Diet culture can hurt kids. This author advises parents to reclaim the word 'fat'

TERRY GROSS, HOST:

This is FRESH AIR. I'm Terry Gross. Most children, by the time they reach school age, believe that being thin makes them more valuable to society. That's according to a new book by journalist Virginia Sole-Smith called "Fat Talk: Parenting In The Age Of Diet Culture." And by middle school, Sole-Smith says, more than a quarter of children will have been put on a diet. She spoke with our guest interviewer, Tonya Mosley, about why she believes our obsession with thinness is more harmful to kids than being fat.

TONYA MOSLEY, BYLINE: If the latest frenzy around the diabetes drug Ozempic for weight loss is any indication, we are a weight-obsessed culture. And our obsession, according to Virginia Sole-Smith, starts pretty young, before most children have even entered kindergarten, and they get it from their parents. In the new book "Fat Talk: Parenting In The Age Of Diet Culture," Sole-Smith lays out how we've tangled health, beauty and morality and how reversing fatness, as she puts it, has become our society's passion project, our most popular national pastime, with damaging consequences. Because as science has shown us, diets do not work.

Virginia Sole-Smith is a journalist and author who began her career writing for women's magazines. She's the author of "The Eating Instinct: Food Culture, Body Image, And Guilt In America" and a contributor to The New York Times and Scientific American. Sole-Smith also produces the newsletter and podcast "Burnt Toast," where she explores fatphobia, diet culture, parenting and health. Her latest book, Fat "Talk: Parenting In The Age Of Diet Culture," is out now. Virginia Sole-Smith, welcome to FRESH AIR.

VIRGINIA SOLE-SMITH: Thank you. It's so great to be here.

MOSLEY: Before we get started, I want to talk a little about language because we'll be using the term fat as a neutral descriptor. And I want to ask, how does reclaiming the word fat help in efforts to fight anti-fat bias?

SOLE-SMITH: It's really the starting point. But it is a difficult starting point for a lot of people, you know? When I hear from parents on this issue, one of the most common questions that comes up is they'll say, you know, my child pointed to some lady in the grocery store and said, why is her tummy so fat? And what the parent wants to do is rush in and say, don't say fat. That's not nice. But as soon as you do that, you've told your child that fat is not an OK way to be. So if we can step back from that and we can instead say, yep, bodies come in lots of shapes and sizes - some people are thin, some people are fat - and use fat in a neutral way like that, we really take all the power out of the word. We make it something that can't be weaponized against us. And that really is the first step towards starting to dismantle anti-fat bias.

MOSLEY: One through line in your book is the perception that an overweight child is a sign of bad parenting. And you say very plainly that a child's body size is not a parent or caregiver's fault. This sounds so obvious, but it's something that you really had to lay out and then provide data and research behind.

SOLE-SMITH: Yeah. I mean, parents are held - and particularly mothers are held responsible for our child's bodies even before we have them. I mean, if you talk to any person trying to conceive, weight is really on their mind. There's a lot of emphasis on being at a, quote, "healthy weight" to get pregnant. Or how much weight can you gain during your pregnancy? And I've done reporting for The New York Times magazine. I did a piece a few years ago that really got me thinking about this, where we saw that most fertility clinics in the country actually have BMI cutoffs where they won't give you fertility treatment if you're in a - you know, if you're over a certain way. And there really wasn't science to support that. That really was about the fertility industry trying to protect their stats. They want to treat people who are easy to get pregnant so that their clinics have high success rates. And they see fat bodies as harder and more complicated to treat.

It's not necessarily what the science says. But right off the bat, we can see that women in particular are being judged for their fitness as parents through their bodies. And then after you have the baby or adopt or, you know, however you make your family, parents are then held responsible for how their kids are eating and their child's body size. And this comes at us from all directions, from the pediatrician, from other parents, from family members. You know, there's all these sources that kind of come at us and tell us, if our kid isn't, like, right around that 50th percentile mark on the growth chart, that we're doing something wrong.

MOSLEY: At the same time, roughly 1-in-5 children in the United States between the ages of 2 and 19 is affected by obesity, meaning they have a body mass index at or above the 95th percentile for their age. Childhood obesity also seems to have increased during the COVID-19 pandemic. And we're going to get to some of the flaws around BMI as a barometer of health shortly. But I'm curious, do you actually see childhood obesity as a potential health problem that needs to be fixed?

SOLE-SMITH: I really don't. What I see is us using childhood obesity as a proxy to talk about issues that really do need our attention, things like childhood hunger, things like poverty, experiences of chronic compression. You know, we know that the kids who are in bigger bodies also tend to be kids who are dealing with other systemic issues that we don't have good social supports or solutions to. And I think we as a culture have really zeroed in on weight because we think that's the piece that we should be able to control.

But not only do we not have very much control over weight, it also won't fix anything else. If you have a single mom working three jobs, struggling to feed her kids, putting everyone on a diet is not going to make it easier for her to get dinner on the table. It's probably going to make it more stressful. You know, if she's having a hard time choosing between the grocery bill and the heating bill, like, telling her that she needs to eat organic or she needs to get more vegetables in their diet, this is not useful, actionable information for anybody. But this is where we start the conversation. And all it really ends up doing is pathologizing kids' bodies and giving parents extra pressure and extra guilt and these sort of unrealistic standards we can't get to.

MOSLEY: Yeah. What you're saying, basically, is that racism, poverty and other inequities, solving those things is much more likely to improve health regardless of whether there are weight changes. Your book actually lays out some pretty compelling research that shows focusing on weight loss interventions, in particular in kids, can, in some instances, also cause greater harm. This was really interesting to me. What are the ways that weight stigma can be more harmful than actually being a bigger size?

SOLE-SMITH: Well, so just the chronic experience of weight stigma - and this is similar to the research we see on, you know, chronic experiences of racism or other forms of bias. This raises your stress level. This has you in a constant state of, you know, fight or flight. And stress hormones are elevated. That takes a toll on our bodies for sure. So just that sort of baseline, this is how we ask fat people to move through the world, always on guard, knowing that they may be ridiculed, shamed, stigmatized. That takes a toll on our mental health and our physical health. The other thing that weight stigma does is it becomes a really concrete barrier between fat people, fat kids and fat adults, and access to health care.

We know that doctors in particular are a profession that hold really high levels of anti-fat bias. And this comes into the exam room with them. So the fact that the first thing we're all asked to do at a doctor's office is to get on a scale, right there, you've immediately given the doctor this number to focus in on that doesn't tell your full story about your health, but that narrows the focus of the conversation down to weight. And if you're fat, that means that that's really all the doctor is going to focus on, is weight loss, weight management - what are we doing to get your weight down? Even if you've come in with something like a sinus infection or a sprained ankle, you know, they're going to bring the conversation back to weight.

And what this does is it means that fat folks often receive subpar health care compared to thin people with the same conditions. They may be delayed on getting actual treatment because they're told they have to pursue weight loss before they're a candidate for medication or surgery or whatever would be the recommended course of action for a thin person. It also means fat folks then understandably delay going to the doctor. They're more likely to doctor-shop. So that impacts your health - right? - because you're not getting your regular preventative care appointments. You don't have doctors you have strong relationships with. By the time you finally do show up, you're probably less healthy because you haven't benefited from that preventive care. But this isn't a failing of fat people. This is a failing of the system.

MOSLEY: You know, and thinking about the language that we use, can you describe thin privilege and what that might look like in the day to day?

SOLE-SMITH: Yes. Thin privilege is a concept that I think is tricky to get our heads around because if you have it, you don't really see how much you have. I mean, it's a lot like white privilege in that way because you don't see how much it's benefiting you. But what we're talking about with thin privilege is the fact that if you are someone who can wear straight sizes, you know, you can walk into the Gap or Target or whatever and find your size easily on the rack, if you have that kind of benefit...

MOSLEY: And straight sizes are, like, zero to 18, essentially.

SOLE-SMITH: Zero to 14, I would say.

MOSLEY: Zero to 14. OK.

SOLE-SMITH: Yeah. Most retail, like, the straight size section caps out at 12 or 14 and then plus sizes like 16 and up. Yeah. So if you're someone who wears a size 14 or smaller, you have some straight-size privilege or thin privilege, and that means that you can get clothes that fit your body. It means when you go to the doctor, your weight is not the first and often only thing that's talked about. It means you can sit on an airplane and not worry about buckling the seat belt. You can go to a restaurant without worrying, you know, will they have booths that are too tight for you to get into? Will the chairs have arms that are too tight? Physical spaces are built for your body.

And whatever your own personal struggles might be - because, of course, thin people get eating disorders. Thin people struggle with this stuff too. We're all harmed by anti-fat bias. Whatever your personal struggles are, you are not - your body is not a target for the world in the way that someone in a bigger body is. And what's also sort of nuanced and tricky about thin privilege is the fact that you can be fat and still be benefiting from thin privilege relative to someone fatter than you. So I think there's a lot of gray area where people get hung up.

I identify as small fat. I wear like a 16, 18, 20, and so I can order clothes - mostly only online, not so much in-person stores, but I can get clothes that fit my body pretty easily. You know, I can take weight out of the conversation with a health care provider. I have certainly experienced medical weight stigma, but if I say I don't want to get on the scale, they respect that decision. That's not available to someone who's in a bigger body than me.

So that's where it sort of helpful to think about, how am I able to move through the world in this body in a way that someone else isn't? And why are we OK with the fact that the world is not built to include all bodies?

MOSLEY: Thin privilege, you also write, is a white and heteronormative ideal. When we strive for thinness, you write, we're reinforcing every other form of stigma at the time. You kind of alluded to this. For people of color, specifically, thin privilege then gives you access to white privilege. Can you explain this?

SOLE-SMITH: Yeah. I mean, the thin ideal is definitely a white ideal. When we trace the history of modern diet culture, we really trace it back in the United States to the end of slavery. And Sabrina Strings' book, "Fearing The Black Body," is sort of, you know, the iconic work on this that I would refer people to. But her research talks about how, as slavery ended, Black people gained rights. Obviously, white supremacy is trying to maintain the power structure. So celebrating a thin white body as the ideal body is a way to other and demonize Black and brown bodies, bigger bodies, anyone who doesn't fit into that norm.

So this is really about maintaining systems of white supremacy and patriarchy, which I think is very helpful to understand because I think a lot of us are really working to divest from those ideas. But we haven't given ourselves permission to stop dieting or to accept our weight wherever it might fall. And if you can understand that actually, by continuing to pursue thinness, you are in some level maintaining your complicity with white supremacy and patriarchy, I personally find it very motivating to let that go. So I think that can be a really helpful set of dots to connect for folks.

MOSLEY: Let's take this moment for a break. If you're just joining us, I'm talking with author and journalist Virginia Sole-Smith, author of the new book "Fat Talk: Parenting In The Age Of Diet Culture." Virginia is also the author of "The Eating Instinct: Food Culture, Body Image And Guilt In America," which explores how we can reconnect to our bodies and our own innate understanding of how we eat. I'm Tonya Mosley, and this is FRESH AIR.

(SOUNDBITE OF KEVIN EUBANKS AND STANLEY JORDAN'S "OLD SCHOOL JAM")

MOSLEY: This is FRESH AIR. And today we're talking with author and journalist Virginia Sole-Smith, author of the new book "Fat Talk: Parenting In The Age Of Diet Culture." Virginia got her start writing for women's magazines. She's also the host of the podcast "Burnt Toast."

I want to go back to more recent history, the 1990s, because that's when we really saw a direct shift in our fixation on body size. It's when a doctor by the name of William Dietz became the director of a division within the CDC that took on obesity and deemed it an epidemic, essentially. What were some of the things he implemented that changed our language and perceptions around health and body size?

SOLE-SMITH: So Bill Dietz is the doctor who came to the CDC and developed the hot zone maps, which I'm sure most people are familiar with. They get released every two years, and they show, you know, spread across the map of the United States, which states have the highest rates of obesity. So you see like these red states versus green states. And, you know, it's really like laying out in a very visual way where we are the fattest, basically. And this was definitely a concerted effort to sound the alarm, to make Americans extremely anxious about the fact that we were getting bigger and that this was a problem we had to solve.

And so we saw - at the same time, we saw a lot of research come out starting to support this idea that obesity was this major health crisis and, you know, figures like 300,000 deaths a year can be attributed to obesity. That's a number - 400,000. There's different versions of this that get bandied around. Unfortunately, a lot of what was happening at this time was a pretty blatant miscommunication of the science. You know, that 300,000 figure, for example, is not what the study actually found. It attributed that amount of deaths to diet and lifestyle but not to body size. And the researchers who published that original data published a letter, you know, a few years later, after the statistic had been so misused over and over, saying that is not what we found. But that is - you know, the headlines were already written. That number had sort of become embedded in our consciousness - how many deaths a year attributed to obesity.

MOSLEY: This is very interesting in the context of the research that you found. I think there was a study that you found that was done in 1945 around Dutch women who had children, and their children were born bigger than other children during famine times and what that told us about epigenetics. But then we're seeing an - even with all of this research, for instance, the latest American Academy of Pediatrics recommendations to combat childhood obesity, they agree with you that people with fat bodies should no longer be stigmatized as simply a result of personal choices. But it's understood that it's a complex disease with short- and long-term health implications. But some of the interventions they cite are pretty controversial - for instance, undergoing intensive health behavior and lifestyle treatment and, in some instances, weight loss medications. And you've written that this terrifies you.

SOLE-SMITH: It does terrify me because what they're doing is reducing children's health to body size. They're - the guidelines talk a lot about the harm of weight stigma, and then their solution is weight loss. And it's - just really blows my mind that they can't quite see - they're, like, almost there. They're articulating the dangers of weight stigma, and this is a big shift. I can tell you, as someone who's reported on this stuff for quite a long time, 10 years ago, when I asked researchers in the obesity field about weight stigma, they had no idea what I was talking about. They were very dismissive of it.

That's not the case anymore. They all acknowledge that anti-fat bias is real, that people in bigger bodies are treated terribly and that this has a real impact on their health. Nobody is disputing that anymore. Just like nobody in the obesity research field is disputing that weight is not a matter of willpower, that this is not within your control. And yet they are still completely committed to the idea that the solution is to make people smaller. And there is just no other form of bias that we think it is OK to solve by erasing the characteristic that you're biased against.

MOSLEY: So, you know, we've been talking a lot about Ozempic. It's been very popular, the diabetes medication, as a weight loss drug. And it's been in the news for its popularity and lots of shortages. You have mixed feelings about the coverage around the use of Ozempic, not necessarily that people are using it for weight loss, but the message that the popularity sends that if we have found a silver bullet that will make people thin, does that mean we just forget about anti-fat bias?

SOLE-SMITH: Yeah, this is what really scares me about it. I mean, Ozempic as a diabetes medication - great. I want people to have access to the medication they need to treat their health conditions. And that's what I'm really arguing for in general here, is that let's focus on the health conditions, let's manage people's health and take weight out of the equation. And instead, Ozempic is a perfect example of how anti-fat bias drives us in the opposite direction. Because when they realized that weight loss was a side effect of this drug for some folks and that they could, you know, deliver what looked like really dramatic weight loss with minimal side effects, they immediately started marketing it in that direction very aggressively. And, you know, this is not the only weight loss drug being marketed that way. There's also Wegovy, which the FDA just approved for use in ages 12 and up, which I think was a big factor in those American Academy of Pediatric guidelines that we just talked about.

And so what we're doing, again, is saying - you know, we're acknowledging that anti-fat bias as a problem. We're acknowledging that it's terrible to treat people in big bodies badly. But if we can just make everyone thin, that goes away. And again, you know, the solution to racism is not to make everyone white. The solution to homophobia is not to make everyone straight. Like, this is not a - this is not how we, as a culture, want to be proceeding on this issue. But there is so much money at stake here. These are - you know, these drugs are worth millions and millions of dollars. And the industry has lobbied hard over the years to create this market. A lot of the data we were talking about in terms of the rising rates of obesity, a lot of that has to do with how they've changed the measurements, the BMI, over the years to put more people into the overweight and obese groups to create larger markets for these drugs.

GROSS: We're listening to the interview our guest interviewer Tonya Mosley recorded with Virginia Sole-Smith, author of the new book "Fat Talk: Parenting In The Age Of Diet Culture." We'll hear more of the interview after a break. I'm Terry Gross, and this is FRESH AIR.

(SOUNDBITE OF BILL EVANS' "ON GREEN DOLPHIN STREET")

GROSS: This is FRESH AIR. I'm Terry Gross. Let's get back to the interview guest interviewer Tonya Mosley recorded with Virginia Sole-Smith about her new book "Fat Talk: Parenting In The Age Of Diet Culture." Sole-Smith says our obsession with thinness is more harmful to kids than being fat. She's the author of the earlier book "The Eating Instinct: Food Culture, Body Image And Guilt In America" and a contributor to The New York Times and Scientific American. Sole-Smith also produces the newsletter and podcast "Burnt Toast," where she explores fatphobia, diet culture, parenting and health.

MOSLEY: Let's talk about BMI. Can you briefly explain why using BMI as a barometer is problematic?

SOLE-SMITH: So the BMI, the body mass index, was developed in the 19th century by a Belgian astronomer and statistician. It was never intended to be a measure of health. He developed this formula to measure what he called the average man, by which he meant Belgian white men in the 19th century, which is not any of us today. It is not - you know, it's definitely not you and me. It's not a relevant body measurement anymore. And the formula has changed very little over - since then. It is still primarily a tool that's used for measuring population growth. It's useful to epidemiologists who are tracking population size on a - you know, across the country, on a global level. But it does not tell us anything about anyone's individual health. It's only because the life insurance industry adopted it in the 1920s as a way of deciding how to price out insurance premiums that it got connected to health in the first place.

And so it's become this metric that doctors start and end every conversation about our health with when it really doesn't tell us very much. It doesn't tell us, you know, percentage of body fat relative to percentage of muscle, which is why you'll hear people, you know, talk about pro athletes who have, quote, "obese" BMIs, even though they're all muscle. With children, it doesn't take into account the age - you know, where they are in terms of puberty development, and that is a stage of life where weight gain is critically important. Girls have to put on a certain amount of body fat in order to start menstruating. And so it's normal and healthy that kids put on weight during those years. But if you start puberty young, you might look like you have a, you know, quote, "too high" BMI relative to your peers. And it's just not taking into account the fact of where you are on - you know, in your own growth trajectory.

So it really gets weaponized against folks, and it gets used, like I said, to determine access to health care, to determine access to fertility treatments. There are a lot of surgeries that doctors won't do if you're over a certain BMI, not because it's actually that dangerous to do surgeries on people in bigger bodies - after all, they manage to do bariatric surgery on fat folks every day - but because they're worried it'll sort of tinker with their success rates or be a more difficult case. It might require slightly different equipment. So it becomes this barrier to health. And that's where, if we are really concerned about health, which I think is always the sort of question people want to throw out - like, oh, you don't care about weight, but, you know, what about health? If you are concerned about health, the best thing we can do is take weight and take BMI out of these conversations.

MOSLEY: There have been efforts to change this. Your book actually lays out how the CDC recommends that pediatricians use the World Health Organization's chart to track growth. But you argue, then, that data set is narrow, and it doesn't factor in children who may come from economically unstable environments. That really is - it sounds like one of the biggest challenges in all of this is access to health care and the ability for those who come from lower economic status to be able to have a voice in all of this.

SOLE-SMITH: I think that's the entire thing. I mean, you know, the conversation around the guidelines - a lot of advice I'm seeing on social media and that I - you know, that I've talked about, too, is, OK, well, as parents, we still have the right to say, I'm not going to give - let you prescribe a weight loss drug to my child. I'm not going to put my child on a diet. You know, you still have that power of no because patients have to give informed consent. But the problem is it's not safe for every patient to stand up to a doctor and say, no, I'm not going to do that. And so the people I am the most worried about are the people who are marginalized going into a doctor's office, where the power balance is so out of whack. You know, we really - this makes me sound anti-doctor and I'm not. I want to be clear. Doctors are - saved my child's life. They've played a really important role in my personal life. But we do have this weird sort of reverence for their job in our culture that leads to them being this ultimate authority rather than it being a partnership between patients and doctors.

And so, yeah, if you are fat, if you are disabled, if you are Black, if you are queer, if you are walking into these rooms with these marginalizations and you were already worried about whether a doctor is going to take you seriously, to have to push back against this whole framework and say, I don't want you to consider my BMI as part of this, that's asking too much of people. And it does mean the folks who are most vulnerable to these - you know, to the guideline changing, the kids who are going to get put on these diets and put on these drugs are going to be the folks who have the fewer resources.

MOSLEY: Let's take this moment for a break. If you're just joining us, I'm talking with author and journalist Virginia Sole-Smith, author of the new book "Fat Talk: Parenting In The Age Of Diet Culture." Virginia is also the author of "The Eating Instinct: Food Culture, Body Image And Guilt In America," which explores how we can reconnect to our bodies and our own innate understanding of how we eat. I'm Tonya Mosley, and this is FRESH AIR.

(SOUNDBITE OF GILAD HEKSELMAN'S "DO RE MI FA SOL")

MOSLEY: This is FRESH AIR, and today we're talking with author and journalist Virginia Sole-Smith, author of the new book "Fat Talk: Parenting In The Age Of Diet Culture." Virginia got her start writing for women's magazines. She's also the host of the podcast "Burnt Toast."

One of the challenges that parents face is how to talk to their kids about weight and health without perpetuating these harmful stereotypes or inadvertently promoting diet culture. And in the book, you tell the story of Harry (ph) and Dana (ph). They're parents of two children. Harry and Dana's relationship with food growing up had a direct impact on their parenting. I actually find that my children are hyper-aware of my eating habits, for instance. And I know my feelings about my body were informed by the knowledge that my mom was always on a diet. Was that connection surprising to you?

SOLE-SMITH: No, because that's - it rings true with my own experiences. It's - you know, any time I talk to anybody about their relationship with food, it always comes back to things that their parents said or did. And I want to be really clear - there's a lot of blaming of parents around all of this, as we talked about, and I don't blame the parents. I think we're all struggling. We're all swimming through the soup, and we're getting these messages that our bodies are our value and that we have to control our body size. And I think very often, it's super well-intentioned from parents. You know, if you grew up fat and you experienced teasing and bullying, you want to protect your kid from having that same experience. Or if you grew up thin, but you remember teasing a fat kid in your class, or, you know, you've seen it play out - you know how fat people are treated, and you want to protect your kid from that. And you know that you will be judged as a parent, and you want to protect yourself. So it's very understandable.

But the mistake parents make - and I think the mistake that Harry and Dana realized they were making in the way they were handling food with their kids - is that we try to control the food, we try to control the kids' bodies, instead of saying, home should be your safe place. Your body should be unconditionally safe and loved and respected here, and we will help you navigate the world, where that is not true.

MOSLEY: Have you had that conversation with your children that your body is safe here at home - not just you, but your body?

SOLE-SMITH: We do talk about it. Both my girls have a fair amount of thin privilege right now. So we haven't - you know, they haven't come home saying, someone called me fat. We haven't navigated that yet. It may very well happen, but, you know, that hasn't come up for us. But what I also do with them is I use fat constantly in a very matter-of-fact way, even in a positive way, to describe my own body and to describe other fat bodies of people we love. So they know that fat is not a bad thing and that that is not something to fear.

MOSLEY: Another example that you talk about in the book around neutralizing language is neutralizing language around food, in addition to body size - for instance, the idea that some foods are treats, and if you don't have a restriction around food, then treat is a neutral term. What are some other ways you neutralize language around food?

SOLE-SMITH: So I do say treat, exactly as you said, because we don't restrict treats, so therefore, treat is just a food you think is fun to eat. That's fine. But I don't say junk food. I don't say bad. I don't say garbage. You know, I don't say, oh, you have to eat real food. You're having too many treats. I never put treats in opposition to anything else. They're just also part of the meal. And what's cool about that is you can see this is - again, this is super nuanced stuff. And if you have been in a different place with food, you may want to enlist the help of a therapist or a dietitian who can help you really get to this more neutral place.

But if you start to work towards it, you will see that the foods that you think, I can't have that in the house - I will never stop eating it. I can't buy that snack food for my kids. They'll eat the whole bag in one sitting. You know, they're constantly going for that. We can't have that much sugar in the house. If you start to take a more relaxed approach and let these foods be part of your family's life and make sure your kids have regular access to them and you don't judge how many cookies they take and you don't - you know, and sometimes you have to sit on yourself to not make the comment or not freak out. You let it play out. You will see that these become foods your kids can enjoy but in a much less fraught way. And you'll find there are some that they actually don't even like that much, and they're leaving the bag in the pantry for weeks and not touching. Or they're excited to see it for a few days, and then the novelty wears off.

It's a completely different way of engaging with food. I think that's one of the pieces of this that feels the most radical to a lot of folks because it's a level of permission we've never given ourselves.

MOSLEY: Yeah. I mean, intellectually, it makes sense. I think one of the things you learn, Parenting 101, is, like, the thing that you restrict the most - if you're strict with your children, you don't allow them to go out, they're going to sneak out. And you're basically saying, it's the same thing with food. The more you restrict it, the more a child may gravitate towards those things that you're trying to restrict.

SOLE-SMITH: Yeah, this is very well supported in the research. There's a famous study that was done by Leann Birch where they told children - you know, they told one group of children, here's the soup. Here's the dessert. Go, you know, have as much of either as you want. And then they told the other group of children, you have to finish your soup before you can have the dessert. And the kids who were told to finish their soup liked the soup less and ate less of it than the kids who were given that permission to choose for themselves. So it's not just that you're going to end up with kids sneaking the food you don't want them to have. You're also not going to raise kids that like the foods you want them to like because you've told them, this isn't really worth having; you just have to power through this to get to the thing you want. Like, you know, you've taken all the magic out of it. So - yeah.

MOSLEY: But if you live in a restrictive household, this is going to take time. It's not like tonight you can go to the dinner table and be like, OK, you can - you know, there's no restriction. You will have to take time to make this a normal part of behaviors within your household.

SOLE-SMITH: Yes. And you will also see your kids will need time to trust this. You know, there's a mother and daughter pair in the book who started in a much more restrictive place and have been really working to ease up on this. And, you know, there was a moment where I was talking to them, and I said to the daughter, how does it feel now that your mom's not giving you rules around sugar and candy, and you're allowed to have as much of your Halloween candy as you want? And they had been trying to do this for months at this point. And the girl looked at me, and she said, it feels like, you know, I'm in a mousetrap, and when is she going to come - like, when is it going to be pulled away from me? She didn't believe it yet. And the mom looked at me, and she was like, this is a long road. This is hard.

And so what may happen initially is kids finally get access to the food you've been limiting; they're going to do exactly what you're worried about - they're going to eat lots of it. And that is a feature, not a bug. That is their body saying, finally, we have access to this thing that's been restricted. Like, great, we can have it, and we don't know when we're going to get it again, so we're going to eat as much as possible. But over time, once you let them kind of move through that, you will see them develop a more balanced relationship with it. Again, it's not going to be like, now they never eat ice cream. It's going to be they love ice cream, but they don't love ice cream, consume it to the point where they feel sick and feel guilty about it afterwards. You interrupt that whole shame spiral.

MOSLEY: You've created this really strong community through Burnt Toast, your podcast and newsletter. I'm just curious, though, about the public's reaction to your work because a few years ago, I interviewed author and fat activist Virgie Tovar about her book "You Have The Right To Remain Fat," and I never received so much hate mail than when I did that subject. And, you know, I do a lot of subjects. I talk about a lot of things. What is - what has been the public's reaction to your work?

SOLE-SMITH: Yeah, you're probably going to get some hate mail after this episode, too. You know, "Burnt Toast" has been such a gift in my life because it is this real safe space. It's this community of people who want to be doing this work, who want to engage in these conversations. And we can really support each other in doing this, which has been phenomenal. Whenever I write about this topic for a mainstream media outlet, it is a completely different experience. The comment section is almost always majority hateful comments, and a lot of them end up in my email and my Twitter and Instagram DMs. And it's a really exhausting experience to - you know, to sort of wade through that onslaught. So whenever I write about these things for mainstream places, I kind of have - I know going in - you know, when I wrote about the guidelines - the American Academy of Pediatric guidelines for The New York Times, I knew going in it was going to be rough, and it was. And I remember the night the piece came out, Aubrey Gordon, who's an incredible fat activist, texted me and was like, how are you doing? Because any time one of us goes on the front lines of this, it is a rough gig. And, you know, we see that you're taking your turn.

At the same time, you know, I am a multiply privileged person. I am, again, a small fat end of the spectrum. I'm white. And so a lot of other folks have it way worse than me. Virgie definitely gets it way worse since she's a person of color. Aubrey gets it way worse. And so I'm very aware, whenever I experience it, that this is the really ugly part of this conversation, and this is something we need to address to make it safer for people to tell their stories. But it's also, in some ways, like, not where we can be doing the work right now because we - you know, there's only so much you can do when someone is an internet troll who's just sending you fat insult after fat insult in your DMs. Like, there's no reasoning with that person, you know? So all you can do at that point is protect yourself and figure out what you need to move through that.

MOSLEY: Virginia Sole-Smith, thank you so much for this conversation.

SOLE-SMITH: Thank you. This was amazing.

GROSS: Virginia Sole-Smith is the author of the new book "Fat Talk: Parenting In The Age Of Diet Culture." She spoke with guest interviewer Tonya Mosley, host of the podcast Truth Be Told. After we take a short break, classical music critic Lloyd Schwartz will review a new set of CDs collecting almost all the music ever danced to by the Ballet Russe, a company that revolutionized ballet. This is FRESH AIR.

(SOUNDBITE OF TOMMASSO-RAVA QUARTET'S "MONDO CANE") Transcript provided by NPR, Copyright NPR.