How the Tax Movement Fared in 2011

Share a coke withChildhood Obesity News has been looking back at some of the attempts to curb obesity by making it more expensive, a tactic that seems to have had success with smoking. There are obvious differences between the two behaviors. Nicotine is a substance that anyone could quite easily go without for an entire lifetime. Food is not. Tobacco products, in most places and for most people, do not come into play until the teen years. Food is a part of everyone’s life from Day 1.

Communities of every size and description have taken different approaches in their attempts to convince their constituents that taxing junk food is the way to go. Trying to figure out how to tax junk food is a definitional nightmare. There are so many brands, varieties, potential ingredients, caveats, exceptions, and entrenched emotions. Dr. Pretlow’s Weigh2Rock polled youngsters on this very subject. The list of problem foods is predictable—cookies, pastry, chips, soda pop, chocolate.

In many parts of the U.S., food for home consumption is not taxed. One of the lurking dangers in junk food taxation is that the law of unintended consequences could come into play, opening the door to a much wider range of food taxation, which would cause great harm to people in lower economic classes.

In 2011, reflecting on how change might be induced in the nation’s food system, Michael Pollan wrote:

The food movement is about to gain a powerful new partner, an industry that is beginning to recognize that it, too, has a compelling interest in issues like taxing soda, school lunch reform and even the farm bill. Indeed, as soon as the healthcare industry begins to focus on the fact that the government is subsidizing precisely the sort of meal for which the industry (and the government) will have to pick up the long-term tab, eloquent advocates of food system reform will suddenly appear in the unlikeliest places—like the agriculture committees of Congress.

All along, the beverage wing of the food industry has played a dual role. Because of the high calorie content of sugar-sweetened beverages and the obvious fact that no human actually needs soda pop, ever, SSBs have seemed to be ostensibly the easiest place to drive in a wedge. On the other hand, the soda business has been the most staunchly defended bastion of manufacturers’ alleged rights to do whatever they please, no matter how much damage they cause to the nation’s health.

In 2011, the Center for Science in the Public Interest floated the nice round number of $10 billon per year as the amount that could be generated if every state put a 7-cent tax on each 12-ounce can of soda. If applied correctly and diverted into the right budgetary pockets, that huge amount of money could go a long way toward repairing the damage done to the health of American citizens.

But the countervailing forces were strong, and Rebekah Wilce was one of the writers who warned of the lurking sinister presence of ALEC—the American Legislative Exchange Council. Two years earlied, ALEC whipped up a document titled, “A Resolution in Opposition to Discriminatory Food and Beverage Taxes.” Posing as a friend of the hard-working, typical American just trying to pay the grocery bills, ALEC promoted the idea that any tax on food or drink is discriminatory.

A fellow named Adam Putnam, described as an “alumnus” of ALEC, became Florida’s Commissioner of Agriculture, and upon taking office the first thing he did was throw a monkey wrench into Florida’s efforts to ban SSBs in its schools. At the same time, Coca-Cola and the American Beverage Association and the notorious Koch brothers were partaking of secret meetings with ALEC. Wilce reported:

Coke and the ABA have successfully resisted bills and overturned laws imposing taxes on soft drinks in Florida, New York and Washington State…In Philadelphia, they defeated a modest tax on soft drinks by using the tobacco industry tactic of applying strategic philanthropy to purchase leverage in the form of goodwill. The ABA formed a deceptively-named front group, the Foundation for Healthy America, that they then used to funnel a $10 million donation to the Children’s Hospital of Philadelphia to, of all things, expand its obesity program.

Your responses and feedback are welcome!

Source: “How Change Is Going to Come in the Food System
TheNation.com, 09/14/11
Source: “ALEC and Coca-Cola: A “Classic” Collaboration
PRWatch.org, 10/12/11
Image by DietDoctor.com

Fame Weighs Heavy

Toronto-Wintergarden Theater

Childhood Obesity News, like the rest of America, has been interested in the conjunction between celebrity and obesity. We have asked such questions as “Who can get away with being fat?” “Childhood Obesity, Celebrities, and Eating Disorders,” which appeared over a 3-day period, covered Beyoncé and some aspects of Michelle Obama’s relationship to weight problems.

Actor and TV personality Ricki Lake managed to keep fans interested in her career through years of weight struggles. Her career was atypical, in that her first big show business break arrived specifically because the role required an overweight person. Subsequently, Lake lost a large amount of weight and, unlike many other formerly obese stars, maintained a healthy weight for many years afterward.

A trio of very prominent women entertainers all admitted to being obese due to comfort eating, and publicly identified themselves as food addicts. Valerie Bertinelli even wrote a book about her weight loss journey. Kelly Osbourne lost a bunch of weight, bleached her hair blonde, and appeared on the cover of Cosmopolitan magazine. Carrie Fisher, whose portrayal of the Star Wars character Leia won the hearts of multitudes, has waged a very public battle against obesity. Her particular problem is a frame that barely tops five feet in height. Such a petite lady can’t successfully carry even a few extra pounds.

Singing star Lady Gaga went through an obese stage, which she used as a platform for urging fat acceptance, or at least a more compassionate attitude. Other celebrities who “came out” as food addicts include Wynonna Judd and Kirstie Alley. And let’s not forget the men – like Adam Ray, Tom Arnold, and Matt Mira who are all actors and comedians. The challenge is no easier for them.

Politicians have a tougher row to hoe. The public does not seem interested in cheerleading political leaders through the ups and downs of weight struggles. Ed Koch, who served three terms as governor of New York, took his advisors seriously and reduced enough to satisfy voters.

One politician who may not be able to get away with being fat, despite having undergone lap-band surgery, is New Jersey governor Chris Christie. The country has already endured one round of editorial discussions about his waistline and the moral implications thereof. Now, with his intention to make a run for the presidency, the questions are back with a vengeance. Last month, Watchdog.org reported:

Christie spent $360,000 from his state allowance during his five years in office. More than 80 percent of that money, or $300,000, was used to buy food, alcohol and desserts.

Apparently, at least $100,000 of the expenditure was for food and drink for his personal consumption, the rest being spent on food for official entertainment purposes. Despite Christie’s reported loss of 85 pounds, the discussions about his weight are also back in the headlines.

Your responses and feedback are welcome!

Source: “_Christie buys $300K of food & booze with NJ expense account,” Watchdog.org, 05/11/15
Image by Canon in 2D

Everything You Know about Addiction is Wrong

hugs not drugs

In a recent Huffington Post article, Johann Hari discussed what he calls “the essential mystery of addiction:”

What causes some people to become fixated on a drug or a behavior until they can’t stop? How do we help those people to come back to us?

He suggests that the answer can be found in the work of Bruce Alexander, a psychology professor who challenged the validity of famous experiments in which rats became addicted to cocaine. Those poor rats, housed in barren environments, were lonely and bored. Prof. Alexander built the Rat Park, and all bets were off. The Rat Park inhabitants had good eats, fresh water, recreational opportunities, plenty of company and what, in the rat community, passes for intellectual stimulation—and cocaine, too, if they wanted it. The result, Hari says, was:

The rats with good lives didn’t like the drugged water. They mostly shunned it, consuming less than a quarter of the drugs the isolated rats used. None of them died. While all the rats who were alone and unhappy became heavy users, none of the rats who had a happy environment did.

Dr. Pretlow notes that this research may shed light on what is going on with eating addiction, as well:

The underlying cause seems to be lack of a social connection. We have observed this in our three studies, where the participants would hardly interact with each other. Obesity self-perpetuates this social isolation, e.g. being teased/rejected, turning more to food for comfort (“food is my best friend”), further loss of social skills and self-esteem, and more isolation.

This might be a good place to mention a remark made by Morgan Black, a drug counselor who works with addicts every day. He says they tell him, “Heroin feels like a warm hug.” In other words, it begins to look more and more as if human connection is the answer to everything. Johann Hari says:

This new theory is such a radical assault on what we have been told that it felt like it could not be true. But the more scientists I interviewed, and the more I looked at their studies, the more I discovered things that don’t seem to make sense—unless you take account of this new approach.

That paragraph was a tease, because the wisest course of action here would be to check out entire long-form piece. Incidentally, artist Stuart McMillen transmogrified Alexander’s work into an easily-comprehensible graphic novel format, and it has been translated into several languages.

Alexander, Hari, McMillen, and many other thought leaders have paused to take a step back and consider some of the things we think we know about addiction. Consequently, they are all about acceptance, compassion, unconditional love, and empathetic support. On the other hand, tough love rehab apparently works for some people, as described by David Foster Wallace in his novel Infinite Jest. On the whole, it appears that the clash of controversial (and maybe ultimately unprovable) ideas fits right in with the frequent Childhood Obesity News category, “Everything You Know is Wrong.”

It may very well be that social isolation is the underlying cause of the addictions to eating and other harmful behaviors that many people experience. There is also a good argument to be made that it is self-perpetuating. On the other hand, many of the distracting activities that people set for themselves are solitary ones, and for many people, they work. In his advice to a mother in England, Dr. Pretlow recommended that her daughter take up drawing or a craft project. Occupying a person’s hands is often enough to prevent other activities that are harmful to the self, like compulsive eating. Childhood Obesity News reader Cat McClintock wrote:

You listed activities kids can try instead of comfort eating, but you failed to mention my teenage favorite: playing sad songs on my guitar in my room alone for hours and hours. I laugh about it today, but it did the trick!

Of course, the lovely thing about an activity like playing the guitar is that it can inspire the person to seek out more social interaction, like forming a musical duo or joining a band. So it could go either way. Dr. Pretlow adds this note about the W8Loss2Go smartphone app, and how it can pave the way to engagement in social relationships that can be either preventative or curative:

Our app tries to help the child/teen reverse this vicious circle by building self-esteem and interacting with other users in the Peer Support area. Plus, the face-to-face group meetings, where the kids share wireless microphones connected to a loudspeaker and a recorder, seem to foster openness and camaraderie and have the potential to re-establish a social connection.

Your responses and feedback are welcome!

Source: “The Likely Cause of Addiction Has Been Discovered, and It Is Not What You Think,” Huffingtonpost.com, 01/20/15
Source: “#197: Injection Protection (Morgan Black),” LibSyn.com, 12/16/14
Source: “Rat Park,” StuartMcMillen.com, undated
Image by Vark1

Reply from a British Mum

About Gluttony

Because all of Dr. Pretlow’s time is spent working hard on a program to guide millions of children out of the prison of obesity, he is not able to respond to every individual. A recent letter, a true cri de coeur from an English mother at her wits’ end, is a classic example of the pain felt by exasperated parents everywhere. It included so many specifically addressable points that Dr. Pretlow was inspired to create a document comprehensive enough to serve as a universal reply to parents who desperately want to help their kids, but who just don’t know where to start or how to proceed from there.

Along with this very detailed list of suggestions, Dr. Pretlow referred the British mum to an instruction manual he authored, at the same time making Addiction Model Intervention for Obesity in Young People available to all as a PDF download. (You’re welcome!!!)

This was only a short time ago, and of course the British mum has not had a chance yet to put into effect many of the recommended changes, or to get much practice at doing things in new ways. Sometimes, problems seem so overwhelming that a person just doesn’t know where to start, and there is not even a gleam of light at the end of the tunnel. Despair moved this lady to express herself further, and the rest of the words in this post (except at the very end) are hers.


 

Things are even worse with my daughter’s eating—I do not know what is going to happen with her. I do find it hard with the manipulating as she makes a real fuss and gets nasty if I say she can’t have stuff. That said, I do not give in very often. The thing is, I do have to have some food in the house, and she will do stuff like mixing flour, butter, sugar or sweetener and raisins to make cookie dough and eat it, or this morning at 5 AM she was making pancakes with eggs, milk, manuka honey (which I keep in for my arthritis), and some gluten free flour which I had bought for a coeliac friend.

This afternoon she went out with her father and he bought her quinoa, craisins, goldenberries, kale and then a giant pepperoni pizza. As soon as he went home she cooked and ate the whole pizza. I told her not to, but she did. I am sometimes afraid to say no to her because she will cut herself (she has self-harmed for some years now).

You would think that this all must stem from some trauma, but I honestly don’t think that there has been anything. Her father and I divorced when she was little, and she hasn’t dealt well with it. She is very jealous of his new partner—hates her—and when her father said that they were going to get married, she cut her arms really badly. We have seen several psychotherapists and they have all said that she is very strong-willed and that she doesn’t have clinical depression, and that the self-harming is seeking attention.

Her last blood work showed an underactive thyroid, so she has to go for another blood test next week. The doctors we have seen say that her eating is essentially a lifestyle choice and that unless she wants to lose weight then they can’t (or won’t) help. We live in the UK and it is very different trying to access help over here. I wanted to send her to a weight loss camp but they are prohibitively expensive and my health authority refuse to pay. (They will pay for weight loss surgery though, which is ridiculous.)

I worry because she is so unfit and immobile. The slightest effort makes her breathless and sweaty, and she has almost no clothes which fit her. She never goes out unless her father, elder sister or I take her in the car. She won’t go to school and says that it is because the stairs are too difficult for her. It breaks my heart.

After her pizza tonight she was so full that she became drowsy and went up to bed and is now asleep. Tough love is hard, especially with the “self harm” threat which hangs over things all the time. She is so stubborn. If I say things like “If you don’t stop this I will take your laptop/phone/etc.,” she counters with “How about this? If you take my phone/TV/whatever, then I will eat and eat and eat,” or do whatever I don’t want her to do, “until you give them back to me.” So it becomes a Mexican standoff.


 

Dr. Pretlow comments:

Like all addicts, the daughter has to reach rock bottom. Until then, it is indeed a stalemate.

Such histories of long-standing and seemingly intractable problems point urgently at the need to start young, before behaviors can become entrenched. Childhood obesity is an area of life where the old saying, “An ounce of prevention is worth a pound of cure,” should be carved in stone over the doorway. Once more, we encourage readers to take advantage of the availability of Addiction Model Intervention for Obesity in Young People.

Your responses and feedback are welcome!

Image by Celestine Chua

 

Dr. Pretlow’s Advice to a British Mum

Addiction Model Intervention

{NOTE: Yesterday Childhood Obesity News published, with the kind permission of its author, a moving communication from a mother in Great Britain, along with the beginning of Dr. Pretlow’s response. Here is the rest of that reply.}

You can’t make her accept your help, but only offer her the opportunity. It’s up to her. She really should be the one who mentions that her weight is a problem, not you. Be caring. Be her friend. Be patient. Try to find out what’s important to her, what she likes, what she’s good at, what she might like to do in life.

Educating her on the health dangers of weight gain may have no effect. Education on health effects of smoking doesn’t have much effect on kids either. Kids, particularly teenagers, tend to feel invincible. Motivations such as being able to move faster, not being teased, being able to wear cool clothes, and attracting the opposite sex, have much more effect. Try to tap into the things that are important to her in order to help motivate her. Your daughter desperately needs to see a way out of her vicious circles and the life that she’s backed herself into. She needs believable hope that there is a way out. She likely feels that food is currently her only recourse. You can help her find hope and see a way out.

Escaping the Vicious Circles of Obesity

You can help guide her to break out of the vicious circles, find other ways to get comfort and cope, and re-establish her life again. A vicious circle will cease rotating if broken at any point on the circle. The possibilities:

  • Help her to reduce her emotional pain, perhaps with counseling on problem solving. Give her a journal or a tablet and see if she will write down her problems and aspirations, and what she might do about them.
  •  Help her to stop eating as a way to ease emotional pain, anxiety, or boredom, and to find non-food alternatives like pets, volunteering at a shelter, or activities with other teens. What activities are capable of preventing boredom and diverting her attention from the eating urge? She might take a course in drawing, pursue arts and crafts, or join a photography club or fishing club. She could fill a Distraction Jar with slips of paper containing ideas, and, when the eating urge strikes, pull one out and do it.
  • Help her build self-esteem. If she could lose even a few pounds, there would be less need of food for comfort. Other self-esteem builders are to write down her strengths, what people like about her, and do something nice for someone else.
  • Help her to move. Her heavy weight causes her to get out of breath easily and causes joint pain, both of which make her more sedentary, which equals more weight gain and another vicious circle. Staying sedentary burns fewer calories, and doesn’t supply muscle movement endorphins, and she snacks more. The loss of just a few pounds brings better movement, so she can get out of the house, find distractions, and break that second vicious circle. Each time your daughter is able to break a vicious circle for even just a bit, the circle will get smaller and easier to break the next time.

Helping as a Parent

As you have realized, nagging or being the food police is counterproductive for helping overweight teens and typically turns food into a power struggle. Your distress about your daughter’s weight or disapproval of her sneaking food may be felt as abandonment by her, resulting in more seeking of comfort from food. The impetus to stop sneaking food has to come from her.

Continue to be the mom who cares about your daughter’s health and her future well-being. Reassure her that you love her no matter what and that you understand why she sneaks food, that it’s a way to ease sadness, nervousness, or stress. Once you have re-established a relationship with her, please consult the booklet “Addiction Model Intervention for Obesity in Young People,” downloadable from Weigh2Rock.com as a pdf file.

Help your daughter understand that her urges to snack really are not hunger, and that she will be fine if she doesn’t snack. Suggest that when she has the urge to go and eat something that she just relax, take a deep breath, hold it for a second or two, blow it out, repeat, then distract herself. She’s likely lost her other coping skills and will need to re-kindle those skills, like writing her problems down, looking at life as an adventure, getting support from other people, etc.

At Home, Practice “Tough Love”

Help her to avoid, or immediately get away from, food cues. Avoid having any food in front of her other than at meals, especially when she might feel nervous or upset. She should distract herself if she can’t avoid food cues—go outside, read a book, send a text, call or hang out with a friend, or journal what she’s feeling and also write what she might do about it. Help her to stay away from food except at meals, and replace eating between meals with some activity that she likes, as mentioned earlier.

You must be able to endure displeasure and anger from your daughter when you stop allowing her to have treats and snacks or extra food at meals. You will need to take her through withdrawal from problem foods, snacking, and excessive food amounts. She will try to manipulate you and make you feel bad. Don’t give in. Lock up all food in your house, even canned and boxed goods. Any available food is a trigger for her to eat. As you indicated, your daughter is able to buy food herself or order food delivery to your house, yet someone still has to pay for it. Do not give your daughter any money. If she earns money herself, at least it will get her out of the house and with other people.

Food Withdrawal

Once she starts feeling better about herself, you can broach the subject of food withdrawal and that you are going to help her gradually break her eating addiction. Hopefully, this will be with her cooperation, once you are able to talk to her and explain that it is for her benefit and that you care very much about her and will help her. Food withdrawal is explained in the booklet, and is summarized below.

She must identify her problem foods, foods which she craves or cannot resist when available, and then stop eating them, one at a time, until her cravings or difficulty resisting the food have resolved (typically 10 days). Withdrawal from snacking (including binge eating) is accomplished by progressive snacking avoidance time intervals—first morning, then afternoon, next evenings, and lastly night time—with the aim of zero snacking during the entire day.

Methods to use include: distractions (e.g. going outside), avoidance of triggers (e.g. boredom, the kitchen), alternative behaviors (e.g. squeezing hands), distress tolerance (e.g. urge surfing), relaxation techniques (e.g. deep breaths), stress management (e.g. write down her worries and a plan for each), and keeping her hands busy while watching TV (e.g. draw or make crafts). Lastly, she should decrease home meal food amounts by avoiding triggers (e.g. additional food available on the table) and by weighing and recording typical serving sizes (with a digital food scale) of a maximum of 20-25 different foods frequently served at meals with progressive, incremental reductions of amounts all recorded mealtime foods.

Nearly all the kids in our three studies (of five months each) were able to totally stop eating their problem foods with no further cravings. Most (70 percent) of the kids were able to totally eliminate snacking, by simply distracting themselves and avoiding triggers such as boredom and going into the kitchen. On average, they reduced their amounts of foods eaten at meals to half of starting amounts.

If the above does not work and you can afford it, consider sending her to a residential center for obese young people, such as Insula in Berchtesgaden, Germany. It is expensive but is like a drug rehab center.

Above all, practice what you preach. Avoid, “Do as I say, not as I do.” Even if your daughter eventually undergoes bariatric surgery, she still must break her eating addiction or the procedure would not be successful.

Next: a reply from the English mum.


Source: “Addiction Model Intervention for Obesity in Young People,” Weigh2Rock.com
Image by Weigh2Rock.com

 

Letter from a British Mum

London Tower BridgeRecently, Dr. Pretlow heard from a very distressed mother who lives in a large city in England. Her letter is reproduced here with identifying details removed for privacy, and slightly condensed for space. Dr. Pretlow replied with an extensive list of suggestions. Some of those are included here while the remainder will appear in the next post.

Hi Dr. Pretlow,

I am a single Mum, as my husband left about 10 years ago. I am desperately searching for some kind of guidance to help me with my 17-year-old daughter, who currently weighs in the region of 380 pounds and is 5 feet 5 inches tall. She was a normal, if slightly skinny toddler, and a normal-sized child, but when she was about 14 she changed and became very withdrawn and started to self-harm.

We got help with this, and it has stopped, however she began to overeat alarmingly. I told the General Practitioner and her counselor, but the advice I got was to offer healthy foods, etc. But that is not the issue. She eats an enormous amount of food. If she is allowed to have any money she spends it on fast food or calls to have takeout food delivered. She stays up very late at night and eats and eats.

I do not have unhealthy food in the house, but my daughter will make up stuff to eat—the other night she mixed confectioners sugar and butter together and ate that. She will also eat bread and cheese in vast quantities. If I try to intervene and tell her not to eat, she becomes very aggressive and tells me that I am a food Nazi, or that I am making her feel bad about herself.

Her weight means that her fitness level is almost zero. She gets out of breath on exertion, and sweats profusely. She lies on her bed most of the day and does no walking or exercise at all. She used to play hockey, tennis and dancing, but can barely walk now. She is at high school, but often cannot get up of a morning to go in, and no amount of cajoling or chastising will get her up. She has no friends anymore because she can’t do the things that the other kids do.

My doctor says that she will refer my daughter to a dietician, but that is not the issue—she KNOWS what not to eat, but eats it anyway—a lot of the time in secret, as she doesn’t want me to know. I am out of my mind with worry about her, and here in England there is not a lot of help available in terms of advice.

There is nutritional advice, but when I spoke to a psychiatrist, he said that my daughter was making a lifestyle choice, and unless she was in danger of being an imminent threat to herself or others, they would not intervene. I just don’t know what to do and am at my wit’s end.

Dr. Pretlow’s Reply

Rest assured that you are not alone. Parents frequently post on our Parents Board about their frustration with a morbidly obese, housebound teen, and also chat about this in the Parents Chat Room.

Here are some suggestions:

  • Try to talk to your daughter as caringly as possible. Forget about her overeating and weight gain for the time being. It may take time for her to open up and trust that you won’t criticize her. Perhaps try peace offerings, things to build her self-esteem, like taking her out to purchase makeup or to a plus-size clothing store. When going out, you can try to avoid food as much as possible, but don’t make it an issue.
  • Try to distract her by taking a walk or going to see an interesting place. When she will finally talk, again don’t mention anything about her weight. Focus instead on what she’s feeling, and convey the idea that you care about her and want to help. She’s obviously in great pain—even though she probably won’t admit it. Most likely, she is caught in multiple vicious circles of depression, isolation, and poor self-esteem. Eating to ease that pain brings more weight gain, and more pain. There is also a willpower vicious circle, where trying to resist eating is stressful—and your daughter handles stress by eating.
  • Something traumatic apparently happened to your daughter at age 14 to cause her to seek relief first by cutting. (What was behind the cutting?) Then she replaced cutting with overeating, which is more socially acceptable, but the initial pain/trauma was/is still there. After turning to food to cope, she got into the vicious circle of withdrawing and turning more and more to eating as her main coping mechanism. Your daughter’s brain glommed onto eating as a way to escape from pain and stress and be comforted.
  • Brain wiring changes took place to keep this going. Now when she tries to stop, withdrawal symptoms occur (nagging urges, agitation, and nervousness). Plus, she probably feels a subconscious fear of losing her major coping mechanism of eating with nothing to replace it.

More next time!


Image by Larry Johnson

Apps, Obesity, and Parents

Slide 11 Overeaten Foods

From Dr. Pretlow’s presentation concerning W8Loss2Go, “A Smartphone App Platform for Treatment of Obesity Using the Addiction Model”

Kurbo, a weight-loss app created for young people from age 8 to 18, claims to be different from many others in its market niche. Journalist Amy Graff explored the question of why, and learned that it is “based on practices from a program at Stanford University with a proven track record.” How proven? Graff says:

Since 1999, more than 80 percent of the participants in the Pediatric Weight Control Program at Lucile Packard Children’s Hospital have achieved age-appropriate weight reduction.

Although the program avoids “straight-up dieting and calorie-counting,” it does encourage participants to choose healthy foods (which seems to be walking a fine line). It also encourages exercise, portion control, learning through games, and strategies for food-intensive holidays. There is no caloric math, but foods are sorted into three groups on the traffic-light principle. The goal, obviously, is to stay away from foods in the red zone, eat some from the yellow zone (meat and grain), and eat a very large amount from the green zone (vegetables and fruits.)

The app’s creators aim to provide kids with tools for making healthier decisions and to cultivate “the ability to take charge of their eating, without parents or doctors telling them that they were bad, or overweight, or couldn’t eat the food they like.” That last notion may be the weakest plank of the platform. It has been Dr. Pretlow’s experience that, on the road to health, some foods just have to be abandoned along the way.

The Parent Trap

Kurbo says it can “empower kids to make healthier choices and lose weight without feeling stigmatized.” The implications of family dynamics have been deeply considered, and the program was designed to relieve parents of the onus by inducing kids to take responsibility. Ideally, accountability is removed from the parents, especially the mother, who usually bears the brunt of a child’s displeasure with interference.

One of the company’s self-descriptions is that it takes the power away from the parents and gives it to the kids. A parent can ask, “Did you follow the program?” but even that might be too much for some prickly-tempered teenagers. Supposedly, one of the app’s benefits is that it “changes the way parents and children talk about the issue,” which can make all the difference.

The basic app is free, but the program is partly monetized by the option of dis-involving the parents even further, by signing the child up for pre-paid supportive coaching which is available in two tiers—text/email or Skype. All this is very interesting in the light of the almost universal insistence on the vital importance of parental involvement in weight loss efforts. It’s almost like another of those “everything you know is wrong
paradoxes that keep cropping up in the childhood obesity field. Of course, there are other authorities who advise cutting parents some slack. Kristen Harrision, founder of the STRONG project, notes:

Often people say, “Well parents, just stop feeding your kids so much.” There’s an attitude that people are stupid, they’re greedy, they don’t care. And that couldn’t be further than the truth.

Your responses and feedback are welcome!

Source: “Can an app help a child lose weight?,” SFGate,com, 10/14/14
Source: “Hidden Drivers of Childhood Obesity Operate Behind the Scenes,” ScientificAmerican.com, 10/31/11
Image by Weigh2Rock.com
http://weigh2rock.com/presentations/Obesity_Summit_2015_Pretlow/poster_30sm.pdf

Technology on Parade

The Quiet Earth scene

Not long ago, Childhood Obesity News looked at the calorie counter and energy expenditure tracker MyFitnessPal. Many technological aids are available to consumers for their weight-loss needs, and some of these inventions have capabilities that border on the science-fictional.

An instrument called the TellSpec laser scanner initially market-positioned itself as “for diabetes, weight loss, pre-diabetes, and obesity.” Still in the testing phase and not yet available commercially, it is also of great interest to other populations, including those with irritable bowel syndrome and hard-to-identify food sensitivities and allergies.

Billed as a “food sensor,” the device is technically a raman spectrometer (no relation to the noodles eaten by college students). It emits a laser beam, counts the photons that bounce back, and evaluates an object’s chemical composition. It’s really that simple, and that fantastically outlandish.

The scanner is assisted by the user’s smartphone and, up in the cloud, a database stuffed with algorithms. Together, they reveal what is actually in the substance presented as food. The user gets a read-out of the ingredients in all their glorious complexity—carbohydrates, proteins, fats, calories, tartarzine—it’s all there.

In fact, the device may tell more about what is inside a product than the manufacturer might want a consumer to know. A consumer can compare the food package’s list of ingredients with the scanner’s output and say, “Wait, what?” For instance, if gluten is detected, the user can look it up in the knowledge base known as the TellSpecopedia. Even though the device is not yet on the market, the company altruistically shares this information with anyone who cares to see it, online, now. Go ahead, try it, and learn that although almond oil can help the liver and the heart, it provokes an allergic reaction in some humans.

Where’s the Beef?

A study with what might be described as a meta-focus was featured in the journal Childhood Obesity last year. Apparently, its purpose was to scold. Writer Aditi Pai described the argument it made:

Exercise and nutrition smartphone apps for children do not use the top recommended behaviors and strategies that were developed to prevent pediatric obesity…

…93 percent of the apps complied with the recommended behaviors in the guidelines, only 20 percent had the recommended strategies…

These recommendations came from a report published in the journal Pediatrics in 2007.

It may be churlish and immature, but the very first retort that comes to mind is, “Yes, and look how fabulously well those recommendations have been working out so far.” The numbers and the percentages of obese kids go up and up. The news has been so bad for so long, we are numb to it. When an institution floats the idea that 2007’s recommendations were graven in stone, we are ready to believe it.

In the first area of concern, that of recommended behaviors, it’s hard to even understand the study authors’ disgruntlement. After all, 93 percent is a pretty high rate of compliance anywhere. The behaviors include eating five fruits and/or vegetables per day, exercising for an hour a day, limiting TV to two hours, and limiting sugar-sweetened beverages. As for the recommended strategies—which only 20 percent of the tested applications adhered to—they include:

…setting goals, providing positive reinforcement, telling kids to self-monitor their efforts, and highlighting success and partial-success…

By the way, even the single most popular strategy (self-monitoring) was used by only 16 percent of the tested apps.

Your responses and feedback are welcome!

Source: “We Took The Laser Scanner That Tells You What’s In Your Food Out For A Spin
FastCoExist.com, 01/16/14
Source: “Study finds child obesity prevention apps don’t use recommended behaviors, strategies
MobiHealthNews.com, 04/04/14
Image by Thoth God of Knowledge

 

Pros and Cons of Fat Acceptance

Dinosaurs size

Childhood Obesity News  has been speculating about whether such cultural phenomena as the plus-size fashion industry are, overall, beneficial or detrimental to society. Journalist Ellen King wrote about someone who is probably very uncomfortable in the average airline seat, plus-size model Tess Holliday:

Size 26 is not healthy. I don’t care how much they might say they work out and what they eat: unless they have been diagnosed by a doctor as having thyroid problems then there is a reason they are a size 26—they won’t have got there from exercising for an hour every day and eating healthy balanced meals.

The problem is not that someone is flouting society’s standards of beauty, which King sees as “too rigid and exclusive” anyway. She is against the promotion of an unhealthy lifestyle, one that can actually put people’s lives at risk. Why is it acceptable, King wonders, to tell an underweight person to go eat a burger, but not acceptable to suggest that an overweight person try a salad for a change? Also, since society has determined that the sight of painfully skinny, anorectic-looking models is harmful to young women, aren’t obese model images equally harmful?

Discovering the Harm Done By Obesity

A person looks around and notices that while some normal-weight friends undergo the occasional sick days and hospital stays, all the overweight ones have at least one chronic and serious health problem— diabetes, high blood pressure, heart irregularities, knee and ankle problems, acid reflux, or sleep apnea. The likelihood of mere coincidence becomes less and less believable.

It is one thing to aspire to “health at any weight,” but another to make the claim of perfect health. The “health at any weight” slogan is very annoying to doubters, who are convinced that a 300-pound person cannot fulfill any definition of health. The best-case scenario is that an inevitable serious illness is being temporarily held at bay. Here is how one of this era’s thought leaders, Joe Rogan, looks at it:

It’s not cool to be mean to people. But it’s not smart to just let it go, either… If you care about them, you should probably bring up the fact that they’re morbidly obese. If you can bring it up and have them realize that there’s other options out there, and they change their habits, that’s not necessarily fat-shaming. If we’re all ignoring fat people, or ignoring people that have eating problems, we’re going to ignore a serious health problem.

The HAES movement seems to have been very thoroughly discredited indeed, to the point where people—and here, Ellen King speaks for them—are asking questions:

There are so many solutions to obesity now and so much awareness of the damages it does to one’s health that quite frankly it’s ridiculous that more people don’t get forced into accepting the help they need in the same manner that an anorexic would be treated.

When ordinary people start talking about coercion, the debate turns serious. How much tolerance should be extended to the principle of fat acceptance? In terms of the overall obesity picture, is the Health at Every Size movement good, bad, or neutral? A Reddit contributor called Tyrien says:

What we should do with respect to ‘fat acceptance’ is tell people it’s not okay to say that being fat is okay, because it’s not.

One (among many) of the solid medical reasons for fat not being okay is that it represents a grim prognosis. Especially when obesity begins young, its course is very difficult to reverse. As Dr. Christopher Ochner said in a guest appearance on Michael Prager’s blog, “Once obese, it’s tough to escape.” He also said, in no uncertain terms:

[The] Health at Every Size movement has been debunked—[there’s]no such thing as healthy obese.

Your responses and feedback are welcome!

Source: “Big is beautiful but stop romanticising an unhealthy lifestyle,” The-NewsHub.com, 05/12/15
Source: “Dismantling fat logic makes me an ‘ignorant prick’,” November 2014
Source: “The Joe Rogan Experience #635,” youtube.com, 04/15/15
Source: “The doctor replies again: Once obese, it’s tough to escape.” michaelprager.com, 08/01/14
Image by Zachi Evenor

 

Should Fat Acceptance be Given a Platform?

plus size supermarket fashion

That is a trick question, because fat acceptance has always had a platform, so there is no need to ask. A more useful question would be, “Is it okay that acceptance is tolerated? How much acceptance should be extended, and in what ways?”

Maybe all airplane seats should be extra wide. If a large person’s comfort were a criterion, then lean travelers would enjoy extra space in their seats, and even in the latrines. Normal-weight people would be rewarded, but obese people would not be punished. Of course, all the planes would have to be rebuilt, at great expense. And each flight would hold fewer passengers, which would raise the average ticket price.

Maybe no one but CEOs and Oscar winners could afford to fly any more, but at least their seats would be wide. Just a minute—CEOs and Oscar winners already have their own planes, with seats as wide as they like. Also, they tend not to be obese. Maybe this is not such a good idea.

Where to Draw the Line Around Fat Acceptance?

Obviously, people with medical disabilities need extra consideration from the able-bodied, yet public opinion varies. Someone might be fine with granting pregnant women special parking privileges close to a store entrance yet bitterly begrudge an obese person the sticker identifying the vehicle of a handicapped person. Usually, the government defines the disabled, and individuals don’t always agree.

The government also defines the obese, as in public schools where parents receive “fat letters.” It also allows employers to define, and penalize, obesity. Childhood Obesity News examined the outrage some people feel about obesity, and the lengths to which they will go in an effort to make the world conform to their preferences.

Others commenters have different viewpoints, and do not object when the overweight hold a self-forgiving belief, as long as they keep it to themselves and don’t try to actively spread the Health at Every Size gospel. An example is this person-on-the-street reaction to “fat acceptance:”

Being fat is perfectly fine if you’re making a decision for yourself. But it’s absolutely not fine for you to try to influence others with your grotesque self-abusing logic. Destroy yourself, not society.

A person with the handle crazymcfattypants feels that tolerance ends when “they make their own fatness everybody else’s problem,” and imagines a dialogue:

Obese person: I like the way I look even though I’m 100 pounds overweight.
Tolerant person: No bother.
Obese person: I like the way I look 100 pounds overweight, and the rest of you are [naughty word] for not accepting me the way I am; it’s society’s fault I feel ugly.
Tolerant person: Put down the burger and get on the treadmill, fatty.

Granted, shaming and blaming don’t work. Also, they are not nice. But ought the concept of Fat Acceptance to be given any positive reinforcement? Writing for The New Yorker, Lizzie Widicombe warned that if the plus-size fashion industry reaches its goal of acceptance into the mainstream, “it risks losing some of its outsider energy and community.” But wouldn’t that be a good thing? Do we, as a society, want to reward big fashion entrepreneurs as avant-garde mavericks and stars? Is that for the greatest good?

Your responses and feedback are welcome!

Source: “Dismantling fat logic makes me an ‘ignorant prick’,” Reddit.com, 09/23/14
Source: “The Plus Side,” newyorker.com 09/22/14
Image by athriftymrs.com

Childhood Obesity News | OVERWEIGHT: What Kids Say | Dr. Robert A. Pretlow
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