The American Journal of Bioethics

Publish date

A controversial diet guru in France, Dr. Pierre Dukan, has raised a lot of eyebrows and ire for proposing that all high-school students in France, in order to graduate, pass a weight exam. And Dr. Dukan doesn’t mean weights and measures or conversions from grams to pounds. He means beating the battle of the bulge or being skinny enough to leave high school in France.

Dr. Dukan, under ethics investigation for some of his practices such making too much money off of his diet plan, say French officials, and ignoring the ethics rule that “doctors must consider the impact of their comments on the public”. Dukan has been criticized for prescribing a diet that is too extreme and in the case of teenagers could promote eating disorders.

Dr. Dukan’s critics may be right about the extreme nature of his diet, but they are wrong to criticize him for putting forward a radical approach to ensuring our youngest and most vulnerable citizens are not treated to a life of disease and disability due to diet and other lifestyle factors. The United States and other developed nations have failed miserably at protecting our children from the brainwashing of television commercials for sugary cereals and Happy Meals. Our government programs aimed at physical fitness have failed resoundingly and government sponsored breakfast and lunch programs chocked full of unhealthy foods and “pink slime” only exacerbate the problem that many low-income children (and their parents) cannot afford healthy meals.

Of course, there is more to life than being thin. And this is where Dr. Dukan gets it wrong: the idea that ALL one would need to do to pass one’s Baccalaureate exam in France would be to be skinny is ridiculous. The only people for whom that is enough are the Gilsele Bundchens of the world.

So Dr. Dukan may be an extremist in his own dietary recommendations and his “skinny is enough to graduate” plan, but he is right to argue that there must be serious consequences for allowing 18% of the adolescents in the US to be obese. Children deserve the best start in life and starting life as an overweight or obese child guarantees a life of health problems, workplace discrimination, and psychological and social issues. What if, in elementary, middle and high school, we nipped these problems in the bud? Having BMI attached to and considered to be as important as getting an A in chemistry would certainly put our teachers, parents and communities attention to it. Obviously, this cannot be the only program or strategy to help deal with childhood obesity and we must acknowledge that in many communities the factors for childhood obesity extend far beyond the classroom or even the home.

How would parents and students change their behavior if, for example, they could not graduate high school if they were overweight? Might the overweight but brilliant child who wants to go to Harvard exercise a bit more or opt for apples instead of Apple Jacks? These non-radical kinds of behavior change moving us toward a healthier next generation is something we must pursue. How to get there is something that nearly every childhood and adolescent obesity treatment and prevention program has failed at.

Would Dr. Dukan’s plan work? We’d never know unless we tried such a radical proposal, but we don’t try such a thing because it was proposed by a radical.

Given our failures to date, we need radical and innovative ideas to curb this epidemic. And just because Dr. Dukan’s diet has resulted in super-(and perhaps unhealthily) skinny supermodels, movie stars, and a future queen doesn’t mean he wants our children to be waifs with BMIs of 3. And if he does, then he is just wrong. But there is a happy medium here. Children need to be at a healthy weight so that they can be healthy enough to live life to its fullest. And that is a proposal I am shocked to hear anyone would not immediately get behind.

Summer Johnson McGee, PhD

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