Oh, Prudie. No.

Thursday mornings are my “Dear Prudence” time.  One of my small pleasures in life is saving up all of Emily Yoffe’s advice columns for the week and reading them at one go on Thursday morning.  It’s one of those little rituals that makes me a wee bit happier.

Sadly, this morning there was a bit of a snag.  I know I’ve quibbled with her advice before, and I’m afraid I am again today.

My beef is with some advice she gave a mother whose daughter has a friend who likes to overeat.  Apparently this woman was appalled by how much the little girl scarfed down while in her company, and the girl’s own mother is both unconcerned about her daughter’s eating and overweight herself.  The writer wonders how best to handle the situation.  (All of this was in a video segment, and I’m sorry I have to summarize rather than just quoting directly.)

Prudence recommended modeling healthy eating by inviting the girl for home-cooked meals, portioned appropriately.  Sound enough counsel, I guess, though I doubt it will have any real impact in the girl’s life.  But she capped her advice with a real howler.  She recommended sending an anonymous letter to the child’s pediatrician, so an adult “with authority” might intervene on her behalf.

And that’s just ridiculous.

Would you like to know what I would do with an anonymous letter about a patient of mine telling me she overeats?  Nada.  El zilcho.    (An anonymous letter reporting some kind of abuse would be a different story.)  I am super curious to know what in heaven’s name Prudence thinks it would accomplish.

Let’s just say for rhetorical ease that I am the pediatrician in question.  First of all, if I have any kind of meaningful role in this child’s life, then I am already aware that she is overweight.  We record height and weight (and BMI, as a result) at every well check.  Also, I have eyes.  I know if my patients are overweight.  An anonymous tip would tell me what that I don’t already know?

And even if an anonymous letter would somehow cause the scales to drop from my eyes about some random patient of mine, what would she suggest I do?  I can think of no surer way to set off a depth charge under my relationship with a parent than to call her in for an appointment where I could engage in weight scolding based on an anonymous letter.  In fact, I would find her embarrassment and resentment that some busybody was tattling on her perfectly understandable.

Lastly, I am baffled as to what this supposed authority I have is meant to be.  The letter-writer makes clear that the chubby little girl’s mother is not interested in making any changes.  While it is my job to discuss nutrition and wellness as part of health maintenance, and I would be remiss if I didn’t mention concerns about weight to the parents of an overweight child, quite a lot of those parents ignore my advice.  Parents ignore my advice all the time, about diet and exercise and all manner of other topics.  I am powerless to change that, and (excepting cases of actual neglect) have no choice but to accept it.  I put these cases in my “I’m not a fishin’ wizard” file and move on.  And that’s to say nothing of the dismal success rates of physician-based weight-loss interventions even for patients who are motivated.

So, sorry Prudie.  But I have to disagree with your advice again.  An anonymous letter to an overweight child’s pediatrician might make the writer feel better, but it won’t do a thing to help the little girl.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. Parents ignore my advice all the time

    Heh, our pediatrician has been nagging us for years to make our girls drink whole milk, to put some weight on them. But our girls have parents and grandparents who were all skinny as kids–in some cases ridiculously stick thin. It’s genetics, my kids eat well, and they get enough exercise, so I ignore him. This being America, they’ll probably all end up fat by middle age anyway.

    But I agree with your post. Silly advice, clearly Prudence didn’t think through the mechanism of how this note was supposed to work. But maybe it’s just because she was working against a deadline.

    • One of the things I like best about Prudie is that she tends to be a realist most of the time, and also seems to have no compunction about telling writers when they’re in the wrong, need to butt out, etc. I think a much better conclusion to her advice would have been to say “Look, lady, in the end you’re going to have to accept that there’s very little you can do, and it’s for the best that you not make an issue of this if you want to preserve your child’s friendship with the little girl.”

  2. The thought that I could send anonymous notes to people to get them to parent for me had never occurred to me until now. Man, I have been wasting a lot of time with the boys that could have been spent on the Internet.

    • Well, as the hypothetical recipient of this anonymous note, allow me to reassure you that my primary response certainly wouldn’t be to get terribly annoyed and think the letter-writer was a nosy pain in the ass. Heavens, no!

  3. +1 on the post art 🙂

    Ms. Sioux was my gateway to a whole ‘nother world of music.

    Here they are doing it on TOTP, so it’s lip-synced; but the video is good quality, and this is the period when Robert Smith was a Banshee as well as doing the Cure, so you can see him on guitar.

    God, she & the Banshees were great.

      • Agreed – that is both a great song, and a terrible video.

        Here’s a video mashup that is better than any of their actual videos (I love this song; THAT is how you do drama, kiddies – those strings! That tribal drumming!)

      • Prudie’s advice was bad, but the accompanying animations were downright hateful: graphics of child-pig hybrids and tubs of lard with human heads. That’s not acceptable.

        • I thought so, too, Lindsay. The barely-veiled fat shaming was deeply problematic as a stand-alone issue. I don’t know if Emily Yoffe has editorial control over such things (I suspect not), but whoever was responsible ought to be ashamed.

          • Prudie’s one of the most popular writers on the entire Slate site. I doubt her videos go out without her knowledge and approval. If this one somehow slipped passed her, it’s her responsibility to repudiate it and apologize profusely.

          • You would obviously know much better than me. I agree that, if she does exercise that kind of control over the imagery used in her video segments, she has an obligation to offer an apology for such nasty and hurtful choices.

        • Prudence agrees the video was awful. Two postings on Emily Yoffe’s FB page

          “More on the video: We have removed it from the Dear Prudence page and explained why in a note. That page is where the vast majority of readers see the video. At Slate we don’t like to pretend our errors never existed, we prefer to apologize or correct. For that reason, the original video does remain on the Slate V site. (And I did not intend to make a pun in the statement below. Apologies.)”

          “We have taken today’s video off the column because we agree with readers that the depiction of an overweight girl as a pig is crude and offensive. I do not see the animation until it is posted, and usually it’s delightful. But a few times I have objected to the imagery myself, and today is one of those occasions. Thanks to everyone who weighed in.”

  4. 100% agree.

    Can you imagine if Prudie would have suggested a “concerned” note to Child Protective Servcies? Jebus! They’d send a swat team. Stay the hell out of other people’s kid’s lives.

  5. Well, since this is a medical issue, I have to ask myself, “What would Steve Martin do if this were The Man with Two Brains?”
    And I’m having trouble coming up with an answer.

    But I’m thinking that if I use the words “la gordita” that might bring to mind the TB post.

  6. One almost wondered whether Prudie was sure the pediatrician would ignore the note, but thought it might help Mrs. Busybody to shut up and move on… but, as you say, she is usually not so underhanded.

  7. An anonymous letter to an overweight child’s pediatrician might make the writer feel better, but it won’t do a thing to help the little girl.

    What is the actual goal that Prudie is going for, here?

    (Also: What Maribou said.)

  8. I’m glad I have a very good relationship with my son’s pediatrician. Because I’m obese (and Hubby is overweight), we’re very conscious about how what we eat and when/where we eat could teach our son bad habits.

    Having said that, it really pisses me off when I catch one of the child care providers at my son’s daycare pretty much paw through my son’s lunchbox to see what I’ve packed for him. She considers herself the ‘sugar sheriff’ and figures that, because I’m obese, obviously the only food groups I know are fried, chocolate and fatty, and therefore that’s what I give my son 24/7.

    I’ve complained about her doing so, and the response I got was, “Well, it’s reasonable because you’re so large, we want to make sure he doesn’t become obese either.”

    I’m looking into moving him to another daycare, and have filed a complaint with the town hall. It’s a steaming pile of BS that I have to put up with the Food Inquisition in this manner. The real kicker; I see other kids eating candy bars, etc while at daycare – but that’s ok, because their parents are thin.

    • Wow, that’s incredibly crass. I’m flabbergasted at the presumption. Best of luck finding another day care.

    • See this is why I hate “nanny state-ers” and other assoicated “do gooders” who think their opinions on how someone else does something: raise kids, eat, etc. should be changed because it’s “wrong”.


      • If you go by the BMI index, it says my son is obese with a score of 18-19.

        He’s 120 cm tall and weighs about 27 kg. He’s the tallest 4.5 year old in his daycare. He’s height/weight proportionate, and wears a child’s 1 shoe (not a toddler shoe!).

        There are no ‘love handles’, there’s no pudgy arms/legs or ‘babyfat’ creases. He’s large framed and if he keeps growing at the rate he does he’ll probably end up being 6’5. Hell, his bicycle helmet is an adult small because his pumpkinhead wouldn’t fit in a child’s helmet.

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