Senator Tammy Baldwin's office issued the following:
10.4.19
Pediatricians and eating disorder experts warn that Kurbo’s design is filled with red flags
WASHINGTON, D.C. – U.S. Senators Tammy Baldwin (D-WI) and Richard Blumenthal (D-CT) wrote to the CEO of WW, formerly known as Weight Watchers, to call on the company to immediately pull Kurbo—its potentially harmful dieting app designed for children as young as eight years old—from the marketplace. Since the app was launched, numerous pediatric specialists and eating disorder experts have raised concerns that Kurbo’s poor implementation and design, such as the inclusion of before-and-after photos and a focus on weight reduction rather than nutrition, could put a child’s mental and physical health at risk.“Childhood obesity is a medical crisis in the United States, and it is imperative that pediatricians and medical professionals, including those with expertise on eating disorders, guide decisions parents and children and making about healthy eating habits. An app like Kurbo, in conjunction with this lack of relevant medical expertise, has the potential to contribute to eating disorders that plague children, adolescents, and adults across the country. Simply put, Kurbo has no place in the hands of children and we ask that you withdraw the app from the marketplace,” wrote the Senators.
“According to pediatricians and eating disorder experts, Kurbo’s design is filled with red flags,” wrote the Senators. “Unfortunately, Kurbo’s system lacks necessary medical support and oversight for children that could provide nutritional guidance, tips on healthy habits overall, and properly discern, on a situation to situation basis, if it may or may not be appropriate for a child to be seeking to address his/her weight.”
The Senators warn that “Kurbo’s use of before-and-after photos, as well as the use of BMI and weight loss results tells children that they deserve to feel successful only if their BMI or weight drops, or if they look like the child Kurbo had featured, implying that their appearance and the number on the scale is more highly valued their health or character. This emphasis on losing weight directly contrasts expert advice from the American Academy of Pediatrics (AAP) in 2016 that parents should steer their children clear of dieting and avoid specific discussions on weight.”
“Eating disorders have the second highest mortality rate of any mental health condition,” the Senators note. “Unfortunately, adolescents who engage in dieting are five times more likely than their peers to develop an eating disorder, meaning that Kurbo’s consumers are at a particularly high risk.
“There is no question that childhood obesity is a devastating health issue, but WW has seemingly disregarded the medical advice of pediatricians and eating disorder experts, as well as the health of the millions of children who could be at risk of, or currently suffer from, an eating disorder. There are more responsible ways to address the childhood obesity epidemic that do not expose children to so much potential harm. A child’s confidence, mental and physical health, and lifelong relationship with food is invaluable,” wrote the Senators.
The full letter is available below and here.
October 3, 2019
Ms. Mindy GrossmanWW CEO
675 Sixth Avenue
Sixth Floor
New York, New York 10011
Dear Ms. Mindy Grossman,
We write to you today with grave concern regarding the recent release of your app, “Kurbo by WW.” Kurbo, much like WW, formerly Weight Watchers, is an app-based program designed to spur behavior change resulting in weight loss. However, unlike WW, Kurbo is designed to target children as young as eight years old. While parents can pay for a coach to provide guidance to their children, these coaches are not medical professionals. Childhood obesity is a medical crisis in the United States, and it is imperative that pediatricians and medical professionals, including those with expertise on eating disorders, guide decisions parents and children and making about healthy eating habits. An app like Kurbo, in conjunction with this lack of relevant medical expertise, has the potential to contribute to eating disorders that plague children, adolescents, and adults across the country. Simply put, Kurbo has no place in the hands of children and we ask that you withdraw the app from the marketplace.
According to pediatricians and eating disorder experts, Kurbo’s design is filled with red flags. The website and app feature “success stories” boasting the weight lost and BMI of each participating child. Before-and-after photos are also featured on Kurbo’s blog. Kurbo’s use of before-and-after photos, as well as the use of BMI and weight loss results tells children that they deserve to feel successful only if their BMI or weight drops, or if they look like the child Kurbo had featured, implying that their appearance and the number on the scale is more highly valued their health or character. This emphasis on losing weight directly contrasts expert advice from the American Academy of Pediatrics (AAP) in 2016 that parents should steer their children clear of dieting and avoid specific discussions on weight. Instead, AAP advises parents to focus on body positivity, exercise, and healthy habits to address obesity.
This trend continues within Kurbo. Upon registering, children over 13 years old, and children under 13, in conjunction with their parents, are steered into a questionnaire that prompts them to choose a reason for joining, among which options include: “Achieve a healthier weight,” and “Boost my confidence.” Kurbo was more direct initially, including options such as, “Lose weight,” “Feel better in my clothes,” and “Make parents happy.” By using this questionnaire, Kurbo is once again demonstrating that they are disregarding AAP’s advice and focusing on weight loss as a goal.
Children are also instructed to track their weight and any food or drink they consume within the app. Foods are classified into a traffic light system that defines foods as red, yellow, and green. “Red foods” include sweets, but also foods like full-fat cheese and crackers. “Yellow foods” include chicken, beans, rice, and other starches or lean proteins. The only “green foods” are fruits and vegetables. In an attempt to demystify the system and provide guidance, Kurbo offers a loose video tutorial for free and in-app coaching for children at a fee.
Clinical trials and current systems currently utilizing the traffic light system heavily emphasize and integrate families and clinical providers to offer support and guidance. Unfortunately, Kurbo’s system lacks necessary medical support and oversight for children that could provide nutritional guidance, tips on healthy habits overall, and properly discern, on a situation to situation basis, if it may or may not be appropriate for a child to be seeking to address his/her weight. The in-app coaches, which are provided at a fee, are not qualified to provide this guidance for children. Additionally, none of the in-app coaches are pediatricians or health professionals with expertise on identifying and responding to eating disorders. Children need their pediatricians and families, those who understand their lifestyles and needs, to guide them through healthy, life-long eating habits.
This problem is confounded by the uniqueness of Kurbo’s traffic light system in that it focuses on calories, rather than the quality of the calories consumed. In doing so, Kurbo app glosses over the importance of eating a variety of foods, vitamins, and nutrients. Additionally, the system ignores the dietary needs of children who are still developing and progressing through puberty.
Ultimately, a child using Kurbo could be incentivized to develop compulsive eating behaviors that eventually lead to disordered eating. The consequences of eating disorders can be devastating. Patients between the ages of 15 and 24 with anorexia nervosa have a 10 times higher risk of dying than their peers without anorexia nervosa. In fact, eating disorders have the second highest mortality rate of any mental health condition. Unfortunately, adolescents who engage in dieting are five times more likely than their peers to develop an eating disorder, meaning that Kurbo’s consumers are at a particularly high risk. The pressures to engage in dieting start at a young age—the very age Kurbo is targeting. Roughly 50% of elementary school girls are concerned with their weight and 13% of girls under 20 met the criteria for an eating disorder.
There is no question that childhood obesity is a devastating health issue, but WW has seemingly disregarded the medical advice of pediatricians and eating disorder experts, as well as the health of the millions of children who could be at risk of, or currently suffer from, an eating disorder. There are more responsible ways to address the childhood obesity epidemic that do not expose children to so much potential harm.
A child’s confidence, mental and physical health, and lifelong relationship with food is invaluable. We encourage you to heed the advice of medical professionals and experts and immediately pull the Kurbo app from the marketplace. Additionally, we urge WW to thoughtfully consider consulting with clinicians, pediatricians, and other health care providers specializing in eating disorders and weight management before and upon re-designing and re-implementing any future apps or programs. Please respond to this letter by October 17, 2019 detailing your plans to do so