Childhood Obesity, Mothers, and Blame

Every mom cooks like this no

Last time, Childhood Obesity News talked about a controversial public service announcement that Dr. Pretlow discussed in an interview. Many people interpreted the PSA as zeroing in on mothers as the root of the childhood obesity problem. For simplicity’s sake, it’s easier to address mothers as the main nurturers, but of course almost all advice for moms is also for dads, extended family members, day-care workers, and anyone else responsible for putting food into the face of a young human.

Even when mothers are not overtly blamed, they are made to feel like failures. Writing for Patch.com, Lisen Stromberg describes the thought process:

You tell me my kid is obese and two things happen, a) I get defensive because the subtext is I’m not a good mother, and b) I ignore your advice because I don’t want to consider that, as the gate-keeper to my children’s health, I may actually be harming them.

Women have all kinds of complicated feelings about weight and body image, both their own and their children’s. For some women, the modern fitness-conscious mom is a paradigm of self-involvement and narcissism that they don’t want to sign onto. Stromberg says:

For these women, being the mother who provides food and sacrifices herself for her family is more important than her own weight. She doesn’t have time to exercise because what little time she does have, she wants to devote to her children.

Such super-focused mothers may even be aware that example is the best way to teach. But the example they are trying to set for their children is of a mother who stays home, generally in the kitchen, and it doesn’t matter what kind of figure she has because it’s covered up with an apron anyway. The underlying idea is that a true mother is willing to sacrifice herself by “letting herself go,” without realizing that it’s not an either-or proposition. Received wisdom and unquestioned attitudes are what make up a culture, and a culture often prides itself on resistance to change. Stromberg says:

It isn’t as simple as rich vs. poor or white vs. ‘other’. We are hitting women at the heart of their roles as mothers when we tell them their children are obese. We need to find a way to work within their own value system as mothers and women.

The culture in which a mother has been brought up might encourage her, at feeding time, to watch TV rather than concentrate on the baby, and even such small and seemingly unimportant actions make a difference. “Propping” a bottle and leaving an infant alone to drink its milk or formula is seen as harmless in some cultures, while many experts would rather see this practice abandoned. The bottom line is that families of all ethnic backgrounds and races could use a little help in one way or another.

A metastudy conducted by Dr. Tristin D. Brisbois and a team from the University of Alberta looked at 135 relevant studies, comparing 42 variables suspected to be associated with adult obesity. They narrowed it down to seven main early markers. Mothers who smoked and gained too much weight during pregnancy were noted as likely causes, and maternal BMI appears to be a definite cause. Again, rather than being neglectful or uncaring, these mothers might have been operating out of what they considered more important motives than keeping themselves healthy.

Class, or more bluntly, economic status, seems to play a part, and brings to mind an interesting footnote from a previous Childhood Obesity News topic. In this study, the economic difference was confusingly split. Speaking of the effect on unborn babies of electromagnetic fields from cellphones and appliances, Dr. De-Kun Li’s team observed that:

…there was no consistent pattern of MF exposure with family income: women with either low or high family income had lower MF exposure level than women with medium family income.

There are so many ways in which parents can sabotage their children’s heath — using food as a reward for good behavior; being overprotective, negligent, or authoritarian; reacting to stress in unhealthy ways; and many more — and Childhood Obesity News will look at them more deeply.

Your responses and feedback are welcome!

Source: “The Answer To Childhood Obesity? Mothers,” Patch.com, 06/25/12
Source: “Early Childhood Factors ID’d for Predicting Adult Obesity,” DoctorsLounge.com, 12/29/11
Source: “A Prospective Study of In-utero Exposure to Magnetic Fields and the Risk of Childhood Obesity,” Nature.com, 07/27/12
Image by Brian and Mia Elizardi

Dr. Pretlow Interviewed About Controversial PSA

Atlanta Panorama

A couple of years back, Childhood Obesity News discussed the Georgia anti-childhood obesity billboards. Created by the Strong4Life program founded by Children’s Healthcare of Atlanta, they were criticized as tasteless and too judgmental.

So much attention was focused on the billboard/poster campaign that few people remarked on a 1-minute, 41-second video PSA the group released around the same time. “Rewind the Future” didn’t garner much attention at first, but recently it suddenly did. It starts with a patient being readied for surgery. He weighs about 300 pounds and just had a heart attack. We are shown scenes from his earlier life, going farther into the past each time. Here is how Cristina Goyanes of Shape.com describes it:

As the flashback continues, Jim’s mom enters the picture. At first, she seems caring, gifting him an at-home treadmill to help him lose weight. Rewind a little more, and the story shifts. Rather than encouraging her son to be healthy, as she does later, Mom is doing the opposite, picking up fast food for him, buying him candy from a vending machine, letting him eat sugary cereals for breakfast, and feeding him French fries.

Now everybody’s talking about the video’s shock value and alleged fat-shaming. It is a factor worth being sensitive to. The Rudd Center for Food Policy and Obesity has determined that behavior change is not effectively motivated by stigmatizing people. More to the point, the short film is parent-blaming. Still, not everyone is upset. Its proponents describe “Rewind the Future” as bold, and the topic deserves boldness. Writer Beth Greenfield quotes an online comment from an unnamed doctor:

Obesity is perhaps one of the worst comorbidities to have for a hospital patient. It complicates everything. Every. Single. Thing.

“Rewind the Future” just wants to raise awareness and encourage people to make some changes, even small ones. And by people, they mean parents. An honest parent will admit there are times when you will do just about anything to get a child to stop fussing. Some parents have even found themselves struggling to appease a difficult child as if offering sacrifices to a raging monster from a horror movie.

A parent can take a very positive and useful step toward avoiding that situation. Parent Effectiveness Training and other courses can teach parents how to cope in those moments of temptation. Feeding a child is not the only way to get some peace and quiet. The Strong4Life website offers parenting tips from a page that also says:

As parents (and humans), we’ve all made decisions that didn’t look too good in hindsight. But today, right now, we have an opportunity for a life changing do-over…. if your children are still children, it’s not too late.

The Shape.com writer Cristina Goyanes also interviewed Dr. Pretlow, who confirmed that parents often play a role in enabling a child’s obesity. Please do visit and enjoy “Are Parents to Blame for Obesity?”

Your responses and feedback are welcome!

Source: “Shocking Anti-Obesity PSA Sparks Debate,” Yahoo.com, 08/12/14
Source: “5 Tips for Powerful Parenting,” strong4life.com, undated
Source: “Are Parents to Blame for Obesity?” Shape.com, 08/15/14
Image by Tim Dorr

The Closing Childhood Obesity Window

Fat Boy

The journal Childhood Obesity (Volume: 10 Issue 4: August 1, 2014) published an editorial by Dr. Stephen R. Daniels (University of Colorado School of Medicine) and Dr. Aaron S. Kelly (University of Minnesota Medical School). “Pediatric Severe Obesity: Time to Establish Serious Treatments for a Serious Disease” makes the case that the prevalence of severe obesity among teenagers is accelerating, and the need is obvious for more intensive interventions. The authors very strongly urge more drugs and more bariatric surgery for America’s youth.

How did we get to this point? What makes these health professionals advocate such extreme measures? Nearly 6% of children and teenagers in the U.S. qualify as severely obese. Extrapolation from longitudinal studies predicts that 90% of these obese kids will be obese adults, with all the comorbidities that come along with severe obesity. The authors spell out the consequences:

Children and teens with severe obesity … have higher levels of blood pressure, triglycerides, inflammation, oxidative stress, lower levels of high-density lipoprotein cholesterol, signs of subclinical atherosclerosis, and a higher prevalence of impaired glucose tolerance and prediabetes. Severe pediatric obesity is also associated with obstructive sleep apnea, nonalcoholic fatty liver disease, musculoskeletal problems, and reduced quality of life.

However, while diet and healthy lifestyle changes have a chance when implemented during childhood, the window of opportunity closes fast. Prevention is the best approach, and failing that, early identification of the problem and early intervention are crucial. Severely obese teenagers are another story. Although lifestyle modification therapy should be included in their program, the authors feel that lifestyle changes alone cannot be enough, and anything short of surgical treatment is “virtually ineffective.” They write:

The current state of evidence suggests that more intensive interventions, potentially including pharmacotherapy and weight loss surgery, may be required to elicit meaningful reductions in adiposity and the comorbidities associated with severe obesity in this lifestyle treatment resistant adolescent population.

The reason for this dictum is that even if lifestyle modification alone may seem to working the short term, by the time a teenager has become severely obese, the body has already made far-reaching adaptations. The hormones that manage appetite and satiety may be so out of whack that it will be impossible to maintain weight loss over the long term. According to the authors, better access to specialty medical weight management programs, pharmacotherapy, and weight-loss surgery are all important components of a more comprehensive strategy to combat severe obesity among teens. But they pin their best hopes on pharmacotherapy and bariatric surgery.

The additional bad news is, when it comes to pharmacotherapy those hopes at present are slim. Only one weight-loss drug has been approved for adolescents, but it doesn’t work very well and the side effects are considerable. Consequently, a segment of the teenage population experiences obesity so serious that surgery appears to be the only answer. Dr. Daniels and Dr. Kelly feel that surgery is underutilized. They hope that the widespread resistance to it will fall away, and also that more effective drugs will enter the market.

Meanwhile Dr. Pretlow asks, what else could this be, other than addiction? As Childhood Obesity News has discussed, Dr. Pretlow has developed a smartphone app known as W8Loss2Go, which is based on an addiction model of staged withdrawal in small increments from problem foods, snacking between meals, and excessive food amounts at meals. He says:

Intensive treatment using addiction medicine methods is showing potential for such young people, as evidenced by results from our three pilot studies involving 142 obese youth.

Your responses and feedback are welcome!

Source: “Pediatric Severe Obesity: Time to Establish Serious Treatments for a Serious Disease,” LiebertPubMail.com, 07/01/14
Image by Yun Huang Yong

We’ll Drink to That!

drinking water

Hydration for Health (H4H) is a group with a mission: to convince the world that the healthiest way to hydrate is by simply drinking water. Their method is to share educational materials, practical tools, and scientific research. Here is the crux of their message:

Nutritional advice typically focuses on food intake. Yet, the quantity and quality of the fluids we drink every day can have a significant impact on our well-being and long-term health. Therefore, one of our primary challenges is to communicate the fundamental need for healthcare policymakers and practitioners to proactively provide healthy hydration advice.

The H4H website provides a page of information about obesity and healthy hydration, complete with 22 source references. It mentions the huge risk that obesity poses to a large number of people worldwide. Fluid intake influences a person’s metabolic system and the likelihood of straying into overweight or obesity. How much water does a person need? It depends, and math is involved, but thanks to H4H there is no need to find the calculator, because a handy chart is provided.

Water is the main ingredient in us. The body needs water as the medium in which other elements can mingle and react. Without it, we couldn’t have the blood river that takes useful molecules where they need to go and carries harmful substances to the disposal plant. Additionally, we need water for temperature regulation.

Things to drink other than water

No question, clean water is definitely the best thing to drink. But sometimes people want a little flavor and maybe even some nutritional value. Stay away from iced tea sold in bottles or cans, because it might contain as much sugar as soda pop. Tea that comes as a powdered mix is not only inexcusably expensive, but stuffed with sugar.

Childhood Obesity News has had plenty to say about energy drinks, which wear a deceptive aura of virtue. Energy makes you active, and activity is good, right? Not always. Activity inspired by being jacked up on sugar is nothing to write home about. Speaking of excessive sweetness, rice milk is not such a great idea either, no matter what the label says. It’s sheer carbohydrates, and a cup of it contains 92 calories worth of sugar even when none has been added. Instead, many experts recommend unsweetened almond milk.

Misunderstood

Juicing seems to be a misunderstood practice. In many cases, the skins of fruits and vegetables are meant to be consumed along with the insides. But juicing often involves taking the skins off. Instead, Dr. Christopher Mohr recommends,

Make a healthy smoothie that blends the entire fruit and/or vegetable so you … get those vitamins, minerals, and other nutrients along with the fiber. Add a scoop of whey protein, blend in some dairy milk, unsweetened almond milk, or water and you’ll have a perfect breakfast energy drink.

Dr. Julie TwoMoon is a juicing enthusiast, but with reservations and caveats. Commercially available juices, she says, have been subjected to a pasteurization process such that “all enzyme and vitamin function has been rendered neutral.” The vegetables have to be raw, and the juicing needs to be done in the moment.

Your responses and feedback are welcome!

Source: “Our mission,” H4initiative.com, undated
Source: “Healthy hydration and obesity,” H4initiative.com, undated
Source: “Water requirements for daily life,” h4hinitiative.com, undated
Source: “10 Surprising Foods Making You Fat,” Fitbie.com, undated
Source: “5 Foods You Think Are Healthy—But Aren’t,” MensHealth.com, 02/27/14
Source: “Dr. Julie’s Top 7 Misconceptions Of The Health Food Store World,” SevenDirectionsMedicine.com, 03/30/14
Image by darwin Bell

Fooled by Food Again

Fresh-picked apricots

Last time, Childhood Obesity News looked at some of the foods available at the grocery store or even the health food store, that give a false impression of their integrity. Or maybe it’s just that we have a mistaken idea of what to expect.

Dr. Julie TwoMoon is a graduate of the National College of Naturopathic Medicine who also practices Oriental medicine. She finds several prevalent misconceptions about “health food.” One is that anything labeled “low fat” is automatically and unquestionably better. But Dr. TwoMoon reminds us that without fat, there is no carrier for fat-soluble vitamins, and without Vitamins A, D, E, and K, we are in a sorry condition. But what about the synthetic vitamins added to the products by manufacturers? Sorry, but they are no fit substitute.

Writer K. Aleisha Fetters passes along the ideas of author Jorge Cruise, who warns that calories acquired from sugar are the deadliest and need to be most vigorously avoided, for this reason:

They spike your blood sugar levels, triggering the release of hoards of insulin, which tell your body to store food as fat and hang onto the fat your body already has.

Cruise believes that no more than 100 calories per day should come from sugar (or basically from carbohydrates, since once inside the body it becomes pretty much the same thing.) There are, he says, starches that convert so fast they can raise a person’s blood sugar more quickly than straight table sugar. Fetters mentions many foods that people can easily be ambushed by because of their unexpected contents. For instance, in ½ cup of black beans, there are 92 sugar calories. Of course we need protein, but hummus is a much better source.

Although whole grains might contain more nutrients and protein than refined grains, Cruise isn’t crazy about them because at the end of the day they’re still mainly carbohydrate. Whole-wheat pasta, for instance, contains more than 200 sugar calories, twice Cruise’s recommended daily intake. He suggests instead using Japanese shirataki noodles, made from tofu.

Yogurt is a treat that needs to be chosen carefully, because a little container of it can hold as many calories as a can of soda. Even 6 ounces of fat-free yogurt might contain 50 calories worth of sugar, to replace the flavor removed along with the fat. Some experts suggest cottage cheese instead, to get an equivalent amount of protein without the sugar.

Fruits and vegetables

The American public has gotten the message that it’s important to eat many servings of fruits and vegetables per day. But they’re not all created equal. A fresh pear has 92 calories worth of sugar — pretty close to the suggested limit for the day. Cruise’s replacement suggestion is an apricot, which offers only 16 calories worth of sugar, and Vitamin C besides. He is totally against dried fruits, and Fetters explains why:

In nature, water is a main component of fruit, and can actually help regulate the body’s blood sugar levels. So when you suck all of the moisture from your fruit, you also suck dry its ability to moderate blood glucose spikes.

Dried bananas, for instance, account for a whopping 240 sugar calories in the very small unit of ¼ cup. Instead, snack on fresh blackberries, at 29 sugar-derived calories per ½ cup. Veggies can be treacherous too. A sweet potato has as many sugar-based calories as a pear — 92, which is too many. Sadly, this list could go on and on, but the research is worth doing, if we don’t want to fool ourselves.

Your responses and feedback are welcome!

Source: “Dr. Julie’s Top 7 Misconceptions Of The Health Food Store World,” SevenDirectionsMedicine.com, 03/30/14
Source: “10 Surprising Foods Making You Fat,” Fitbie.com, undated
Image by louis bennett

Fooled by Food

Wolf in Sheep's Clothing

There is so much confusion about what is good to eat and what isn’t that it’s really hard to keep up. Many people believe their diets are pristine, while consuming foods that are “wolves in sheep’s clothing” — foods that actually undermine their quest to achieve a healthy weight. From several sources, Childhood Obesity News has gathered tips that might inspire people to take a second look at their beliefs about various foods.

In a Readers Digest list of “27 Foods You Should Never Buy Again,” several examples apply to the realm of weight loss. Low-fat peanut butter, for instance. When the fat comes out, guess what goes in to make it taste OK? A bunch of sugar. There are many reasons to avoid processed, smoked, or cured meats, and chances are anyone visiting this blog has already said goodbye to them. But just in case, we are reminded that pork sausage can legally be composed of up to 50% fat.

Let’s mention “multi-grain” bread, which is called “junk food masquerading in a healthy disguise.” The author recommends just skipping the bread and eating brown rice, steel-cut oats, quinoa and barley. Gluten-free baked goods, if not exactly a scam, are the next-best thing to deception, according to this author:

If you aren’t diagnosed with celiac disease or a gluten intolerance, keep in mind that gluten-free doesn’t necessarily mean healthy — and gluten-free baked goods like bread, cookies, and crackers often are packed with more refined flours, artificial ingredients, and sugar than traditional baked goods.

If the absence of gluten really is important, many weight-conscious cooks recommend bread made from almond flour, which avoids the problems of grain and carbohydrates while providing protein. Which brings us to what Dr. Julie TwoMoon believes is a common misunderstanding of nutritional truth, because many people believe that “You can eat as much protein as you want, just watch the carbohydrates.” TwoMoon warns that protein, while excellent and necessary, can be problematic because the human ability to process it stops after about 4 ounces of it per meal, and after that it’s converted into glucose, and from there into fat.

The Crunchies

Granola, which for some reason still retains a hold on people’s imaginations as some kind of ultimate health food, is nothing of the sort. Of course there are many ways to make granola — it’s kind of like soup in that respect. But a ball-park average calorie count for about ½ cup of it seems to be around 500 calories, and that’s before milk is added. About 150 or more of those calories could easily be from sugar, so read the label and beware of syrups, whether high fructose corn syrup, glucose syrup, or the innocent-sounding maple syrup.

Granola bars, aka energy bars, are just the same stuff glued together tighter. They have fat! They have sugar! They have calories! Dr. Christopher Mohr calls the energy bar a “carb-dense sugar bomb that offers very little in terms of sustainable energy or satiating protein.” Dr. Mohr also advises fish enthusiasts to stay away from Americanized interpretations of sushi, which contain a lot of hidden calories in the sauces. He says:

Instead stick with ‘sashimi,’ which is fish without rice and no sauces. Or if you want the rice, nigiri is the same piece of fish with just a bit of rice underneath. While you’re at it, stick to the better fish varieties like salmon, mackerel, and tuna — all rich in heart healthy omega-3 fats and protein.

Individual servings

It might seem like a good idea to buy little 100-calorie packages of snacks, but you’re probably kidding yourself, because you’ll just keep opening and eating one after another, meanwhile supporting the packaging industry in high style.

Your responses and feedback are welcome!

Source: “27 Foods You Should Never Buy Again,” RD.com, undated
Source: “Dr. Julie’s Top 7 Misconceptions Of The Health Food Store World,” SevenDirectionsMedicine.com, 03/30/14
Source: “5 Foods You Think Are Healthy—But Aren’t,” MensHealth.com, 02/27/14
Image by janwillemsen

Childhood Obesity and Design

missing something

“Design” is a term that has always drawn an emotional response, whether positive or negative, and it makes a difference at every level of life’s activities, starting first thing in the morning.

What size should a breakfast cereal bowl be? Big enough to hold the serving of cereal and the milk, with a little extra space for maneuvering, to get the spoon full without slopping outside the bowl. The recommended serving of most cereals is about ¾ cup, with about ½ cup of milk. The cooking measurement of one cup is about 8 ounces, but “cereal bowls” are sold in 16-ounce size, and even with a 22-ounce capacity.

One trick of the design trade that can help with eating habits is to use a small bowl or plate, which fools the eyes and mind into thinking that the stomach is receiving more. The idea of designing for health applies not only to small kitchen items like bowls and plates, but to buildings and outdoor spaces, which “green” health partnerships work toward changing to improve health outcomes.

The venerable Robert Wood Johnson Foundation is the source of an article called “Fighting Childhood Obesity by Design Thinking.” For a very long time and in most contexts, design merely meant aesthetic appeal, or the way an object looked. The newer concept of design thinking is wrapped up in every stage of development of a product, process, service, or even strategy. It’s what architect Louis Sullivan was talking about with his famous dictum, “Form follows function.”

Increasingly, designers are regarded as partners in meeting the needs of the users of products and services, and their input is solicited from the very earliest stages. This is the kind of thinking the Foundation wishes to apply to the problem of childhood obesity. Vanessa Farrell, a program associate who works with the RWJF childhood obesity team, explains:

Designers can help create compelling solutions and concepts that can make healthy choices appealing and accessible, challenge conventional thinking, and shine light on practices and policies that need improvement. They can play an essential role by putting their design-thinking to work influencing human behavior around choices related to diet and physical activity.

The basic idea here is that individual behavior change alone is not enough to reverse the childhood obesity epidemic, and that many answers must be found or created in the built environment. How can designers more effectively collaborate with researchers and public health practitioners on influencing choices related to physical activity and diet? That was one of the questions addressed by some of the 2,000 design professionals who convened last fall for a design conference called “Head, Heart, Hand.”

One of the panelists was Dr. Matthew Trowbridge of the National Collaborative on Childhood Obesity Research (NCCOR), an organization that has produced a comprehensive report on building sustainable schools for healthy kids. Dr Trowbridge, a pediatrician who teaches at the University of Virginia School of Medicine, talked about a school in Virginia that was redesigned around a food lab and teaching kitchen, with a compost facility and outdoor gardens cared for by students.

Available from NCCOR’s website is a comprehensive report titled “Public health and the green building industry: Partnership opportunities for childhood obesity prevention,” which includes seven recommendations on how to apply green health research and practice to the area of childhood obesity prevention.

Another participant talked about how design thinking plays a vital role in data visualization, which in turn paints the picture of a community’s assets and needs. For schools, cafeteria design was discussed, because it has been shown that placement of various foods can influence which ones are chosen. These are only a few examples of how design of the built environment can work hand-in-hand with health professionals dedicated to eradicating childhood obesity.

Your responses and feedback are welcome!

Source: “Culture of Health,” RWJF.org, 10/09/13
Source: “Green Health,” NCCOR.org, 2013
Image by Jennifer Donley

New Thoughts on Addiction and the Brain

All things which hold us together

Considering how many people fall prey to addiction, and considering how many potentially addictive things are in the world — including food we eat every day — it might seem as if science should know a little more about it by now. But many questions are open, and Bethany Brookshire lists some of them. A human is wired to have a reward system, which is meant to encourage us to continue doing and pursuing things that are good for us. But sometimes the reward system gets its wires crossed and causes us to want things that are bad for us. Is that the root of all addiction?

Or is addiction basically a learning disorder? Or an inappropriate overreaction to normal stress that most people develop healthier ways of dealing with? Or does it stem from an unlucky combination of inborn genetic conditions that interact badly with input from the environment? Brookshire suggests that while none of those ideas are wrong, they are all incomplete:

Addiction is a disorder of reward, a disorder of learning. It has genetic, epigenetic and environmental influences. It is all of that and more. Addiction is a display of the brain’s astounding ability to change — a feature called plasticity — and it showcases what we know and don’t yet know about how brains adapt to all that we throw at them.

While a case can be made that genetic differences cause some individuals to have an increased vulnerability and propensity toward addiction, that is only a small part of the total picture. And while dopamine does undeniably play a role, it turns out not to act in the ways that were originally assumed to be the totality of the picture. Different areas of the brain don’t always connect in the same ways. Neither the chemicals nor the receptors consistently act in the ways that researchers had come to expect. Many times, causality is an open question.

The trouble with studying the brain of an addict is the difficulty of distinguishing what conditions existed there before the addiction. What came first? Some sort of deficit that opened the door for addiction? Or a continuing assault upon the system by some substance, which created a deficit?

Science thought for a while that the answer could be found in dopamine, the brain chemical associated with pleasure. Addictive drugs bring out more of it. But that simple theory has been thrown into doubt.

Paul Kenny, a neurobiologist interviewed by the writer, notes a subtle but significant difference — the notion that dopamine measures not pleasure, but value. For instance, the presence of a drug has the effect of re-prioritizing the reward system. The substance is assigned the highest value, while other parts of life such as family, money, work, and law-abidingness take a back seat. Brookshire explains:

As someone takes a drug over and over, dopamine and other systems in the brain respond with plasticity — that is, those systems adapt to the presence of the drug. Receptors that control the response to chemicals like dopamine change concentration. Connections between brain cells and between different areas of the brain strengthen and weaken.

As Dr. Kenny admitted, “Now, scientists are willing to admit we have no idea where reward comes from or how we experience pleasure.” So, back to square one.

To many researchers, it appears evident that all behavioral disorders are the same because they all involve learning and plasticity. One example given is the development of habits, which generally benefit us. It’s a very good thing that a person can, for instance, remember how to use a toilet even when half-asleep, in pain, or just preoccupied with other thoughts. If we had to stop and relearn how to do it every time, life would be complicated indeed. Most of our habits are good. But when an addictive substance is present, the brain learns differently and in maladaptive ways. We not only catch bad habits, but the process of habit formation gets speeded up.

Brookshire’s article of course goes into much greater detail about all these ideas and the researchers who discuss them. She wraps it up with a comprehensive back-to square-one type of statement:

The only overall explanation for addiction is that the brain is adapting to its environment. This plasticity takes place on many levels and impacts many behaviors, whether it is learning, reward or emotional processing. If the question is how we should think of addiction, the answer is from every angle possible.

Your responses and feedback are welcome!

Source: “Addiction showcases the brain’s flexibility,” ScienceNews.org, 08/05/14
Image by torbakhopper

Childhood Obesity’s Urgent Message

Chubby Baby

Last time, Childhood Obesity News looked at part of the conversation between author Michael Prager and Dr. Christopher Ochner, a researcher in obesity and nutrition. They touched upon many points, but the big takeaway from Dr. Ochner’s studies has to do with prevention. Everything he says emphasizes the importance of stopping childhood obesity before it begins.

The problem is that a commercial or faddish popular weight-loss diet may be successful in the short term. But people who engage in them almost always gain the weight back. Success in shedding pounds does not always result in sustainability. Dr. Ochner defines sustainability as “the ability for most individuals to maintain a particular behavior.” Apparently, most individuals do not possess this ability to any great extent.

Dr. Ochner teaches in three different subject areas — pediatrics, psychiatry, and adolescent medicine. He and his colleagues are experts, and their perspective is results-oriented, related to realistic expectations of what health professionals “can get most people to do most of the time for the long run.” He writes:

Based on the data we have, only 2 percent to 5 percent of the individuals with obesity who are successful in losing a meaningful amount of weight (5 or more percent of initial body weight) are successful in keeping it off long-term using ANY kind of weight loss diet…. I despise that fact but I can’t deny that it is fact.

What he’s saying is maybe, at best, one weight-loser in 20 will be able to sustain the loss. But then elsewhere he gives even worse odds:

[T]he average adult individual who has been obese for a period of time has less than a 1 percent chance of maintaining a healthy body weight long-term…. Once an adult has developed and maintained obesity for an extended period of time (varies but probably about 12 months), the body adopts that new higher body weight and will from then on defend that body weight as if it needs every one of those pounds to survive.

A less than 1 percent chance of sustaining weight loss — what a disheartening statistic! The body always strives to return to its highest weight — what a grim prognostication! It is a biological drive, which originates in the part of the biology called the brain. Dr. Ochner believes that behavioral techniques, willpower, and support groups are no match for the natural tendency to backslide.

What all this points to is the urgent importance of not becoming overweight in the first place, because once obesity sinks its teeth into a person it can be very difficult to shake. There are stages on the road to obesity where it’s still possible to turn around or take another path. But it appears that a year could be the crucial period. After a year of obesity, a person can still return to normal weight, but with an exponential increase in difficulty.

A research team from Emory University established that the kindergarten year is important for children, because the typical overweight 5-year-old is four times as likely to become an obese eighth-grader, compared to the fate of a normal-weight 5-year-old. The lead author, Dr.Venkat Narayan, is not certain to what extent obesity has to do with the things that happen before a child is born. But he is certain of this much:

The biggest risk of developing new obesity from ages 5 to 14 is really driven by kids entering kindergarten overweight…. Those children who were born large or are overweight at age 5, something is happening very early in life which sets the pathway to obesity.

Your responses and feedback are welcome!

Source: “ ‘Food could be considered an addictive substance.’ ” MichaelPrager.com, 06/13/14
Source: “Doctor replies: We have to worry about the other 95 percent,” MichaelPrager.com, 06/20/14
Source: “The doctor replies again: Once obese, it’s tough to escape,” MichaelPrager.com, 08/01/14
Source: “Kindergartner’s weight strong predictor of later childhood obesity,” FoxNews.com, 01/30/14
Image by Eduardo Merille

Differences in Approach to Obesity

October 13, 2013 at 0536PM

Childhood Obesity News discussed the conversation between Michael Prager, whose field is personal sustainability, and research scientist Dr. Christopher Ochner. There are more issues that deserve attention. Dr. Ochner holds the very pragmatic view that human nature is constant. In terms of the obesity epidemic, this implies that people will continue to eat what they love. They will continue to gain weight, and regard obesity as an unfortunate but acceptable side effect of what he calls “the American diet.” He writes:

The trick is not cutting out the foods we love to eat, but finding a way to make the foods we love to eat better for us.

That is an audaciously optimistic ambition. But even if science someday makes potato chips as healthy as Brussels sprouts, in the United States alone we’ve got something like 12 million obese kids who are in trouble right now.

Michael Prager is optimistic in a different way, trusting people to discover and serve their own “raw self-interest.” He mentions food allergies and sensitivities, and anyone can think of examples of how people change to avoid suffering. A person with celiac disease comes to terms with dietetic limitation. A person with diabetes adapts to the food rules. Even vegans who refuse meat for reasons of conscience are acting in their own self-interest, because following one’s conscience is gratifying. In its own way, this philosophy is also practical. Prager says:

I think that ice cream and pizza and onion rings taste great, and do occasionally feel a twinge about not eating them. But briefly put, I have experienced my life with those dishes in it, and experienced life without them, and on balance, without is better.

My experience from having taken those measures…. has been a flowering of my life in ways I couldn’t conceive until I acknowledged my struggles sufficiently to go deep enough to find what worked…. But everyone seeking a solution needs to be willing to keep trying solutions until they get the results they want.

Prager did not want to be obese, so he made choices, like eliminating flour and sugar from his diet. The main thing is, he has maintained a significant weight loss for a meaningfully long time. Also, he does not believe himself to be some kind of exceptional human being. The logical conclusion that follows, and the assumption he makes, is that anyone can do the same — make the tough choices, and find life’s fulfillment in things other than food.

While Dr. Ochner seems pretty well convinced that people can’t or won’t change, Michael Prager believes we are able to change, and specifically that we are capable of getting over the childish idea that actions don’t have consequences. He writes:

A foundational part of my release from extreme obesity has been accepting otherwise, that as just another citizen of the planet, I will experience the obvious outcomes of my choices. If my choices aren’t taking me where I want to go, the answer is to make different choices. Given reasonable reasons to do so, practically anyone is capable of doing that.

Your responses and feedback are welcome!

Source: “The greatest flaw in nutritional dogma?” MichaelPrager.com, 06/19/14
Source: “I didn’t diet, and I don’t feel deprived,” MichaelPrager.com, 06/20/14
Image by Arya Ziai

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