’re not set up to have a healthy attitude toward food, and healthy foods aren’t accessible and affordable for everybody. This then creates an unhealthy system which promotes unhealthy attitudes toward food.
For kids, there’s a flood of excess calories in their diet. It’s become normal to give kids large portions of unhealthy foods. Kids’ meals in restaurants generally are chicken nuggets, or french fries, hot dogs, hamburgers, or pizza. We don’t see these types of foods in other cultures, but in the U.S. we say that it’s fine for kids to eat highly palatable, high sugar, high fat, low fiber, and low nutrient food.
What about this field of research caught your eye?
My undergraduate degree was in education and I started out wanting to be an elementary school teacher. Most of my work, for a long time, was focused on designing educational programs. While I was working in a couple of schools, I would notice what the school kids were being fed, what was available to them, and some of the health problems that they were experiencing. I became more concerned with the health aspect of it than the educational aspect. Not that the education component isn’t unimportant, but it was the health aspect that gripped me. So, I went to get my MPH with the goal of trying to work toward improving child nutrition, especially in school and childcare settings.