Since the app's launch, however, there has been a huge outcry from dietitians, therapists and eating disorder experts. As of now, more than 111,000 people have signed a Change.org petition asking for the app’s removal, and protesters gathered outside WW headquarters in New York on Friday.
Kurbo is really just the latest (and very concerning) example of America’s lack of understanding about dieting.
In truth, however, Kurbo is really just the latest (and very concerning) example of America’s lack of understanding about dieting. The fact that this app features children makes it especially cruel, as it could put kids at risk for developing life-threatening eating disorders, body image dissatisfaction as well as potentially interrupt their growth and development.
Americans have spent over $72 billion a year on dieting and weight loss products, yet dieting is largely unsuccessful. The failure of diets is part of what drives the economics of the industry’s success; people need to keep coming back for a different strategy. A 2016 report by the American Academy of Pediatrics concluded that dieting is “counterproductive” and increases the risk of developing an eating disorder. A study of nearly 17,000 children, ages 9-14, found that dieting was a significant predictor of weight gain and led to increased rates of binge eating in both girls and boys. Additional studies show that the more a person diets, the more weight they gain over time.
“Eating disorders always start with a diet,” Marcia Herrin, a registered dietitian, fellow for the Academy of Eating Disorders and author of “The Parent's Guide to Eating Disorders and Nutrition Counseling in the Treatment of Eating Disorders,” said. “And of course the kids that are really going to take to Kurbo are those at risk for an eating disorder,” she added.
In a large prospective cohort study conducted in Australia over three years that included 14- to 15-year-olds, those who severely restricted their caloric intake and skipped meals were 18 times more likely to develop an eating disorder when compared to those who did not diet; those who dieted at a moderate level had a fivefold increased risk.
Failed diets inevitability lead to agonizing weight cycling (the process of going on a diet, losing weight, regaining the weight and sometimes more). When kids (or adults) lose weight, they are praised by society and the underlying message is, “you look better this way, not at the higher weight.” But since diets are likely to fail, kids are left feeling disgraced and ashamed that they couldn’t succeed. The pediatrician may even lament a “large jump in weight,” adding to the pressure that they should try again. Given the cyclical nature of many diets, some have even wondered if WW is cynically trying to expand its reach in order to make kids lifelong clients.
The way the app works is that it categorizes foods as red (“stop and think”), yellow (“watch portions”) and green (“eat lots of”) in an attempt to guide children into making informed decisions around food. This may seem benign and kid-friendly, but polarizing foods, and in random amounts, as “good” or “bad” instills fear and distrust.
This approach disconnects a child from their innate ability to self-regulate their appetite using their hunger and satiety cues, and creates confusion. For example milk, which is high in calcium, is classified as a “yellow” food in the app, a baked chicken sandwich is red and chia seeds, which are high in omega 3 fatty acids and known to be heart healthy and good for the brain, are also red.
The app also stamps certain foods as yellow, but as portions increase, those foods become red. Yet there is no easy customization for age and size here. Why wouldn’t an older, larger-bodied teen be allotted more volume? If a 15-year-old was using the same portion guidelines as an 8-year-old, one could imagine that the 15-year-old would likely get hungry and perhaps even binge eat later in the day, once again increasing feelings of failure and guilt.
This approach disconnects a child from their innate ability to self-regulate their appetite using their hunger and satiety cues, and creates confusion.
“Having an app tell you what to eat is dangerous (and stupid) when we know that food plans should be individualized,” Herrin says, who is also a clinical assistant professor of pediatrics for the Dartmouth Geisel School of Medicine.
Eager-to-be-successful kids might aim for plates that consisted of only “green foods,” which according to Kurbo, are just fruits and vegetables. Yet if the plate were filled with all green all the time, a significant and dangerous caloric reduction would result, not to mention a protein deficiency (chicken, fish, tofu, beans are yellow foods and red meat is a red food).
Adolescence leads to natural increases in height, weight and bone density, and to increases in the size of all the major organs, like the brain and heart; as a result, nutritional requirements increase dramatically during this time. A caloric deprivation of any kind not only could effect the full trajectory of growth and pubertal development, but could also increase incidences of depression and anxiety; cause poor concentration, irritability or poor sleep; effect menstrual status; predispose someone to injuries; and reduce sports performance. In other words, it could be very debilitating.
“Children and teens that diet — even if only temporarily — lack energy and show less interest for learning, which in return affects cognitive development and academic performance. The emotional and physical consequences of dieting and food restriction are too risky in this age group,” said Dr. Susanne Martin, who is double boarded in adolescent medicine and internal medicine and is the medical director of the Healthy Teen Project, an eating disorder treatment center for adolescents in San Francisco and Los Altos, California.
This is not to say that kids shouldn’t be taught healthy eating habits. But they need to be educated in ways that take into account their body’s innate wisdom. “Calories or food shame should be no part of the family dialogue,” says registered dietitian Rebecca Scritchfield, the author of “Body Kindness.” An intuitive based eating program, or a connected eating style approach, as described in books for teens like “No Weigh! A Teen’s Guide to Body Image, Food and Emotional Wisdom,” helps kids identify manageable hunger, "deciding from the inside" what they would like to eat, and helps them to stop when they feel full.
“It takes time and many positive conversations and efforts to support children’s healthy habits and reassure your child and yourself that weight is not the focus of concern in your house. It’s well being,” Scritchfield said.
Working with kids of all sizes to navigate emotions, stress, maintain good sleep schedules, reduce screen time usage, include joyful movement, establish regular and consistent meal patterns that include family meals, and eat intuitively are all strategies that can help kids typically feel their best.
Note: This has nothing to do with dieting. Teaching kids that all bodies are good bodies allows kids to grow up more peacefully with their body. Embracing body diversity and size acceptance — and meaning it — sends the message that your child will be accepted independent of body size or shape.
Whatever the motivation behind the WW app, it seems likely to do more harm than good. Kids do not need to hear that there is a right and wrong way to look, that diets offer a successful solution or that restricting food amounts and types is the primary response to any body dissatisfaction. By adding to this chorus, Kurbo Health has done little to help teens and has opened another door into the development of eating disorders.