By Jeffrey Azslow
The Wall Street Journal
September 2, 2009

One day in January 1986, fourth-grade girls at Marie Murphy School in Wilmette, Ill., were called down to the principal’s office.

A stranger was waiting there to ask each girl a question: “Are you on a diet?”

Most of the girls said they were.

“I just want to be skinny so no one will tease me,” explained Sara Totonchi.

“Boys expect girls to be perfect and beautiful,” said Rozi Bhimani. “And skinny.”

I was the questioner that day. As a young Wall Street Journal reporter, I had gone to a handful of Chicago-area schools to ask 100 fourth-grade girls about their dieting habits. Researchers at the University of California at San Francisco were about to release a study showing 80% of fourth-grade girls were dieting, and I wanted to determine: Was this a California oddity, or had America’s obsession with slimness reached the 60-pound weight class?

My reporting ended up mirroring the study’s results. More than half of the 9-year-old girls I surveyed said they were dieting, and 75% “even the skinniest ones” said they weighed too much. I also spoke to fourth-grade boys and learned what the girls were up against. “Fat girls aren’t like regular girls,” one boy told me. “They aren’t attractive.”

The front-page story helped spark discussions about America’s worship of thinness and its impact on children. It raised the question: Would these girls be burdened by the dieting culture as they grew into women?

Those girls I interviewed are 32 and 33 years old now, and when I got back in touch with some of them last week, they said that they and their peers have never escaped society’s obsession with body image. While none of them descended into eating disorders, some told stories of damaging diets and serious self-esteem issues regarding their weight.

They felt-and recent studies make clear-that the weight-focused pressures on young girls today are even stronger. In the now-quaint era of 1986, the girls had told me about drinking Diet Cokes and watching Jane Fonda exercise videos. Ms. Totonchi had read a teen novel about a girl with an eating disorder.

But today’s fourth-grade girls are barraged by media images of thinness. They can cruise the Internet visiting “Pro-Ana” (pro-anorexia) Web sites and can view thousands of “thinspiration” videos on YouTube celebrating emaciated young women.

“Models look like popsicle sticks,” Suzanne Reisman told me in fourth grade. Today, she amends her observation: “Now they look like toothpicks.”

In fourth grade, Christy Gouletas told me thin models “are sexy, so boys like them.” Today, she is a middle-school teacher in Wheeling, Ill. On lunch duty each day, she notices 10 girls who eat nothing. “We make them take a few bites,” she says, “but they fight me on it. They say, ‘I’m not hungry,’ and I tell them, ‘You’ve been here since 8 a.m. Of course you’re hungry!’ ”

“The influences are worse now,” says one researcher, Kerry Cave, a clinical nurse leader at Martin Memorial Medical Center in Stuart, Fla. Earlier this year, in the Journal of Psychosocial Nursing, she chronicled the latest research on “the influences of disordered eating in prepubescent children.” Among the findings: A preoccupation with body image is now showing up in children as young as age five, and it can be exacerbated by our culture’s increased awareness of obesity, which leaves many non-overweight kids stressed about their bodies. This dieting by children can stunt growth and brain development.

Incidences of bulimia have tripled since the 1980s and anorexia incidences have also risen, according to studies collected by the National Eating Disorders Association. Parental fixations on weight, children’s urges toward perfectionism, family conflicts, and a $40 billion-a-year dieting industry can all lead girls to disorders. But studies also show that self-starvation in girls can be triggered by media images, including Internet sites promoting anorexia and bulimia as lifestyle choices. Among the pitch lines used on these sites: “Nothing tastes as good as thin feels.” On one recent “Pro-Ana” blog, a woman suggested a 30-hour group fast and received 64 responses such as “I can’t wait to do this fast with you. Thirty hours food-free sounds like heaven” and “I’m with you. Down to the bones.”

Researchers have seen a marked increase in children’s concerns about thinness in just the past few years. Between 2000 and 2006, the percentage of girls who believe that they must be thin to be popular rose to 60% from 48%, according to Harris Interactive surveys of 1,059 girls conducted for the advocacy group Girls Inc.

Compared with the fourth graders of 1986, girls today see body images in ads “that are even further from reality. Retouching is rampant,” says Claire Mysko, author of “You’re Amazing,” a book encouraging self-esteem in girls. She worries that childhood obesity-prevention efforts can make girls obsessive about weight. While these programs are important vehicles to fight a growing problem, “we have to be really careful how we are implementing nutrition and body imaging,” she says.

Those fourth graders of 1986, now all grown up, offer heartfelt reflections on all of these issues.

Ms. Totonchi is public-policy director at the Southern Center for Human Rights in Atlanta. In fourth grade she told me she wanted to be thin so no one would tease her. “What I said that day is still very true,” she says. Today, she watches her weight “so I can be successful in a world that puts great emphasis on how a person looks.”

She vows to do so through healthy eating. As an adult, she once experimented with a low-carb diet and says she still has high blood pressure as a result. “It did so much damage to me,” she says. “It was a lesson to me not to follow fads.”

Ms. Reisman, now a writer and blogger in New York, says she was an emotional eater as an adolescent, “turning to food for comfort.” She got heavier in college, but she now watches what she eats and weighs a healthy 125 pounds. She is concerned about the heightened pressures on girls today to be thin and sexy. She knows of 9-year-olds asking their mothers to buy them thong underwear. “That’s horrifying to me,” she says.

Ms. Gouletas, the teacher, says she was “always a fat kid” and is now 40 pounds overweight. Even though she eats healthy food and exercises five days a week, it’s hard for her to shed pounds.

As a fourth grader, Krista Koranda recognized that some people can’t help being overweight. “We don’t make fun of fat girls,” she said. Not all her male classmates were as empathetic. One boy in her class responded that if someone can’t help being fat, “then you shouldn’t make fun of them. But girls in the fourth grade can help it.”

Now a public-relations consultant in Boulder, Colo., Ms. Koranda Torvik (her married name) says she appreciates it when ad campaigns today use plus-size models. “That’s encouraging,” she says, even though such ads are the exception.

In fourth grade in 1986, Ms. Bhimani says, she and her friends admired teen celebrities such as Molly Ringwald, “girls who were skinny but healthy.” Now, the actresses on teen TV shows such as the resurrected “90210″ are being called “alarmingly thin” in media reports. “They look so unhealthy,” says Ms. Bhimani, an attorney for the Federal Trade Commission in Chicago. “And it’s a skinny that’s unattainable for most people.”

Ms. Bhimani became heavy in college and later took off 40 pounds through exercise and portion control. When she reread my 1986 Journal article, she found some of the boys’ comments “appalling.” She thought about her 3-year-old son. In six years, he’ll be in fourth grade.

“I hope I am able to instill values in my little guy that help him see past weight,” she says. “The pressure to stay thin comes from many different sources in society, and I just hope my son isn’t one of those sources.”