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Fergie and parents' diet dilemmas

BMJ 2000; 321 doi: (Published 09 December 2000) Cite this as: BMJ 2000;321:1478
  1. Rhona MacDonald
  1. BMJ

    Sarah Ferguson, the Duchess of York, was slated in the tabloid press last week for playing “diet games” with her two daughters. On 26 November the Sunday Mirror led with the story that “self-confessed binge eater Fergie has admitted making Beatrice, 12, and Eugenie, 10, diet conscious after a summer of too many sodas, cookies and pizza.” Statements of condemnation from “health experts” followed.

    On Monday the story was rehashed in all the other tabloids, including the Daily Mail, which ran with the headline: “Fergie: how I teach the little princesses to calorie count.” More condemnation followed. It also featured on the BBC's television news that day, with nutritional experts giving their opinion and adding to the dilemma of what parents are supposed to tell their children about healthy eating.

    Childhood obesity is rising (affecting 15% of children at the last estimate in September) but so is the prevalence of the eating disorders anorexia and bulimia nervosa. Could telling children about the dangers of eating too many calories and fat—as Fergie was alleged to have done—be predisposing them to eating disorders?

    The story came from the uncorrected proof of a book Sarah Ferguson has written called Reinventing Yourself with the Duchess of York, due to be published in January and only in the United States. It is sponsored by Weight Watchers, a slimming organisation that has the duchess as its US ambassador.

    Rick Hewett, the reporter who broke the story, is the Sunday Mirror's showbusiness writer. He received a copy of the draft from a “source” and, after digging through all nine chapters for a possible story, was soon on the telephone to the Eating Disorders Association for some juicy quotes. It is the association's policy never to criticise individuals, and Steve Bloomfield, the association's spokesperson who would never classify himself a health expert, could comment only in general terms.

    So what does the book say? I was faxed some of it by the Duchess of York's US spokesperson, Gerry Casanova, who told me that this mountain out of a molehill came from a few sentences buried in the fifth chapter: “I use the knowledge and skills that I use daily to control my weight, to teach and nurture my daughters. … Beatrice and Eugenie and I began talking about their need to be more aware of nutrition. After a summer of too many sodas, cookies and pizza, they were more than eager to join me in a healthy, balanced diet.” Note the absence of any mention of “diet games” or “calorie counting” but rather exactly what the British Nutrition Foundation, the Food Commission, and the Eating Disorders Association recommend.

    There might be some reference to “calorie counting” and “diet games” in the chapters I wasn't sent, but it is not Weight Watchers' policy simply to count calories. Instead, they use a point system based on saturated fat levels in addition to calorie content. Sarah Ferguson issued a press release to say she was adamant that she had never put her daughters on a diet, but she said she did believe that “parents can serve as healthy role models to their children, which is why she openly discusses the principles of healthy eating and fitness with her daughters.”

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    The Yorks: not counting calories

    The duchess's book is all about how to build self esteem. Her lack of it led her to binge eating. The press has always had a field day with celebrities who have admitted to an eating disorder—from Princess Diana to Elton John— and their confessions have been snapped up and hyped up with great glee. Last year, although not admitting to having an eating disorder, “Posh Spice” Victoria Beckham came under ferocious attack from the media for being “too thin.” The assault was so vicious that the Eating Disorders Association put out a statement that “media harassment is not only dismissive of the serious nature of eating disorders, it can also exacerbate feelings of isolation and lack of control over one's life.”

    Anorexia and bulimia are serious. They are not just a passing teenage phase. Half of cases become chronic, and eating disorders are the biggest cause of death of all psychiatric illnesses. In many cases they are a symptom of underlying problems.

    So how should parents handle the dilemma of obesity and eating disorders when dealing with children's diet? Steve Bloomfield says, “Children should receive unconditional love for who and what they are rather than what they might be after counting the calories.”

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