22nd August 2018

To ‘The Healthiest School Challenge’ development & support team, Gemma McCaw, Cory Jane, New Zealand teachers, educators and parents.

We are writing to you express our concerns with the recently launched ”AIA The Healthiest School” challenge. We are healthcare providers working in the field of eating disorders, body image and anxiety around food and bodies. 

We commend and support AIA & Sovereigns interest in health promotion (and extra funding toward sporting equipment) however we believe the risks associated and potential harm caused albeit inadvertently by this program outway the perceived benefits. The Healthiest School competition and its intended us of pedometers by school aged children is problematic for the following reasons:

* Any motivation for children to move their bodies is all externally driven, there is no intrinsic motivation. Is this something that is going to encourage children to engage in health behaviours long term? We predict children will most likely lose interest either before or after the 6 week mark. At best, this competition/initiative  is likely to be ineffective, and at worst extremely harmful.

* This challenge reduces health to a number – and just one aspect of health (exercise) at that. Sending this message to children who are concrete thinkers puts children at risk of disordered thoughts and behaviours around health. This program does not consider a child’s emotional or mental health.

* The use of pedometers encourages children to disconnect from their body, instead relying on technology to tell them how much to move. Furthermore the use of pedometers and other devices measuring steps or energy expenditure teaches children to ignore important intrinsic body signals informing us when to move and when to rest. This ability to rely on internal regulation – a feedback system that is unique to each of us and communicates on the specific needs of our body should be nurtured not stomped on by the repeated silencing of body signals and reliance on external cues for movement and exercise.

* Inititiatives prioritising exercise further reinforce the dominant pedagogy currently used in nutrition and health education to school children – one that is deeply healthist, discriminatory, stigmatising and exclusionary (it is inaccessible for our most economically and socially deprived children, children of ethnic minorities and children living in larger bodies). Programs designed to target childhood obesity, through the promotion of measured energy expenditure and/or intake further reinforce the currently accepted, and incorrect narrative, that the size, shape and weight of our body is a good and accurate representation of our health status and wellbeing – and that deliberate, controlled and measured exercise will attain a body symbolic of “health”.

* This challenge is exclusionary to less physically able, those with health conditions and children with less access to extra opporutnities for movement outside of the school environment.

* The competitive nature of the challenge introduces an opportunity for children to build a self-concept (or view of self) that is rooted in deficit, not measuring up or being “good” enough, or “contributing enough” to the collective effort. School children experience a range of developmental changes both physically and emotionally, including navigation of interpersonal relationships, coping with conflict, bodily changes and development of puberty that are all associated with an increased body preoccupation. We do not need to introduce monitoring and measuring devices that will further encourage engagement in body checking behaviours and potentially facilitate the development of eating and exercise pathologies.

*Self-esteem becomes linked with a number on a pedometer with pride associated with a high step count, however this a case of diminishing returns resulting in children seeking to acquire higher steps than the previous day/week or competition school in ways that do not protect a safe relationship with movement and body. This creates a space for children to develop an antagonistic body relationship, one of guilt, shame and anxiety.

* We have been unable to find any materials associated with the program that offer guidance, advice and tools to assist in the screening of eating disorder behaviours or the predisposing risk factors for the development of an eating disorder, anxiety or obsessive compulsive behaviours – children whom are at most risk of disordered eating/exercise thoughts and behaviours have the potential to be triggered by this program.

* We encourage the inclusion of information and support for teachers to be able to competently recognise harmful behaviours/obsessions in children and outline steps to take after identifying these children in order to access timely intervention and support.

We ask if the possibility of a temporary increase in a child’s physical activity, through an initiative that has not demonstrated an extension into fostering a healthy relationship with exercise or body, worth triggering disordered eating, eating disorders or pathological exercise behaviours in children who may already be susceptible through varying levels of trauma – bodily and/or psychosocial – by inviting an initiative encouraging the use of pedometers/step counting, stigmatisation and discrimination of bodies? 

In permitting this program to go ahead unchallenged, we would be failing in our responsibility to work proactively in Eating Disorder prevention as; providers of eating disorder recovery services, a mother, and size diversity and body liberation advocates. We hope you will reconsider the appropriateness of this initiative in light of the concerns shared here in and we are keen to work with you to modify or redevelop this program should you see value in these concerns and recognise the serious risk of harm.

Many thanks,

Sarah Peck & Jessica Campbell

Eating disorder dietitian, mother- of-3- girls, nutritionist, medical student and size diversity & body liberation advocates.

Sarah Peck is Auckland’s Body Balance Dietitian supporting eating disorder recovery. Sarah specialises in childhood and family nutrition, food flexibility and improving relationships with food and your body.

As a non-diet approach Dietitian Sarah can support you to regain trust in your body through intuitive, mindful eating practices and self-compassion.

Sarah is available for 1:1 consultations and facilitates the in school program “Feeding our Futures” supporting teachers to engage in safe conversations about food and bodies, and the delivery of developmentally appropriate nutrition education in the classroom.

Jessica Campbell BSc PgDip, is a Non-Diet Nutritionist & Medical Student passionate about weight inclusive healthcare practices and Eating Disorder prevention & therapies. 

Jess is a New Zealand based non-diet nutritionist and owner of Body Balance Nutrition, a provider of food and body positive nutrition and dietetic care and eating disorder recovery services New Zealand wide.

Jess is active in the HAES New Zealand working group and co-facilitates the NZ Diet Free Nutrition and Health Professionals online network.