The CDC must re-evaluate the HECAT in consultation with weight-inclusive nutrition education and eating disorder experts. The HECAT and health curriculums that precede it need to consider the following:

1. “Obesity prevention” can no longer be the foundation of the health curriculum or nutrition education. Rather than focusing on weight, health and nutrition education must focus on body appreciation, care, respect, and trust by eating foods that both nourish and satisfy, while also enjoying physical movement.
2. Health Curriculums must accept and respect the diversity of all body shapes and sizes. The seemingly “healthy body shape” is not inclusive in honoring the ethnic and racial diversity in our school systems, among students, faculty, friends, and family members. 
3. Health and nutrition education must accept and respect the diversity of all body shapes and eliminate weight-stigmatizing language from health and nutrition education. For example, “obesity”, “overweight”, “weight management”, “healthy body weight”, “weight control”, etc. must be removed from all curriculums and teachings. All students, in all body sizes, need health and nutrition education. There are those in large and small bodies who are healthy, just as there are those in large and small bodies who are unhealthy. 
4. Do not label food as healthy/unhealthy or good/bad. Nutrition has no moral value. Nutrition is too complex to label in such concrete terms. No child/student should feel guilt or shame with food offerings/choices. All foods have a place. Labeling food as “healthy” and “unhealthy” creates an unhealthy relationship to food. 
5. Reconsider age appropriate nutrition education for elementary students. Elementary students are too young to have moral values attached to food by labeling food as healthy/unhealthy/good/bad.  
6. Students should not count calories as part of the health curriculum. Calorie counting is a diet as the purpose of counting calories is to manage weight. Calorie counting is harmful and may lead to disordered eating/eating disorder behaviors.
7. Health Curriculums must reinforce positive body image talk, body respect, and care while dismantling the culturally thin ideal.
8. Health educators and teachers need to be mindful of their own weight bias. 
9. Health educators and teachers need to be mindful of their own nutrition bias. What is healthy for one person may not be healthy for another person.
10. Health Curriculums must set better guidelines so all students feel safe and included in the diverse world of nutrition and health.

The HECAT (Health Education Curriculum Analysis Tool) is a tool from the CDC (Centers for Disease Control and Prevention) that assists school systems in setting their health curriculums. Therefore, in order for schools and health educators to change their health and nutrition messages for students, the HECAT needs to change first and foremost.

The need for change is the HECAT and the health curriculums that follow the HECAT are based primarily on obesity prevention- the prevention of higher body weights (and preventing body diversity). The language often used in health curriculums to describe how students should eat is the word “healthy”. The definition of “healthy” is very clear in the HECAT- there are “healthy” foods and “unhealthy” foods. I wonder how the CDC, school systems, health educators and teachers decide what healthy choices are for students. 

Additionally, learning “healthy” eating to avoid a higher body weight is dieting and implies that children and others in higher weight bodies are not healthy. This message creates weight bias and fear of weight gain at a time when a child’s body is inevitably changing as they are growing into young adults. The terms “weight control”, “maintaining a healthy weight”, and “weight management” are commonly used in health curriculums. There is harm in classifying nutrition and health in concrete terms: a thin body equals healthy and a larger body equals unhealthy. These concrete messages around health disregard inclusivity and diversity among students.  Nutrition and health education must not include weight management/obesity prevention. Children need to listen to their body and eat intuitively as they grow and their nutrient needs change. The impact of weight bias, weight stigma, weight-based discrimination, diet culture, the culturally thin ideal, body dissatisfaction, relationship to food, and eating disorder prevention, must be considered when providing health and nutrition education. 

Sincerely,

Sarah Ganginis MS, RD, LDN

Contributions by: Dana Snook, RDN, LDN, CIC

*original post edited to provide updated information/language