Healthy Bodies (PDF)

A Comprehensive Curriculum for Addressing Body Image, Eating, Fitness, and Weight Concerns in Today’s Challenging Environment HEALTHY BODIES HEALTHY BODIES HEALTHY BODIES HEALTHY BODIES Teaching Kids What They Need to Know Teaching Kids What They Need to Know Teaching Kids What They Need to Know Teaching Kids What They Need to Know Third edition of the former Healthy Body Image curriculum Kathy Kater, LICSW � � � � An evidence-based resource manual with scripted lessons and activities for grades four, five, or six. Adaptable for any age Aligned with National Health Education Standards Evidence-based documentation by Christina Spinetta, Ph.D (ABD)  Healthy Bodies Third Edition of the Healthy Body Image curriculum �2012 by Kathy Kater All rights reserved. Except for perforated handouts in the Appendix, no part of this book may be reprinted or reproduced in any manner without written permission of the publisher. Published in the United States by Body Image Health 2497 7th Avenue East, Suite 109 North St. Paul, MN, 55109 www.bodyimagehealth.org 651 770 2693 Published in association with the National Eating Disorder Association 165 West 46th Street, Suite 402, New York, NY 10036 www.nationaleatingdisorders.org 212-575-6200 Cover photo by Lincoln Fetcher Cover design by Jennie Engelhardt This is a trade paperback, third edition of a three-ring-binder curriculum guide first published by the National Eating Disorders Association in 1998, with a Second Edition in 2005. In this 2012 edition, the lesson objectives remain unchanged, while the entire text and references have been fully updated to reflect the current cultural context and new empirical support for the model. ISBN 978-0-615-70688-7 Disclaimer The information contained in this book is not intended as a substitute for medical or mental health treatment. Information is offered to inform education related to health, eating, physical activity, and weight. Readers and students of this guide are advised to seek care from an appropriately trained health professional for concerns related to a medical condition.  Authoritative support for Healthy Bodies; Teaching Kids What They Need to Know “Kathy Kater's Healthy Bodies curriculum is incredible. . . I have found great benefit using the lesson concepts for both children and adults. This powerful program teaches children the skills they need to manage food and weight successfully for the rest of their lives. The smiles and sense of confidence radiating from children who have had these lessons speak for themselves.” —Karin Kratina, PhD, RD, LD/N, Nutrition Therapist, Author, Speaker; Nutrition Consultant, Eating Disorder Recovery Center, University of Florida "When I want to know how to talk to kids about their health and nutritional well-being, I read what Kathy has to say to them. Her words of wisdom resonate in today's chaotic food environment. Could it be as simple as she says? Yes, it can be. Kathy helps erase the fear and confusion around eating. At the same time, she promotes a positive body image and high self-esteem for all kids. She has seen the results of stigmatizing bodies that are too fat, too short, too skinny, too tall...and she celebrates the fact that human beings come in a wide variety of sizes and shapes. She has a lesson to teach…not just to teachers and kids, but to all of us.” —Joanne Ikeda, MA, RD, Nutritionist Emeritus, University of California, Berkeley “As a therapist treating eating and body image problems I have spent over 50 thousand hours working to correct the mindset and problems that ensue when what you weigh becomes more important than your health or who you are. On a daily basis I am on the quest for material that will help young people avoid the problems I treat in the first place. I hit the jackpot with Kathy Kater's Healthy Bodies curriculum. This lesson plan is so comprehensive, so important, informative and easy to adapt, it can be used for all ages and all settings. Ms Kater's book will assist anyone wishing to help young and old live a balanced, healthy lifestyle. It should be required reading in every school and is a must for anyone in the field of disordered eating, weight control and body image.” —Carolyn Costin, MA, LMFT, Executive Director, Monte Nido Treatment Center, Author: Your Dieting Daughter “The Healthy Bodies curriculum should be in the hands of every elementary school teacher in the United States. The revised edition has the potential to transform classrooms, and is the resource for any school that wants students to develop positive self- and body esteem, resist unhealthy messages regarding weight, shape, appearance, fitness, and food, and be equipped with the building blocks to a healthy lifestyle. Incorporating the most recent research, the Healthy Bodies user-friendly lessons may be adopted for use beyond grades 4-6 and across the curriculum. Kater proposes and illustrates a clear model for the creation of a healthy body image and includes hand-outs, overheads, and lesson scripts, as well as sufficient background information to prepare teachers to address this timely and sensitive issue. Healthy Bodies teaches lessons will result in fewer children needing referrals to people like me. Thanks to Kathy Kater for creating and revising such a useful resource.” —Margo Maine, Ph.D., Author of The Body Myth: The Pressure on Adult Women to Be Perfect, Father Hunger: Fathers, Daughters and the Pursuit of Thinness, and Body Wars: Making Peace With Women’s Bodies "Kathy Kater has for years been deeply and extensively engaged in developing knowledge, attitudes, and behaviors that contribute to the prevention of negative body image and to the promotion of health. This new edition of Healthy Bodies encourages and enables teachers, school staff, older children, and young adolescents to follow and expand the model she has established as a person, a professional, and an activist. This book is much more than a "curriculum guide." It is an inspiring integration of theory, curricular formats, practical suggestions, and creativity, all tailored to the developmental needs and interests of children ages 8 through 12. This manual radiates a spirit of simple and clear-sighted mindfulness, even as it fearlessly and humanely confronts a host of complex topics that are so important for prevention and health promotion, such as the health and vitality, true control and flexibility, the impact of powerful but conflicting cultural messages, stress and coping, prejudice, and self-respect. I will recommend Healthy Bodies not only to elementary school and middle school teachers, but also to parents, coaches, dietitians in training, and any others who are ready to advocate for healthier youth." —Michael P. Levine, Ph.D., FAED, Emeritus Professor of Psychology, Kenyon College, and former President of the National Eating Disorders Association “Kathy Kater’s Healthy Bodies curriculum is a marvelous breath of fresh air in a sea of misinformation and confusion. This latest edition of her book is the most comprehensive, compassionate, and practical science-based approach for helping children (and their teachers and parents) to navigate the tricky road towards positive body-  esteem and well-being. The focus is on helping kids to distinguish between the realities of physical maturation and the rhetoric of cultural portrayals of “ideal” bodies, make physical activity fun and accessible, and learn to eat according to innate, internal hunger and appetite signals. Incorporating the lessons contained in this book into the school curriculum will go a long way towards helping our kids to grow up feeling good about themselves by taking the best possible care of the wonderful and diverse bodies they have been given.” —Jon Robison, PhD MS, Department of Physiology, Michigan State University “With our current rule-based and weight-focused approach to eating and physical activity, adults and children alike are confused and conflicted about how to support their own health. There is an incredible need for positive, rationale messages reinforcing the need to listen to and care for our bodies from the inside out. The lessons in Healthy Bodies serve this purpose, and provide a powerful foundation for health and wellness for today’s young students.” —Michelle May MD, founder of www.AmIHungry.com; author of Eat What You Love, Love What You Eat. “This updated edition of the most widely-used curriculum for preventing disordered eating and body image issues is even better than the original. Kater’s orientation is rooted in the most successful prevention programs and research. She presents a resource that should be incorporated into every fourth, fifth, and sixth grade classroom.” —Leigh Cohn, Editor-in-Chief, Eating Disorders: The Journal of Treatment and Prevention “Kater’s Healthy Bodies curriculum continues to be perhaps the premier prevention program for elementary school children. Kater focuses on the crucial issue of building positive body image, rather than simply preventing negative body image. By encouraging children to respect and appreciate their bodies, Kater’s program facilitates the development of self-esteem, positive affect, assertiveness, and, importantly, the motivation for girls to focus on something other than body shape! Firmly rooted in empirical work, this program is accessible and flexible enough to be used in a variety of settings with different age groups. Teachers will find the increased emphasis on mindful eating interesting and perhaps even helpful with their own eating. I wish all children, adolescents, and adults could have the advantage of participating in this program.” —Linda Smolak, PhD Emeritus, Professor of Psychology, Kenyon College, Gambier, Ohio, USA “Healthy Bodies teaches exactly what every child and adult needs today: the facts about body size diversity, the wrongness, destructiveness, and proven ineffectiveness of weight stigma, why "weight control" is a flawed approach to a healthy weight and contributes to weight gain, the importance of connecting to who we are from the inside out, trust in listening to our bodies, encouragement to value and pursue vitality and happiness (instead of size) as a goal, and how to care for our bodies through mindful eating, and enjoyable movement. These smart, evidence-based, compassionate, engaging lessons teach both educators and kids the essence of self-care. Fully aligned with the Health at Every Size principles described in my book of that title, this curriculum should be taught to every child, everywhere!” — Linda Bacon, PhD, author of Health at Every Size “Healthy Bodies is an invaluable resource for any school interested in helping students navigate the topic of weight and well-being. Filled with positive and easy-to-understand lessons, teachers, children and parents will welcome this evidence-based approach that fosters lifelong healthy behaviors and attitudes. As a therapist who deals with the casualties of eating and weight problems, which often start in childhood, I highly recommend Ms. Kater’s curriculum as a means to promote self-esteem and body esteem for our nation’s children.” —Judith Matz, LCSW – Director of The Chicago Center for Overcoming Overeating, Inc. and co-author The Diet Survivor’s Handbook and Beyond a Shadow of a Diet. “Simply put, the Healthy Bodies curriculum contains the best tools available for effectively teaching the concepts that children-and adults, for that matter-need in order to encourage healthy, realistic body images. Its elements are a breeze to integrate into almost every learning environment and subject area. In today's appearance-obsessed culture, it is essential for adults who work with children to have Healthy Bodies in their toolkit.” —Joe Kelly, President, Dads & Daughters “As an educator who has taught thousands of university undergraduate students the basics of personal health, fitness, and nutrition, I find the Healthy Bodies curriculum to be comprehensive and compelling. The perspectives and information provided offer a holistic, person-centered approach to helping young people understand the complexities that characterize body size, shape, and image. Moreover, the lessons for the students themselves are  practical, enjoyable and effective. Professionally, I would recommend this text to anybody who faces the challenge of how to appropriately develop positive body understanding and acceptance for people in any age range. Future generations will be better prepared to face a looksist and ableist society with these lessons.” —Tucker Readdy, Ph.D Assistant Professor, Exercise & Sport Psychology, University of Wyoming “Kathy Kater brings her expertise, compassion and experience as a psychotherapist concerned about the pressures facing young people. She transfers this knowledge to the classroom in this important program for promoting a positive body image and preventing weight-related problems in youth. Programs such as this need to be implemented in schools!” —Dianne Neumark-Sztainer PhD, MPH, RD, Division of Epidemiology and Community Health, University of Minnesota Praise from teachers who have used Healthy Bodies “One of the things I really appreciate about this curriculum is that any teacher, whether they have experience teaching Health or not, can pick it up and follow it very easily. I'm also very impressed with the way it reaches the boys in my classes. When they take the packet home to go over with their parents, it truly does help alleviate some of their tension. The air diet is such a clever way to introduce the dangers of dieting, and my students referred back to it often throughout the year as a reason to make sure they’re getting enough of the healthy foods they need. Most of all, I've enjoyed how much the book makes the students realize that they’re “all in this together” when it comes to puberty. I feel that if more schools introduced these lessons at a young enough grade level, they would notice a sharp decrease in the body teasing that is so harmful. This curriculum encourages students to embrace diversity and look out for each other. It ties in so nicely with our anti-bullying unit, and I believe it would be an excellent starting point for any upper elementary or middle school health program. We began by piloting the curriculum in its entirety with our 6th grade. After noticing a genuine sense of relief among the kids as we read Terry the Tadpole, we decided to try to include lessons in our elementary school. Again, thank you for such great resources.” —Amy Smith, Shanghai American School , Middle School Health Teacher/ Department Head "I have taught 4th grade for 30 years and am so pleased to have a curriculum that addresses student's concerns over why everyone looks so different. Healthy Bodies is perfect for this age. Students are not yet as worried what their peers will think, and they are still curious about how their bodies will change. Lessons provoke wonderful, engaging discussions that the children love. This is a fantastic curriculum, and I'm grateful to have it." —Mary Beggin, teacher of the Healthy Bodies curriculum for 6 years “I have taught the Healthy Body Image curriculum multiple times to 3rd-6th graders in a public school setting and also used many parts of it for a mother daughter 9 week group focusing on Body Image. The kids (and adults) in both settings fully related to the material and loved the curriculum. There was much enthusiastic discussion and everyone especially enjoyed and learned from the experiential exercises. I recommend this curriculum to anyone working with kids and wanting to make a positive impact on body image. The curriculum is so well written that even someone without a great deal of experience in nutrition and body image could teach it. I give this curriculum my highest recommendation.” —Julie Hayes-Nadler, RD, eating disorder specialist in private practice, Santa Barbara, CA “The Healthy Bodies curriculum meets a critical need today. It addresses vital, age appropriate developmental needs and is truly one of the most exciting new programs that have come along in my 26 years of teaching.” —Helen Nelson, Dept. of Epidemiology, University of MN, Health Educator “Kathy Kater's Healthy Bodies (HBI) curriculum is a wonderful program, and the Board of Jewish Education of Greater New York has urged its use elementary schools. For many students, these are their 'favorite classes' and parents are heartened that their children are learning these important lessons so enthusiastically.” —Shayna Oppen, CSW, Director, Dept. of Student Health Services, Board of Jewish Education of Greater NY   The doctor of the future will give no medication, but will interest his patients in the care of the human body. Thomas A Edison  HEALTHY BODIES Mission Statement To empower boys and girls to maintain positive body esteem based on recognition and acceptance of what they can and cannot control in regard to size and shape. To empower boys and girls to resist unrealistic and unhealthy cultural pressures regarding body image, eating, fitness, and weight. To inspire boys and girls to develop a stake in caring for their bodies; in eating well, enjoying physical movement and fitness, and in appreciation of the healthy, diverse bodies that result .  TABLE OF CONTENTS Healthy Bodies is aligned with the National Health Education Standards. Analysis of this alignment is included in the Appendix. PREFACE Page xv ESSENTIAL BACKGROUND FOR EDUCATORS Page xxii UNIT INTRODUCTION: Growth and Change in Appearance (Health) Page 1 Building Block: The way we look will change as we grow up. Students will recognize that change is a natural part of life, understand that developmental change is expected for preteens and teens, and learn there are tools to help manage changes smoothly. They will recognize the importance of this unit, and will be reassured that discussions will be safe, respectful, and occasionally gender-specific. They will learn that differences in appearance are highly individual and should never be judged as good or bad. LESSON 1: Gaining Perspective: The Development of Unrealistic and Page 16 Negative Body Images in Western Culture (Literature, History) Building Block: People become unhappy trying to control something that is not in their power to control. As for looks, it’s best to make the most of who we were born to be. Students will develop historical and cultural perspective on today’s prevalent body image, eating, nutrition, fitness, and weight norms. In this light, students will be motivated to develop critical thinking skills about current weight-related attitudes, eating for weight control, and the influence of mass media. LESSON 2: Identity and Competency: More Than the Way We Look (Health, Page 28 Art) Building Block: The way we look is only one part of us. We need to pay attention to all of who we are. Students will consider many different aspects of their identities. They will learn that the whole is stronger than the sum of its parts. Attention to all of who they are makes them stronger than undue focus on any one aspect. A strong sense of self based on an appreciation of diverse attributes will empower students to resist objectification and comparisons to unrealistic, idealized images.  LESSON 3: How Your Appearance Will Change in Puberty (Science) Page 39 Building Block: There are many different normal ways for looks to change in puberty. Sooner or later, most girls and boys gain weight and fill out. While recognizing that looks are only one aspect of their identity, students will acknowledge that physical changes in puberty naturally draw attention to their bodies’ appearance. Students will learn the normal outward changes to expect as they enter puberty, and that words describing body sizes are not judgments. They will learn that talking about these changes can be reassuring and supportive. LESSON 4: Genetics: How Body Size and Shape Are Determined (Science) Page 64 Building Block: Most of the way we look is determined before we are even born: taller, shorter, fatter, thin—all are normal, all built in! Students will recognize that genetics are the greatest determinant of body size and shape. This lesson provides a foundation for their own body images as they learn the biological limits to what they can and cannot expect to control about their outward appearance. Students will identify characteristics of their own personal genetic heritage. LESSON 5: Internal Weight Regulation: The Metabolism Factor (Science) Page 75 Building Block: Each person’s body works to grow and maintain a weight that is natural for him or her. Students will recognize that the body’s internal weight regulatory system defends the body’s natural weight. Metabolism provides an example. Through an experiential activity, they will learn that if everyone ate exactly the same food and was active in exactly the same way, people would still have diverse bodies, from fat to thin. Students will understand why it is not safe to make assumptions about how much a person eats or how active they are from appearance alone, and will learn that care must be taken with labels, such as “overweight” and “underweight.” LESSON 6: “Sold” on Looks: The Influence of Mass Media (Family Life & Page 89 Consumer Science, Social Studies) Building Block: Hardly anyone looks as perfect as the models in advertisements. I will be careful not to compare myself or others to them. Students will consider the role of looks. They will document the pervasiveness of media images in our culture and understand the potent role mass visual media has had in determining current cultural values about looks. They will recognize the ways in which unrealistic media images create misunderstanding and destructive expectations. They will learn to interpret media messages and reduce their vulnerability to being “sold” unhealthy messages.  LESSON 7: Hunger and Eating: What Is and Is Not in Our Control? (Science) Page 104 Building Block: Weight-loss diets are not a good idea. We can hold back hunger for a while but will eat more to make up for it later. Students will discover that predictable outcomes occur when basic needs are not fully met. Food fulfills a basic need, and if internal hunger cues are discounted, counterproductive results can be expected. Restrictive eating (dieting for weight loss) is not an effective strategy for long-term weight loss or control. Students will understand the importance of trusting hunger to regulate their eating. LESSON 8: How to Eat—Caring for our Bodies with Mindful Eating (Health) Page 118 Building Block: Satisfy hunger completely with enough wholesome food at regular meals and snacks. Students will learn that eating well is one of the most important things they can do to care for their bodies. This includes tuning in, listening, and responding to physical hunger, along with mindful awareness of other cues for eating. They will understand that foods are not good or bad, but have different qualities that serve different purposes. This eating wisdom will empower them to choose foods for the outcome they truly want in a given context. LESSON 9: How to Care for our Bodies with Movement (Health) Page 149 Building Block: It’s important not to sit too much in our free time. Being active is one of the best things we can do for our health and self confidence. Students will learn that in addition to eating well, movement is one of the most important things they can do to care for their bodies. With new awareness of today’s default sedentary lifestyles and its costs, students will see the value of tuning in to their body’s need to move. They will be motivated to intentionally seek ways to be active that are enjoyable. They will also learn that, while aerobic activities produce benefits, “no pain, no gain” is a myth. LESSON 10: Compared to Whom? Selecting a Standard for Choosing Role Page 169 Models (Health) Building Block: Choose role models you admire for things deep inside and who make you feel good about who you are. Students will identify how fads and fashions may influence their choice of role models and will learn to select positive, realistic role models. They will consider “daring” to stay true to their authentic selves even in the face of peer and cultural pressures, and will reflect on their current and future role models. APPENDIX Page 180  Does Healthy Bodies teach a Health At Every Size® (HAES®) Approach? —A note from the author The model underlying this curriculum was developed in 1996. At that time, I had specialized for nearly two decades in treating adults battling eating disorders and women and men of higher weights who were demoralized by repeated weight loss failures. My clinical experience had taught me that in order to heal physically, emotionally and cognitively, these struggling patients—all of them—needed to learn the same underlying principles: 1) The limits to control over weight through healthy means 2) The biological facts regarding genetic diversity of size and shape 3) The counterproductive effects of dieting for weight loss 4) The need to resist unrealistic pressures in our cultural context affecting body image and attitudes about weight, eating and health. In addition each patient had to relearn: 5) How to eat (as opposed to not eat); to listen to their hunger and honor it 6) To re-established a connection to their long banished bodies; to be embodied, to move and be physically active in ways that expressed their individuality and gave them vitality 7) To accept the diverse sizes and shapes that would result from positive eating and movement Finally, it was clear that all of this would happen only if these individuals could learn to: 8) Accept and care for themselves with compassion, understanding and great love. One day when my daughter was 9 years old, it dawned on me: these principles were simple enough for a fourth grader to learn—before problems began! Out of this grew the Model for Healthy Body Image and Weight, upon which all editions of this curriculum are based. It is not surprising that as my clinical experience was revealing to me the relationship between body dissatisfaction, the drive to be thin, dieting for weight loss, poor and disordered eating, and very often, weight gain, that others were discovering the same truth about what can and cannot be controlled about size and shape. They too were arriving at the only sane and helpful alternative: to promote health and the behaviors that support it, rather than size. Out of this shared awareness, the HAES movement was born and has grown exponentially since, along with a growing body of empirical support. One of the pioneers of this approach, Deb Burgard Ph.D. describes HAES principles in a way that underscores why my answer is “yes,” this curriculum teaches a HAES approach (words in parenthesis are mine): “HAES does not mean every size is healthy for an individual (child). It means that anyone (any child) of any size can (learn to) care for the body they have and focus on what it is that supports their well-being. It means that size is a terrible proxy for health. It means that since there is no empirically supported intervention for permanently changing someone’s (a child’s) size, we will focus instead on what we know supports health at any size, and be agnostic about what size they should be. HAES is weight neutral. It is not against weight change itself—which happens naturally for all kinds of reasons—but against the pursuit of weight change as a process.” Health At Every Size ® and HAES® are registered trademarks of the Association for Size Diversity and Health; used with permission.  ACKNOWLEDGMENTS Many things have changed since the original Healthy Body Image curriculum was published in 1998; some for the better and some not. Just as it seemed we were making inroads in changing unrealistic attitudes about the “thin ideal,” concern about higher weights and associated health risks exploded. Rather than pausing to question whether there might be a correlation between the prevalence of weight stigma, body dissatisfaction, and higher weights, many health leaders persisted with the same thinking that was largely responsible for poor eating, diminished fitness and obesity that alarmed them. Unfortunately the words of Einstein resonate all too well here: You cannot solve problems with the same thinking that caused them. More than ever a new approach to eating, fitness and weight concerns is needed today. I have been thrilled to see both the first and second editions of this lesson plan come to print, but the new Healthy Bodies is the best. This is because there are now so many of us who have worked to expose the problems inherent to weight-focused paradigms, and so many who are providing the evidence to challenge this, and so many who are promoting the only sane alternative, which is to strive for health instead of size. And so my first note of gratitude is to all of of my colleagues around the world who have become activists and leaders in service to this cause. Please, if you are among them, count yourself here. This Healthy Bodies curriculum would not exist were it not for the ongoing efforts those who have dedicated their time to research, treatment, education, and a joint effort to prevent the full spectrum of body image, eating, fitness, and weight problems. A few have been directly helpful with this revision. I am grateful to Jon Robison and Linda Bacon for feedback on the Preface, and especially to Judith Matz, Evelyn Tribole, Karin Kratina, Michelle May and Joanne Ikeda for their expert input on Lesson 8. It is wonderful to have had the critical contributions of this extraordinary group of dieticians and one physician. In addition, in ways big and small, I am always in debt for support and inspiration to Michael Levine, Margo Maine, Carolyn Costin, Dianne Neumark-Sztainer, Linda Bacon, Walter Kaye, Nan Dellheim, and the late Lori Irving and Ansel Keys. Likewise to teachers across the country who have made these lessons come alive in their classrooms, and who have provided invaluable feedback to make this guide better than ever. I remain grateful to the board and staff of the National Eating Disorders Association (NEDA), who published the First Edition of this curriculum in 1998, and the 2005 Second Edition. Without the support of this national organization, now headed by Lyn Grefe, it is possible these lessons would not have gone beyond Minnesota, not to mention around the world. To my very able research assistant, who was passionate about searching for the latest evidence to document Healthy Bodies principles, thanks to Christine Spinetta, not only for long hours and thoroughness in digging for data, but for her always cheerful way of going after what was needed. As has always been true, it is my clients whose struggles drive my search for effective ways to challenge the cultural forces that they and we all face, and to prevent problems for the next generation. I am ever grateful to them for trusting me with their stories of feeling too long at odds with bodies that were perfect from the start. Last and always most important, I am so thankful for and rely upon the continuing enthusiastic support my family—Lincoln, Adam and Anya.  “Some people believe that stigma is helpful in motivating weight loss - that making it uncomfortable or undesirable to be overweight will somehow help people lose weight. But a large and growing body of research disputes this. Studies show that youth routinely cope with feeling bad about their weight by trying to lose weight in harmful ways (fasting, diet pills, vomiting, and chronic dieting) leading to binge eating and avoidance of physical activity - all unhealthy behaviors that can actually impede weight loss and reinforce weight gain… Confronting stigma, bullying and weight bias needs to go hand-in-hand with efforts to reduce the prevalence of obesity nationwide.” Nan Feyler, reporting for the Philadelphia Media Network, September 25, 2012, regarding the call from Yale’s Rudd Center for Food Policy and Obesity for weight-stigma reduction programs.  xv PREFACE INTRODUCTION Beyond Prevention of Eating Disorders and Concerns about Obesity This curriculum was developed to aid in prevention of risk factors common to eating disorders and rising rates of obesity in developing children and teens, but its purpose is much larger than this. While a disturbing number of children will suffer diagnosable concerns stemming from poor and disordered eating and fitness choices, well over half of all children today—thin or fat, boys and girls alike—will learn at far too early an age to worry about and be dissatisfied with their body size and shape. Far from benign, children who are anxious about weight begin to view their bodies from the outside-in—objectifying and judging themselves harshly according to external standards. In the process, they disconnect from internal hunger cues that are perfectly attuned to what and how much their bodies need to eat, as well as the ways their bodies want to move naturally and joyfully in daily life. As a result, these children are less able to care for their bodies; less able to make normal, sound, eating and activity choices, particularly in today’s challenging food and entertainment environment. Primary prevention is therefore needed to target the seedbed out of which the full spectrum of interrelated body image, eating, fitness, and weight concerns take root and grow. The Healthy Bodies curriculum was developed to help prevent, reduce, or reverse the influence of insidious risk factors that diminish the body esteem, well-being, and health of countless children today. First, Do No Harm While well documented, shared cultural risk factors for eating disorders and rising rates of obesity are cultivated in the same environment, these problems have routinely been regarded separately when it comes to prevention and treatment. It has become increasingly clear that this disconnected approach is counterproductive and even destructive, resulting in “solutions” that are short-sighted and contradictory, and that thereby add to problems. With concerns about obesity fueling ever more stigma and fear about fatness, a reminder about the directive to “first, do no harm” has never been more urgent. Models for health promotion must take into account all known factors contributing to body image, eating, nutrition, fitness, and weight concerns. These models must pro-actively provide children with a guide for long-term health that is realistic, not at odds with any aspect of itself, and non-discriminatory. The model upon which this curriculum is based provides both goals and the means to reach them—healthy body image attitudes and healthy lifestyle choices—that are attainable by all, regardless of size, shape, cultural and socio- economic background, genetic predisposition, or gender. This approach will help without harming any child. Teachers should carefully read this entire Preface in order to become very well acquainted with the new, evidence-based paradigm these lessons teach and to understand why a new approach is critical to avoid reinforcing old and problematic paradigms. In fact, schools and organizations are advised to make this Preface available to all teachers and staff who interact with students in order to encourage a consistent set of messages about body image, eating, nutrition, fitness, and