August 29, 2019
The announcement of a new smartphone app for children 8-17 from Weight Watchers, called Kurbo, has been met with horror and anger by many in the parent community, advocacy world, and a growing number of professionals who treat eating disorders. This concern has also been felt in the child health and nutrition world more generally. Many in the F.E.A.S.T. community and beyond have asked F.E.A.S.T. for a statement on this app and for our position on weight loss programs for children.
While Weight Watchers has insisted that the Kurbo app is not a diet; children are guided in weight loss as the measure of their health, positive body image, and self esteem. While the company has responded to criticism pointing to the university-based weight loss program, extensive consultation with professionals and children, as well as a promise of internal controls against those with eating disorders using the app, we remain concerned.
The disordered thinking and behaviors promoted, and rewarded, by the Kurbo app and add-on coaching are familiar to our families:
- Labelling individual foods and ingredients as good or bad
- Exercising to compensate for eating
- Unlimited low-calorie foods
- Tracking one’s eating
- Ignoring appetite and satiety
- Fearing weight gain
- Talking online with strangers about food, weight, and appearance
All the points listed above are familiar as targets for intervention during eating disorder treatment: countering these ideas and behaviors are part of successful treatment. Any of the above behaviors would indicate the patient needs more treatment. The app coaches children and their parents in disordered eating.
Our community is expressing outrage and is shaken by the promotion of weight loss dieting in developing children. We believe apps and programs such as Kurbo cannot be made safe and risk enormous harm by encouraging a restrictive and disordered approach to food and a weight-stigmatizing view of health. We believe the evidence supports parents being best placed to decide on their family’s food culture and their children’s activities. The values and prescriptions seen in Kurbo are exactly those we help parents to move away from not only for their children with eating disorders but for all children.
No community could be more aware of and genuinely horrified by children and their peers being encouraged in and coached by adults in disordered thinking and behavior. We see the normalizing of diet culture as both irresponsible and as a toxic influence on all children.
While we know that eating disorders are biologically based brain disorders with genetic predispositions, as yet there is no science to identify who is at risk. Weight alone is not enough to diagnose an eating disorder. Weight alone is not sufficient to diagnose whether a child is metabolically or mentally well.
The American Academy of Pediatricians, among others, recommend against weight-focused interventions and point to lifestyle modifications implemented and modeled by parents as key to sustainable healthy habits for all family members.
The Academy for Eating Disorders also takes the position that clinicians and families can promote healthy behaviors and attitudes by focusing on health promoting lifestyles that are not motivated by or measured by weight.
Our community is speaking with one voice to express how disappointed and angry we are that this app is not only an option on our children’s phones but that professionals in the eating disorder field have sanctioned and consulted on it. We do not understand the motivation or the lack of alarm by those we expect to be the most aware of how to safeguard our children’s lives and health. Eating disorders disable our children and have one of the highest mortalities of any mental illness. We are fighting for a world that prevents those harms, not one that normalizes them.
There are other apps and other dieting programs. We cannot condone any of them, as the science does not support weight loss programs for children. In our community we have learned first-hand and at great cost how important our role as parents and caregivers is to model a family-centered approach to food and health. The evidence does not support children being in charge of and consulting others on what will be served, and on how much to eat. Nutrition advice and feeding are best done by and with parents and caregivers.
An app with the visibility and marketing behind it from one of the largest weight loss marketers in the world presents a danger to our children and their peers. Gamifying weight loss specifically for children presents an innovation of targeted harm that will bear fruit over time, long after the app has stopped being used. The harm cannot be tracked as easily as the Kurbo app counts green, yellow, or red foods. The damage will not be displayed alongside the badges and kudos from this app.
Parents around the world, along with our children, are inundated with messaging and marketing encouraging a negative body image and offering promises to improve it. Often, these messages come with a veneer of medical concern and a dose of moral peril. They are almost always accompanied by a conviction that attractive appearance and low weight are inextricably tied. Our families have taken bold steps to fight that belief in our homes, our communities, and our organizations.
We encourage parents to look into the known medical and psychiatric risks of restrictive eating and compensatory behaviors, including exercise. For those at risk for an eating disorder, the impact of starting that first diet can be life-altering or life-ending. For those without a predisposition, beginning the habit of disordered eating at a young age can lead to lifelong ill health and a lower quality of life.
As parents of those who have experienced an eating disorder, we would not wish that experience on anyone’s children. We will not stand by silently at efforts to risk those harms on others, even if our voices cause discomfort.
It has become clear to our community that a deep divide has developed between those who believe children’s weights can and should be suppressed under certain circumstances, and those who believe this suppression is harmful and risks long-term health problems, including mental illness. Some of the same academic and for-profit organizations that treat eating disorders are also offering treatments for “obesity.” We lack an agreed-upon scientific literature to guide this conversation and we worry that these mixed messages confuse the public.
F.E.A.S.T. calls on those in the treatment and advocacy world of child health to join the conversation and face that worrying ideological divide. If the eating disorder treatment world is unable to find consensus on the issue of marketing diets to children then we are not sure how families can trust the field to make policy or health recommendations more widely. It takes courage to stand up to well-financed marketing and possible funding support. However, if pressure for children to diet is not an issue worth gathering that courage for, we are not sure what would be.
The F.E.A.S.T. Board of Directors
The fact is this app takes a protocol that may have some efficacy in a specific, high-risk population and when used under strict medical supervision, and they've made it accessible and are marketing to children under very different circumstances. It's unconscionable and I believe it's unavoidable that it will lead to great suffering for most users (diets still don't work for most people, and weight cycling is unhealthy) and possibly even death for some children who are genetically vulnerable to eating disorders.
Our 10 year-old daughter began to gradually lose weight after deciding to “eat healthy” and “get fit” which lead to a full-blown case of Anorexia Nervosa by the time she was 11. Nobody saw it coming.
"I cannot adequately express the guilt that parents feel from having allowed their teens to start these diets."
As a psychologist specializing in child and adolescent eating disorders, I stand firmly against the Kurbo app, and any app or program that promotes weight loss in children or teenagers. The best available scientific evidence demonstrates that dieting is, at best, ineffective, and at worst, blatantly harmful. For many children and adolescents who develop eating disorders, their illness was initially triggered by a diet or an attempt at "eating healthy" (which is usually a diet in disguise). For these reasons, I would never encourage a child or adolescent under my care, or any child or adolescent I know, to utilize this app or any other weight-loss product.
As an 11 year old, developing a restrictive anorexia nervosa, if I’d had access to Kurbo, I would have been drawn to it with a magnetic force, and would have quickly become a star user – I would have lost more weight than others, because I would want to do my best (for the eating disorder). I dread to think that this App has appeared at a time when my grandchildren are aged seven to 12 years.
- Guidelines for Childhood Obesity Prevention Programs from the Academy for Eating Disorders
- Preventing Obesity and Eating Disorders in Adolescents from the American Academy for Pediatrics
- Change.org petition: “WW, Remove Children’s Weight Loss App Before Countless Eating Disorders Occur”
- A New Weight Watchers App for Kids Raises Concerns (New York Times)
- Parents, Don’t Let Your Kids Download Kurbo!
- The New York Times: I Help People Recover From Disordered Eating. Don’t Give Your Child This App.
- #WakeUpWeightWatchers website
- National Eating Disorder Association: Statement on Kurbo by WW App
- Your Adolescent Daughter Doesn’t Have a Weight Problem. She’s Going Through Puberty.
- APA Monitor: Losing weight, but not healthy: Eating disorders among people who are overweight or obese often go unrecognized
- Trading Health for a Healthy Weight: The Uncharted Side of Healthy Weights Initiatives