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- Hunger that comes on suddenly and can’t wait another minute to be satisfied.
- Hunger that will only be satisfied by one particular food, and it’s probably not broccoli.
- Hunger that starts “above the neck.”
- Hunger that is paired with an upsetting emotion.
- Hunger that is paired with mechanical behavior.
- Hunger that doesn’t have an “off” switch.
- Hunger despite guilt.
9 Ways Gluten Goes Undercover
December 6th, 2013
In the science of forensics, transfer theory holds that a criminal will always leave trace evidence at the crime scene. A person with celiac disease has to be as suspicious and hyper-vigilant as a detective dusting for fingerprints. If the grocery store has bulk bins, the scoop you use to measure out some safe food may have previously been used for a gluten-containing food, and you might get sick. People who don’t have CD but wish to avoid gluten for other reasons are constantly surprised to find the stuff popping up everywhere.
Yesterday, Childhood Obesity News mentioned the input received from the Weigh2Rock kids, who confide their problems and secrets to Dr. Pretlow’s website. Where do they stand on gluten? Well, aside from treats featuring wheat flour, they also tend to get hooked on fried foods, cheese, corn chips, popcorn, sour cream, nuts, burgers, potato chips and chocolate — none of which seem, at first glance, as if they would be guilty of containing gluten. Many sources were consulted to take the measure of just how innocent these particular items actually are.
Fried foods — Any fried item that has been marinated, breaded or battered has gluten. Flavorings have it. “Fillers” and anti-clumping agents have it. In most restaurants, all the fried entrees are cooked in the same fryers. The intense heat of the oil doesn’t kill gluten but transfers it to foods that are sold as gluten-free.
Cheese — Cheese is dairy, right? Why would it contain gluten? Yet it can. If it’s processed or “beer-washed,” the gluten avoider will shun it. If it’s blue cheese or Roquefort, it might have been treated with bacteria grown from rye, and bingo — you’ve got gluten. Now imagine a fancy supermarket, the kind that buys gigantic wheels of cheese. Every cut and repackaging is an opportunity for cross-contamination. Plus, flour from the store’s bakery floats in the air and lands on things. Incredibly, the ingredient lists on yogurt tubs must also be carefully read.
Corn chips — Again, careful scrutiny of the ingredients is a must. Tortilla chips can be manufactured with a variety of flours, making them a risky food for gluten-intolerant people.
Popcorn — The movie-theater kind seems to be okay, gluten-wise. Microwave popcorn and the pre-popped kind in decorated tins are not.
Sour Cream — This is amazing, but nonfat, light and full-fat sour cream are all perfectly capable of harboring gluten.
Nuts — Yep, flavored nuts, dry-roasted nuts, coated nuts, any of them could contain gluten. Even the ones that start out gluten-free can be cross-contaminated in retail store bins.
Burgers — When kids are talking about burgers, they mean buns too, which of course are bread and therefore crammed with gluten. Okay, so just order the burger without a bun. Not so fast! Even some hamburger meat is enhanced with “filler,” or the kitchen might stretch it by adding bread crumbs. It might be cross-contaminated from anything in the kitchen, and did the worker change gloves before handling your food?
Potato chips — These crunchy treats are hugely addictive, and some brands contain gluten ingredients like seasonings, while others are subject to gluten cross-contamination in production.
Chocolate — Here’s the bad news, from Jane Anderson:
Some chocolate candy products feature gluten ingredients — either in the form of wheat (most frequently in chocolate-cookie confections) or in the form of barley malt (a popular sweetener frequently used in candy). Other chocolate candies contain no gluten ingredients, but they are subject to gluten cross-contamination because they’re made on the same manufacturing equipment or in the same facilities as those gluten-containing items.
The list of unsafe foods and additives is literally hundreds of items long: imitation crab meat, licorice candy, soy sauce, malt vinegar — it just goes on and on. This gets into another realm of addiction, but beer, of course, contains gluten.
Dr. William Davis says that whole wheat bread increases blood sugar, and eating a couple of slices of it is pretty much the equivalent of eating a candy bar or drinking a can of soda pop. But the news gets even worse. He cautions patients not to go near processed foods labeled gluten-free that substitute various forms of starch. Why?
The few foods that increase blood sugar higher than even wheat include … rice starch, cornstarch, tapioca starch, and potato starch — the most common ingredients used in gluten-free foods…. [M]any celiac patients who forego wheat and resort to gluten-free foods become fat and diabetic.
Your responses and feedback are welcome!
Source: “Is chocolate gluten-free or does chocolate contain gluten?” About.com, 02/29/12
Source: “Summary: Wheat Belly by William Davis, MD,” TheHealingProject.us, 09/22/12
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Dr. William Davis Warns of Gluten
December 5th, 2013
In 2011, William Davis, M.D., published the book Wheat Belly, whose message is that “over-consumption of wheat is the main cause of the obesity and diabetes crisis in the United States.” Some of his medical peers are uncomfortable with assigning so much blame to the fabled Staff of Life, and they all have different reasons. For instance, Dr. Pretlow has remarked, “The youth on our website and in our study identify many foods with which they have a problem, outside of the flour and sugar realm, such as fried foods, cheese, corn chips, pop corn, sour cream, nuts, and burgers.”
The next post will go into that sentence deeply. The website Dr. Pretlow referred to is, of course, Weigh2Rock. Thousands of young people have supplied information on their problem foods by way of the website polls, and data has been gathered from the first study and the current study establishing the usefulness of the W8Loss2Go smartphone app. Dr. Pretlow says, “Withdrawal from specific user-identified problem foods is thus the approach of our app, then progressing to all food amounts. This self-identified problem food approach seems to resonate with the youth in our pilot study.”
But something else is going on here. While America wasn’t looking, gluten has snuck into everything, and wheat is its delivery system, to the point where the average American eats 133 pounds of wheat per year. “It’s in over 90% of the foods on supermarket shelves,” Dr. Davis says, possibly without exaggeration. He’s not talking about vegetables, fish, or nuts. The shelves in the middle are where the boxes and cans of processed food are, and an astonishing number of them contain gluten in some form, often disguised by alternate terminology. Dr. Davis asserts, “For most Americans, every single meal and snack contains foods made with wheat flour.”
Like fish in water, we are surrounded by enough of it that it becomes almost invisible. Maybe its ubiquity is part of the reason why, at first, biochemical addiction to wheat flour sounds like an unlikely reason for an obesity epidemic. Wheat seems so innocent, so helpful to humankind and so necessary. Revolutions have begun over a lack of bread.
Also, it’s not wheat
As in a science fiction film about pod people, wheat has been replaced by something that bears the same name but is not, in fact, the same. When a person longs for the incomparable biscuits that Grandma made, it isn’t just nostalgia. Davis says:
The wheat of today is not the same grain our forebears ground into their daily bread. It has changed dramatically in the past 50 years under the influence of agricultural scientists. Wheat has undergone a drastic transformation to yield something entirely unique, nearly unrecognizable when compared to the original.
This was accomplished, by the way, with no testing in regard to the safety of animals or humans. The scientists had other priorities, such as increasing yield per acre. Nobody paused to ask, “What will this do to people?” So what does it do to people? Thanks to Lisa, who took the trouble to deconstruct the book into easily graspable bites, we find Dr. Davis’s answer. For starters, the carbohydrate in wheat is very digestible and the body converts it to blood sugar with remarkable efficiency, which is undesirable in health terms.
High blood sugar, in turn, provokes high blood insulin. High blood insulin provokes visceral fat accumulation, which causes tissues such as muscle and liver to respond less to insulin. This so-called insulin resistance means that the pancreas must produce greater and greater quantities of insulin to metabolize the sugars. Eventually, a vicious circle of [increase ensues]: insulin resistance, insulin production, deposition of visceral fat, insulin resistance etc, etc…
Gluten sensitivity can even cause such unlikely-seeming problems as peripheral neuropathy, affecting the nerves of the hands and feet. In cultures where teenagers don’t get acne, they’re not eating wheat. Dr. Davis says that among his own patients, three months off grain can lead to the loss of 20 or even 40 pounds, and the remission of diabetes.
Your responses and feedback are welcome!
Source: “Summary: Wheat Belly by William Davis, MD,” TheHealingProject.us, 09/22/12
Source: “Wheat Belly: Frequently Asked Questions,” WheatBellyBlog.com, 07/26/11
Image by Robert Couse-Baker
Dr. Daniel Amen Identifies 5 Brain Patterns of Overeaters
December 4th, 2013
As we have seen, one school of thought holds that gluten is addictive. A lot of foodstuffs (as well as myriad other products) contain gluten, and gluten critics say the substance is what causes so many people to be addicted to certain foods. Any doubt can be banished by observing how often people want to take naps after meals involving pasta, bread, pancakes, pastries, and so forth. (This might be a good place to mention the meticulously detailed and mind-blowingly extensive list of unsafe foods and ingredients compiled by Scott Adams.)
Dr. Daniel Amen is a neuropsychiatrist who, according to his bio, “has worked with tens of thousands of patients from 90 countries for more than 20 years,” and that is an impressive amount of experience. He calls the 31% success rate of gastric banding a disappointment but is not surprised by this failure because, as he puts it:
Most weight problems occur between the ears, which may explain why most diets don’t work…. It’s the brain that makes our eating decisions, and what we’ve found is that there isn’t just one brain pattern associated with overeating — there are at least five.
Dr. Amen is convinced of something that far too many professionals overlook, the fact that everyone is different. In any individual case of obesity, there may be still more factors at work, including economic status, availability of food, cultural norms, physical activity level, genetic predisposition, medications and so forth. But insofar as the brain itself is concerned, he sees the five broad categories.
Then, just to complicate things, people can have more than one of the five types of reaction going on in their heads at the same time, and for this they need extra individual attention. Amen’s whole theory can be found in his 2011 book The Amen Solution, but here are the essentials as boiled down by writer Mary Monroe and then condensed a bit more here. They are all fully explained in Monroe’s Ideafit.com article, along with suggestions about supplements that might help.
1: Compulsive Overeater. Tends to get stuck on the thought of food and feels compulsively driven. Tends to be a nighttime eater. Typically claims to have no control over food.
2: Impulsive Overeater. Exhibits poor impulse control, is easily distracted and reaches for food without thinking. Research suggests that having untreated ADD nearly doubles the risk of being overweight; without proper treatment, it’s nearly impossible for people with this condition to adhere to a nutrition plan.
3: Impulsive-Compulsive Overeater. Exhibits symptoms of 1. and 2. Compulsive gamblers, for instance, are compelled to gamble and have little control over their impulses.
4: Sad or Emotional Overeater. Overeats to medicate feelings of sadness and to calm the emotional storms in the brain. Often struggles with depression, low energy, low self-esteem and pain symptoms, and tends to gain weight in winter.
5: Anxious Overeater. Medicates feelings of anxiety or nervousness with food, complains of waiting for something bad to happen and frequently suffers from headaches and stomach problems.
Amen sums it up:
So giving everyone the same diet plan will make some people better and some worse. Instead we’re seeing that we need to match our strategies for overeating to the type of brain pattern or patterns that are affecting us the most.
Plenty of information on the activity of the addicted brain is here too, as well as another list of nine strategies to control cravings, including advice on how to identify a harmful allergy to gluten.
Your responses and feedback are welcome!
Source: “It’s All in the Brain: Unlocking the Secrets of Overeating With Neuroscience,” IdeaFit.com, November 2011
Image by Tumblr.com
Dr. Mark Hyman Indicts Gluten
December 3rd, 2013
The best way to avoid foods that are bad for you is to stay away from foods with health claims on the label. They are usually hiding something bad.
What a powerful quotation! These are the words of Dr. Mark Hyman, who, like Dr. Pretlow, has written and talked about food addiction. In Dr. Hyman’s case, that subject is tied in with his suspicions about gluten as a major player in the obesity epidemic. “Gluten Free” is one of the health claims that needs to be closely examined if a person is serious about eliminating gluten from the diet.
Why would anyone do that? A relatively rare condition called celiac disease (CD), whose sufferers cannot tolerate any gluten at all, has been recognized for some time. But only in the last couple of years has there been any acknowledgment that a lot of people who don’t technically have CD are nevertheless intolerant of gluten.
The damage is inflicted on the lining of the small intestine, which is only supposed to let certain things get through to the rest of the body. But gluten empowers zonulin, which makes holes in the mortar between the cells of the intestine wall. The “leaky gut” allows chunks of undesirable material to float around in the bloodstream and wreak havoc. It’s like getting the fresh water line in the kitchen sink crossed with the sewer pipe — not recommended.
The debris that is now circulating comes to the attention of the immune system, which attacks it, and pretty soon there’s a general whole-body inflammation going on. Trouble could spring up anywhere, including further damage to the gut lining.
General confusion
In such a widespread attack of the body upon itself, the weakest points will succumb first. Patients turn up with a bewildering variety of seemingly unrelated symptoms, and doctors don’t know what’s going on. Like celiac disease, non-celiac gluten sensitivity is tricky to diagnose. But evidence is piling up that convinces many health professionals that wheat is to blame for not only obesity, but heart disease, diabetes, dementia and cancer.
A person might think skeptically, “Hold on there, my grandpa ate a loaf of bread every day for 94 years and was never sick a day in his life.” This is what Dr. Hyman addresses as one of the “hidden reasons” that actually prove how much obesity and other illnesses stem from consumption of the fabled Staff of Life, wheat.
This is not the wheat your great-grandmother used to bake her bread. It is FrankenWheat — a scientifically engineered food product developed in the last 50 years…. [I]t is different in three important ways that all drive obesity, diabetes, heart disease, cancer, dementia and more.
It contains a Super Starch — amylopectin A that is super fattening.
It contains a form of Super Gluten that is super-inflammatory.
It contains forms of a Super Drug that is super-addictive and makes you crave and eat more.
Now, that is what you might call a real triple threat. The third item must pique the interest of anyone interested in the area of food addiction. The exorphins created by digesting wheat are molecules that latch onto the brain’s opioid receptors, making a person “crazy, hungry and addicted.” These “super drugs” even have their own name — they are gluteomorphins. More impressive still, they can be counteracted by the same emergency-room drug used to treat a morphine or heroin overdose. As Dr. Hyman eloquently puts it, “Bottom line: wheat is an addictive appetite stimulant.”
Your responses and feedback are welcome!
Source: “Three Hidden Ways Wheat Makes You Fat,” DrHyman.com, 01/25/13
Image by Jeff Keacher
Is Gluten a Childhood Obesity Villain?
December 2nd, 2013
As a childhood obesity villain, gluten is one of the “usual suspects” and Childhood Obesity News has looked at the case against it before. InsuliteLabs.com takes an especially dim view of gluten:
As many as 75% of overweight and obese people in the U.S. may be addicted … to either carbohydrates or the protein called gluten, which is found in all wheat, rye, barley and oat products.
It’s found in a great many other places too, including some unexpected ones, like vitamin pills. The unavoidability of gluten is a huge problem for people with celiac disease, because they are extremely sensitive to even the tiniest amounts of it, and the consequences of exposure can be very severe. But there is a growing school of thought that gluten is harmful for just about everybody.
The contention here is that a lot of people are having milder reactions to gluten in their systems, and just generally feeling lousy most of the time, without ever being able to pinpoint the cause of their illness. InsuliteLabs.com weighs in again:
Eating gluten can cause inflammation in the sensitive mucous membranes of the intestinal lining which can trigger an immune response. Because of this immune reaction, individuals experience wide variations in symptoms such as rashes, fatigue, mental fog, behavioral disorders like hyperactivity in children, gastrointestinal symptoms such as constipation or diarrhea, chronic headaches and more.
All that is bad enough, but we haven’t even gotten to the childhood obesity connection yet. Gluten is also believed to be very addictive — as in food addiction, which by now has been well established as a real thing. The writer goes on to say:
Many individuals have increased food cravings as a reaction to consuming gluten, but are unaware of the reason for their desire to eat continuously or even out of control…. Due to the lack of specificity in identifying their disorder, many people continue to eat gluten for decades and struggle constantly with their food cravings.
Next up is Icelandic medical student Kristjan Gunnarsson. In the description of his book, Vicious Eating: The Food Addict’s Guide to Redemption, he writes: “I now haven’t touched sugar or gluten in over 6 months. I’ve lost ALL my excess weight with little effort and feel better than I ever have in my life.”
The Kris Health Blog discusses how wheat glutens form opioid peptides, which in the brain act just like heroin and morphine. Wheat, in fact, forms 4 types of opioid peptides. As it turns out, the blood-brain barrier is not much of a barrier at all, and those molecules can get through. Gunnarsson writes:
I believe that humans are able to become addicted to these substances. The process often starts in childhood, when kids are rewarded with candy when they behave well, contributing to psychological dependency as well. Judging from the above studies and personal experience, I think it is highly likely that junk food causes addiction in the brain of many people, causing them to become unable to change their diet despite wanting to.
Your responses and feedback are welcome!
Source: “Addiction to Carbohydrates and Gluten Often Underlies Excess Weight and Obesity,” InsuliteLabs.com
Source: “Junk food causes addiction in the brain,” Kris Health Blog, 03/25/11
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7 Danger Signs of Emotional Eating
November 29th, 2013
One thing to keep in mind, always, is that children are different from grownups. They do go through what used to be called “phases” and are apt to try out and then quickly discard behaviors as part of their natural development. Another thing to remember is that children are different from one another. The very young ones have many urgent concerns. Sometimes they don’t even realize they have to use the bathroom until it’s embarrassingly too late. They are still getting used to interpreting their bodies’ signals.
No parent should panic because of a single episode of what looks like emotional overeating. But in a general way, and especially with older children and teens, it’s a good idea to keep an eye out for patterns that suggest a child’s hunger might be triggered by emotional distress. These are some signs that could, if they show up often enough, indicate a need for help.
For some reason, emotional hunger seems to hit like that, rather than sneaking up in a progressively insistent way.
A craving for donuts or a cheeseburger or any specific foodstuff, especially if it’s sweet and soft, is likely to have an emotional origin.
As our source expresses it, “An emotionally based craving begins in the mouth and mind.” Real hunger, physical hunger, feels like a gnawing in the stomach, and will be just as happy with a tuna sandwich as with a package of cupcakes.
Something bad happened at school or a trip to the mall had to be canceled, and suddenly your child is eating everything in sight. Such an obvious connection is one of the easiest for a parent to spot. In a stressful situation, a parent sometimes feels an impulse like, “Fine, go eat whatever you want, just don’t bug me.” It might be difficult to resist the temptation to take this easy way out. But taking time out for a talk, or suggesting an alternate activity, could pay off big dividends.
If a child is watching TV and scooping up handfuls of cereal in an automatic, robot-like fashion, she or he might not even be aware of eating. Absentminded eating — the kind that looks like a machine adding a part to an automotive assembly line — is never healthy.
If a child plows through a second or third helping with no sign of slowing down, or even continues to eat despite signs of “too full” discomfort, the overstuffing process just might be an attempt to tamp down feelings that the child thinks can’t be dealt with any other way.
If a child is so conflicted as to feel bad about overeating but keeps doing it anyway, this is a sign of trouble. When a kid feels guilty about pigging out but goes ahead and accepts the trade-off because it buries some other emotion that’s even worse, you’ve got a situation on your hands.
These danger signs are adapted from a chart for adults that was created by Doreen Virtue for her book Constant Craving. Again, do remember that children are not yet fully formed beings and therefore can’t be judged by the same standards as adults. It’s never a good idea for a parent to get all bent out of shape over something that turns out to be nothing. On the other hand, emotional eating can quickly take over a life, and the resulting obesity, undesirable as it might be, is not really the core problem. Emotional eating is a symptom of a deeper problem that needs to be addressed if the whole family is to be healthy.
Your responses and feedback are welcome!
Source: “The Eight Traits of Emotional Hunger,” Ebookbrowsee.net
Image by Dave Parker
Health Professionals and Compensation
November 27th, 2013
Although obesity is the second most widespread cause of preventable death in the United States, many people still disagree over the American Medical Association’s June decision to classify obesity as a disease. Licensed mental health counselor William Anderson agrees that it is, and he carries an unusual personal credential: after “years of obesity and dieting failure,” he lost 140 pounds and then maintained his new weight for 30 years. Anderson asks a question and, in the spirit of full disclosure, makes a statement:
Is classifying obesity as a disease about health, or is it really all about money?
I should also point out that I’m one of the professionals whose mission and livelihood is providing weight loss treatment to overweight people.
Many professionals believe that the disease classification is the only route to receiving fair compensation for their work. Insurance companies are reluctant to pay unless they see that label. But Anderson seems to have doubts when it comes to, for instance, the American Society for Metabolic and Bariatric Surgery. Many professionals in the childhood obesity field view surgical intervention as a desperate last resort, and would prefer that it not be too easy for patients to afford. Anderson writes:
Drugs and surgery are not going to fix what is causing this epidemic…. It’s caused by recent changes in our environment and behavior. We have a different culture than we had — different foods, a different food industry, a different mindset and habits. Those are the things that need to be fixed to end obesity. Drugs and surgery will not do that, but if we’re not careful, that’s where all the attention and money will go. If that happens, the problem will get worse and we’ll go broke to boot.
It is certain that many professionals contribute beyond what they can collect payment for — like Dr. Jamie Jeffrey, who checks in with her young overweight and obese patients through Weigh2Rock. She does this pro bono, but she says it’s worth the effort in terms of its effect on the children, who seem “more likely to stay on track with their nutritional and activity goals,” as well as more conscientious in keeping their appointments.
Weigh2Rock is of course the website founded by Dr. Pretlow, who describes the process:
The children weigh in on their secure individual charts on the site, via the eCare system, and the provider[s] may monitor the weight charts of their patients and post secure supportive and educational messages to the child in each child’s individual ‘e-Room.’
As always, the financial aspect of the obesity epidemic looms large. Even with the modern availability of data, it is difficult to quantify such things. Lisette Hilton, author of the Contemporary Pediatrics article that extensively quoted Dr. Pretlow, found information on what happened throughout the United States in 2005. The figures always take a while to sort out and tabulate, and that year’s numbers suggest that obesity-related health care expenses totaled around $190 billion, which is a staggering amount. When the figures from subsequent years have all been crunched, the big picture is apt to look grim.
Future Shock
The American public is periodically stunned by impossible-sounding numbers coming out of Washington — numbers that have become so huge we can’t even wrap our heads around them. But Hilton makes a much more comprehensible point, one that has perhaps been lost among the many facets of the obesity discussion:
Because of obesity, today’s pediatricians are witness to an onslaught of pediatric patients with adult-like physical and mental health problems. Obesity in children and adolescents is associated with multiple comorbidities, including metabolic, cardiovascular, gastrointestinal, pulmonary, orthopedic, and psychological disorders.
In other words, although all physicians go through the same basic training, they do concentrate on one specialty, and the doctors trained to care for children have been ambushed by an onslaught of problems and conditions they never expected. Forced to play catch-up, they must acquire expert knowledge of conditions they never thought would show up in their waiting rooms.
Your responses and feedback are welcome!
Source: “Calling Obesity a Disease: Is This About Health or Is It About Money?,” HuffingtonPost.com, 07/09/2013
Source: “Overview: childhood overweight and obesity diagnosis and treatment,” ModernMedicine.com, 09/01/13
Image by Wayne Noffsinger
Childhood Obesity Payment Systems Catching Up
November 26th, 2013
Yesterday, Childhood Obesity News discussed a Contemporary Pediatrics article in which Dr. Pretlow was generously quoted. The substantial piece, by Lisette Hilton, went on to examine an aspect of treatment that’s not often mentioned — the difficulty doctors sometimes have in getting paid for their services. One problem is that obesity, in many cases, is immediately rejected by insurance companies as a pre-existing condition. Even in the most elastic interpretation of their rules, neither private insurance plans nor government programs cover childhood obesity thoroughly enough to meet the need. Hilton writes:
Researchers concluded in 2010 that few states ensured coverage of recommended treatments for adult and pediatric obesity through Medicaid or private insurance. Most states, according to the investigators, allowed obesity to be used to adjust rates in the small-group and individual markets and to deny coverage in the individual market.
Although the American Medical Association recently designated obesity as a disease, noticeable change has not yet happened in the area of physician reimbursement. Hilton quotes Cecelia Nardslico, a practice administrator from a pediatrics clinic in Syracuse, N.Y.:
When our collaborative efforts do not provide the success we wish for our patients, we have limited resources for further referral, let alone possible insurance reimbursement…. With the recent recognition of obesity as a disease by the AMA (June 2013), we are hopeful that the carriers who do not currently cover an obesity diagnosis will be changing their policies.
Prevention Is Key
Prevention obviously should be a huge concern, and when it comes to keeping a child healthy, a once-a-year visit is not enough to cover all the bases. If preventive care is to be a priority, time is needed for conversation between doctor, parents and child. The opportunity to follow up is essential, but is often not allowed by insurance unless the child is already suffering from a medical complication connected with being overweight. For health care providers, it is extremely frustrating to have to wait until serious illness develops, when with timely intervention it could have been avoided.
Dr. Stephen Pont teaches pediatrics and serves as medical director of the Texas Center for the Prevention and Treatment of Childhood Obesity. He told Hilton that Medicaid and private insurance companies generally do what Medicare does, and since Medicare covers obesity and weight loss, there is a good chance that the other institutions will follow. Dr. Eliana M. Perrin, a professor of pediatrics in Chapel Hill, N.C., agrees:
I see predominately children reimbursed by Medicaid, which does reimburse us for counseling related to healthy lifestyles. I actually think we have much better reimbursement than we used to for counseling about this.
In general, the doctors Hilton interviewed were optimistic about the situation improving even more.
Your responses and feedback are welcome!
Source: “Overview: childhood overweight and obesity diagnosis and treatment,” ModernMedicine.com, 09/01/13
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Youth Clinic 184
Dr. Pretlow in Contemporary Pediatrics
November 25th, 2013
The September issue of Contemporary Pediatrics rounded up the opinions of several experts on the question of how to make a difference in reducing the alarming rate of childhood obesity. The author, Lisette Hilton, found that they agree on one thing: telling children and parents “eat less and exercise more” doesn’t work. Communication is a problem, starting with a doctor’s ability to convey the information to parents that their kids are overweight. An even bigger problem is overcoming basic, ingrained ideas and habits. An obese child may be the designated patient, but the whole family needs to change.
Dr. Pretlow, who was interviewed by Hilton for the piece, discovered this not long after creating Weigh2Rock.com. The original intent was to provide a safe place for kids and teens to discuss their issues around weight. With parents, peers and sometimes even their doctors seemingly aligned against them, he figured that young people need sympathetic ears, even if the ears belong to other kids in the same socially isolated niche. In the piece, Dr. Pretlow is quoted as saying, “The level of human misery that is expressed in what these kids write in chat rooms is just appalling.”
With around 100,000 kids dropping in to socialize at Weigh2Rock in an average month, the obvious conclusion was that more use could be made of the platform. The audience had selected itself and shown up. It was sitting there with open ears. What more could a helpful adult professional ask for? Hilton tells the story:
The next logical step, Pretlow thought, was to use the site to teach those on it conventional wisdom about healthy eating and exercise. The educational component, coupled with the site’s peer support, would surely help them lose weight and maintain healthier weights. Or so he thought.
Further study — including asking the kids, via interactive polls, what was going on with them — led to what Hollywood might call the big reveal. The kids had enough education. They were armed to the teeth with information about calories consumed in food and calories burned by exercise. They were not intellectual rebels, refusing to accept good advice, but psychological prisoners, aware of what needed to be done and unable to do it. A significant number even self-identified as addicts, and this was the theme of Dr. Pretlow’s 2009 book, Overweight: What Kids Say.
Today, Weigh2Rock incorporates an eCare system used by health care providers to keep tabs on their overweight and obese young patients. More importantly, the system lets young people know that someone cares and helps to promote feelings of safety, comfort and connection that are very different from the sense of isolation many of the kids have suffered.
The supportive environment created by Weigh2Rock is endorsed by, among others, Dr. Jamie Jeffrey, who runs the pediatric weight management program for, and is medical director of, the Children’s Medicine Center in Charleston, W.Va. After kids complete an intensive two-month program at the clinic, Dr. Jeffrey stays in active contact with them via Weigh2Rock. She says the interactive website appears to have a positive effect on their ongoing weight management:
The kids that do Weigh2Rock on a regular basis seem to do better. I don’t have absolute data — I can just tell you that they are more likely to come to their appointments. They are more likely to stay on track with their nutritional and activity goals.
Your responses and feedback are welcome!
Source: “Overview: childhood overweight and obesity diagnosis and treatment,” ModernMedicine.com, 09/01/13
Image by Laura Lewis
Singapore Addresses Eating Habits
November 22nd, 2013
As Childhood Obesity News has been discussing, the city-state of Singapore is quite serious about lowering its childhood obesity rate, and is pursuing that goal with a two-pronged strategy. One prong is more physical fitness for all citizens — regardless of their age or what kind of shape they’re already in — because exercise can do nothing but good, and because team sports foster a spirit of cooperation and cohesiveness that can only be beneficial for society.
The other path by which the goal is being approached is a general improvement of everyone’s eating habits. The authorities recognize that the mind plays a large role in what the body eats, and the minds of children are being influenced in ways that are not healthy. Studies show a correlation between video games and obesity. Singapore is well known as one of the largest markets for consumer electronics, and speaking of consumption, videogaming has been shown to go hand-in-hand with increased junk-food intake. Once this realization sank in, the prevalence of cybergaming and television rose to the top of the worry list.
In August, Singapore reported its childhood obesity rate as 11% and stepped up its efforts to follow World Health Assembly recommendations to do something about the way foods and beverages are advertised to children. The government found that:
…children, especially the younger ones, do not comprehend the persuasive intent of advertising. They generally lack the capability to effectively evaluate commercial claims and appeals, and therefore tend to accept the information conveyed in advertising as truthful, accurate and unbiased. They are thus more susceptible to commercial persuasion.
Singapore, unlike some other countries, has very little faith in or regard for the concept of industry self-regulation. Officials are aware that industries do an inadequate job of setting limits for themselves and that someone else must do it for them. That someone is the government, which has a Code of Advertising Practice. This code gives guidelines for the types of ads that can be beamed at kids, but currently only one clause directly addresses the food and beverage industry:
Advertisements should not actively encourage children to eat excessively throughout the day or to replace main meals with confectionery or snack foods.
Studies of how children in Singapore spend their discretionary time indicate that they do a lot of television watching and reading. Other studies, of advertising expenditures, indicate that food and beverage manufacturers spend about four-fifths of their ad dollars on television and print media. So the current thinking about obesity is that the best places to start tackling it are TV ads and print media that are popular with children. The government puts it this way:
Consultations have been conducted with stakeholders from the public/regulatory sector [e.g., Ministry of Information, Communications and the Arts (MICA), Media Development Authority (MDA), Advertising Standards Authority of Singapore (ASAS)], private sector (e.g. food industry, media owners and advertising agencies) and people sector (e.g. focus group discussions with parents). The general agreement is that this is an important initiative and more robust standards for food advertising to children should be developed.
The regulators will start with the foods and beverages considered to be the biggest childhood-obesity villains — substances that are high in fat, sugar or salt. They will focus on free TV programming most likely to be watched by children, paid TV outlets that provide dedicated children’s channels, and print media primarily seen by children.
By the way, one might assume that the harmful effects of print media are negligible because kids don’t read anymore. One would be mistaken, at least where Singapore is concerned. A quick look at just one source indicates that reading is a very big deal on the island. The “Born to Read, Read to Bond” program includes a CD that reads stories to a child still in the womb, while at the same time teaching parents how to read stories in case that is not part of their skill set. The “10,000 Fathers” program encourages dads to take part in literacy development. There is a “KidsREAD” program and a “Read and Reap” program, and those are just from the public libraries’ website. No doubt other agencies and institutions offer many more.
We hope you have enjoyed this in-depth look at what one very determined country has been doing and plans to do about childhood obesity.
Your responses and feedback are welcome!
Source: “Public Consultation on the Proposed Strengthening of Food Advertising Guidelines for Children,” hpb.gov.sg, 08/21/13
Source: “Reading Campaigns – Children,” PL.sg
Image by alex yosifov
