You may have heard about the drug trial of giving obese pregnant women the drub Metaformin to see if it keeps babies from being obese. Or something. I had a lot of trouble finding clear information about how and why this is supposed to work but I think I’ve got enough to talk about this.
According to Pharmaceutical National News:
Women who are overweight give growing babies too much food and, as a result, both can experiences subsequent health issues. Those involved in the metformin research trial will examine whether the drug can control these food transfer levels.
What with the who now? I’m definitely not an expert in this but that’s not how I remember infant nourishment working. So I googled “How do a fetus get fed?” The answer from http://www.laboroflove.com was:
While the baby is in the womb he receives his food and nutrients from his mother. The baby is connected to the placenta by the umbilical cord. This cord carries nutrients straight to the baby and nourishes him for the time he is in the womb.
That’s what I remember – the baby eats what the mother eats. So when they say “Women who are overweight give growing babies too much food” does that mean that they assume that every overweight woman overeats? If the problem is that mothers who overeat give their fetuses too much food then, even if the intervention works, it should be prescribed to women who overeat – not women of a certain size. If I’m following this correctly then once again the lazy medicine of substituting weight for health or behavior means that some large women will receive the medication even though they eat normally (ostensibly under-nourishing their fetus?) and some thin women who overeat will not be given the medication, thus exposing their babies to all of the “risk” that this treatment is supposed to solve.
But The Imperfect Parent elaborates:
Metformin reduces blood-sugar levels, which is passed on to the baby
Ok. So this is for women who have high blood sugar levels? Problematically, not all obese women have high blood sugar levels. Once again, if the treatment is indicated for pregnant women with high blood sugar levels, then shouldn’t we be testing their blood sugar instead of their height/weight ratio?
I’m also very concerned about how this will give additional momentum to the trend of putting babies on diets. You read that right. Babies. On. Diets.
Britainny and Sam Labberton were convicted of starving their baby out of fear she would become fat, because her father is fat. After the baby gained only 1 pound in her first two months of life and her bottle was found to contain traces of laxatives they faced criminal mistreatment charges. According to court documents after the infant was placed in foster care and gained weight, her mother’s reaction was, “Oh my God, she’s fat … I have a fat baby.”Hopefully somebody ELSE has a fat baby and this lady has a long jail term.
Parents are putting their kids on low-carb diets, low calorie diets, highly restricted diets, gluten free diets despite no sign of gluten intolerance. They are putting water and skim milk in their baby’s bottles instead of formula. They are electing not to breastfeed because breastfeeding is known to cause weight gain in babies.
We keep hearing that in the last 20 years rates of childhood obesity doubled. Well, between 1999 and 2006 the number of children under 12 years old hospitalized for eating disorders doubled.
Children under 12. Under Twelve. UNDER TWELVE. With Eating Disorders. If we’re going to do the “won’t somebody think of the children” thing then can we please think of these children too?
I’m also concerned that our obsession with childhood thinness (not health, thinness) is not only causing kids to have a lifetime of issues with their own body image and with food, but is also producing a generation of kids who erroneously conflate weight and health and are judgmental and inappropriate and going to end up getting a smack down in this blog someday.
I remember when kids would talk innocently about fat people: “Mommy, that is the fattest lady I’ve ever seen”. Just like a little kid to make a plain true statement. Not a value judgment, just statement. The kid could have just as easily said “Mommy, that flower is blue”.
But now, with Michello Obama encouraging kids to wage war on their fat peers, it seems that the tides may have turned:
A commenter on another post here wrote:
When I was volunteering in my kindergartner’s classroom, and a little boy said, “Your belly is proof that you’ve eaten too many sweets.” The first time was when a kindergarten-age Girl Scout said, “Miss L? I think that when you were young, maybe you didn’t play sports or eat the right kinds of foods.”
The commenter asked me what I would say and my response was “Nope. People just come in different sizes. Just like in nature there are big dogs and little dogs, big cats and little cats, big tress and small trees, there are people who are bigger and people who are smaller. I’m a big person”.
But what I want to say is “Where are you getting this from? Go find whoever told you it was ok to speak to someone like that and bring them to me so that we can have a little come to deity meeting.”
Let’s be honest: Even if the statistic about childhood obesity is true (and there is a lot of controversy about that), nobody knows why. A hundred years from now we could find out that it was due to something in the air and nothing could be done to stop it. We could find ourselves in another ice age and discover that the fat people are the ones who survive. Nobody knows.
So before we start starving babies, maybe we could take a step back and consider the idea that health is both mental and physical. So not only does a Health at Every Size approach of focusing on healthy food and behaviors make a ton more sense than medicating a fetus, it also has the benefit of creating children with a healthy relationship to food, exercise and their bodes. There is plenty of research that shows that starting to diet early and dieting repeatedly can cause irreparable harm and changes to the body. I haven’t seen research on it but I’m going to go out on a limb and say that I think dieting in the womb is just a bad call.
I’ve said it before, I’ll say it again (and again, and again):
Weight and Health are two different things and cannot be freely substituted for one another. Health is multi-dimensional and includes things in our control and things out of our control such as genetics, environment, access, stress and behaviors, and being healthy is not the same as being thin. There are healthy and unhealthy people of every shape and size. Therefore, if you want to be healthy doesn’t it make much more sense to focus on healthy behaviors instead of making our bodies smaller? I say yes, including and especially for children, babies, and fetuses.