A resource for health professionals, parents, teachers, counselors & kids on the childhood obesity epidemic.

This new webinar is called “The Epidemic of Childhood Obesity: What’s Our Plan?” and although Dr. Pretlow designed it for health care professionals, it’s probably safe to say that most parents feel they are included in that group — they have certainly put in the time!

The webinar covers two major questions. How do we spot childhood obesity, and then, what do we do about it? The purported causes of the obesity epidemic are examined, and treatment options are discussed. Since the obesity epidemic is so interrelated with public financing and public institutions, there are always policy considerations. What might we expect the government to do?

In the “causes” department, Dr. Pretlow talks about the food-rich environment. If it’s around, people will eat it. At first, this seems like an obvious, “no-brainer” explanation. But does not see it as enough of a reason.

Yes, the presence of a lot of food is a necessary condition to overeating, because before any person or group of people can overeat, food has to be there. But it’s not what the old-school philosophers would call a sufficient condition. The presence of massive amounts of hyperpalatable food is not, in itself, a guarantee that a person will make bad nutritional choices, or eat too much. This is demonstrated by the fact that plenty of people don’t make bad choices, or overeat, despite the abundance of available food.

Too expensive?

There is a popular belief that healthful food is expensive and boutiquey, and too costly for the ordinary working person to afford. But what about the Native American communities where casinos have brought in unprecedented wealth, but not much improvement in good nutritional choices? The popularity of “fry bread” is undiminished, as Dr. Pretlow can attest from many shared meals near his home base of Seattle.

Despite their ability to shop for whatever they choose, humans have a tendency to stick with dishes that have traditional ethnic and cultural significance. And sometimes, with crummy junk food diets.

Aside from the wealthy and unenlightened, another group draws criticism for preferring junk food and fast food — the very poor. Cooking from scratch is something not everyone can do. It takes a working stove and refrigerator, a paid-up electric bill, some equipment, a minimal store of condiments, and so on. Without a freezer, even a responsible adult inclined to shop at the farmers’ market can’t preserve organic fruits and vegetables beyond season.

A homeless person might seem to have the ideal opportunity to go with an all-raw vegan diet and become spectacularly healthy. But for someone living in the streets, it’s difficult enough to even find clean drinking water, much less water for fancy stuff like washing veggies. To carry around a knife for peeling apples and carrots could lead to a jail sentence.

People who are homeless, or signed up for various food assistance programs, don’t have much choice about what they eat. The shelter or soup kitchen serves what it serves. Donations to food pantries must necessarily be non-perishable foods, meaning they are filled with preservatives and pretty much drained of nutritional value.

People face all kinds of problems and obstacles that can’t really be understood by others who have not participated in the same lifestyle. Unavoidably, there is a certain amount of truth in the “good food is too expensive” argument. But it’s certainly not enough to explain the entire obesity epidemic.

And neither is the “food desert” theory, which posits that in some geographical areas and urban neighborhoods, people are both undernourished and obese because good food is not available. Yes, it is true that there are such places. That unfortunate fact is contributory to the obesity epidemic. But as a major causative factor, it doesn’t hold up. Dr. Pretlow says:

The kids that I have contact with say ‘No.’ They say where they are, there is some healthy food available, but nobody wants to buy it. So it appears that the residents of those communities just don’t want to buy healthy food, for whatever reason.

Your responses and feedback are welcome!

Source: “What’s Really Behind the Childhood Obesity Epidemic?,” Weigh2Rock.com
Image by Joe Mabel.

Yesterday we looked at “catfishing,” which basically is going online and fooling another person into believing you’re someone you are not. Often, when people fall in virtual love, it turns out that one of them is up in the plus sizes, and hiding behind fake photos. If the obese person attracts a partner who says, “Let’s get together,” the jig is up, and heartache ensues.

In the 2010 film Catfish, one of the characters explains the term. Codfish used to be shipped in water to keep them alive, but they arrived flabby and inedible, so catfish were added to give the cod a reason to exercise. The implication was that online tricksters are actually good for us in some way.

Apparently, many people have made a hobby of arguing over whether or not the catfish analogy is historically and scientifically accurate. They cite sources going back as far as 1909. Here is an interesting point. A 2007 post by a blogger known as “Runrandall” says:

After studying the cod fish someone discovered that their natural enemy was the catfish. This time when the cod fish were put in the tanks they placed a few catfish in with them. Those catfish chased the cod fish all the way across the country to the west coast. This time when they were prepared they were flaky and had the same flavor as they did when they were caught fresh and prepared on the east coast. You see the catfish kept the cod from becoming stale. The catfish kept them fresh.

We all have and need catfish in our lives to keep us fresh.

Now, it gets really weird. Why did Runrandall tell this story? In order to describe an entirely different kind of human catfish. This catfish was not an online stranger, hiding obesity behind pictures of swimsuit models. This was someone he knew in real life, in the course of his “running and weight loss journey,” which is the declared topic of the blog. Runrandall says:

Last year when I weighed 284 I would jog 3 miles a few times a week… I would see the man, a neighbor riding his bike… Well every time Maynard would ride by me he always had something negative to say about my weight… He would say things like, ‘You need to do some push ups, push ups from the table that is.’

I decided I needed to do something more than just run to lose weight. I started going to a diet clinic, got on a diet, and kept running… One day after I had lost 90 lbs in 5 months I was running a 5 miler and I saw Maynard… As I ran past him he said, ‘Are you losing weight?’ I smiled and said yes.

But I thought are you blind? I have lost 90 lbs and you have to ask me if I’m losing weight. When I got home I told my wife that my catfish was still a catfish.

Runrandall seems to feel that, overall, he benefited from the nagging presence of this kind of catfish, the neighbor who never had a good word to say. So how about it, readers? Do we know of any cases of this kind of catfish?

And what about the other kind, as in the movie and TV show? Is it ethical to pose online as someone more svelte? Under what circumstances is this okay, if ever?

Your responses and feedback are welcome!

Source: “The Story of the Catfish,” Runrandall, 06/15/07
Image by Clevergrrl (Heather Hopkins).

Although catfishing has existed as long as the Internet, the actual name by which the cultural phenomenon will forever be known was not decided until 2010. This happened thanks to an indie documentary film made by Henry Joost, Ariel (Rel) Schulman, and Nev Schulman. Catfish is wonderfully complicated, but its essence is simple — through Facebook and email and telephone communications, somebody got fooled.

As one of the characters explains, in the old days shipments of gastronomically desirable codfish were transported in water. Supposedly, the cod arrived at their point of sale all flabby and lethargic. But if catfish were added to the mix, they would chase each other around and the codfish would be well-exercised and acceptably textured. And once in a while you meet up with a person who is like the catfish, whose purpose is to keep you in motion, mentally alert, fresh, and “on your toes.”

Next came the MTV series “Catfish,” captained by Nev Schulman, and about (what else?) people getting romantically bamboozled through social media. Some call this brand of foolery “factitious disorder;” others call it “interactive storytelling.” This is in fact the very phrase used by filmmaker Rel Schulman, who goes on to say:

One of messages of the movie is you can’t trust social networking at first glance. You’ve got to do your research and you’ve got to be defensive. But don’t be too defensive, because it might be a real opportunity on the other end.

When people pretend, in order to attract online friends and encourage emotional attachments, it is perhaps not surprising that the deception often involves body size. In one episode of the series, a 10-year electronic relationship could go no further because the man was morbidly obese. An article titled, “MTV’s ‘Catfish’ Reveals The Big Fat Problem With Internet Dating,” discusses an episode in which another man’s supposedly trim blonde sweetheart turned out to be a chubby brunette.

One online commentator noted that the catfish in question was more like a whale, and another complained that fat people seem to be the show’s common factor, while a third chimed in that a lot of overweight people have self-esteem issues. Another was moved to ask whether the show is “fat shaming” or merely reflective of the plain fact that when people lie about their true selves online, obesity is usually the reason.

The writer of this piece, Danielle Young, reveals her own questionable past with a website called Paxed.com:

I didn’t think twice about plastering myself up on the site, until I stumbled into a forum labeled, ‘The Top 10 Ugliest Girls On Paxed’ [...] I saw something that changed the course of my online life, forever. I saw myself as the 6th ugliest girl on the site…

The caption said something like, ‘She thinks because she doesn’t post a full body photo that we don’t know she’s fat as hell. Maybe if she lost some of those chins, she could actually be cute.’ From that moment forward, I was no longer comfortable with being myself online. I was already struggling with my self-esteem because of my weight, but this list solidified my discomfort with myself.

And then Young goes on to tell how she misappropriated someone else’s photos and made up a false thin-girl profile for herself, and confesses the mortifying consequences. She writes:

I know what it’s like to pretend to be someone else online… I was faced with my own former insecurities… Yes, the revealing of the common thread that ‘Catfish’ is exposing is uncomfortable for me… Many overweight people create profiles online to receive the type of love they think they deserve, but could never get in real life.

Your responses and feedback are welcome!

Source: “’Catfish’ Film Exposes Lies, Mental Illness,” Discovery News, 10/15/10
Source: “Trust me, I’m a film-maker,” The Guardian, 11/19/10
Source: “MTV’s ‘Catfish’ Reveals The Big Fat Problem With Internet Dating,” HelloBeautiful.com, 10/11/12
Image by Vacacion (Miguel Vaca).

Remember Dara-Lynn Weiss, who was called “Monster-Mutter #1” by a German newspaper, and lots of other uncomplimentary names by the press all over the world? This was last spring, when Vogue magazine published what Weiss wrote about childhood obesity in regard to her own daughter Bea, and how she put the girl on a diet at age 7.

Her program was loosely based on that of Dr. Joanna Dolgoff, who distanced herself by saying that her ideas had been misunderstood and misapplied.

Well, Weiss is back, with a book called The Heavy, which is a venerable film industry term for “the bad guy,” a very appropriate choice. And of course it is about weight, the issue that made Weiss the target of so much criticism, and initiated what Deirdre Donahue characterizes as a raging debate.

And indeed, the memoir’s author told the USA TODAY reporter:

It’s not really about weight loss. It’s more about the challenge of modern parenting where decisions are judged so readily.

At the same time, she says, it is the story of a difficult decision prompted by parental love. Even in preschool, Weiss says, Bea “approached food differently,” and was too frequent a visitor to the snack table. By the age of 7, she was in the obese range, almost 30 pounds overweight.

In her own family, as she grew up, Dara-Lynn readily admits that she was the sibling with the warped relationship to food and body image, always thinking she was too big, and always struggling with some reducing diet or other. Her two sisters, she says, had a “normal” relationship with food.

And what about Bea’s father? If Bea has any fat genes, they came from his side of the family, or so Weiss broadly hints.

Having an overweight daughter made Weiss feel as if her friends were looking down their noses at her. Fat daughter = bad mother, is how the stereotype goes. Donahue’s interview with Weiss is presented in question-and-answer format, and here is one of the pairs:

Q. The biggest surprise in the book was how you were doing everything right. Your family ate home-cooked dinners together. You picked your kids up at school because you work part-time from home. As New Yorkers, you walk everywhere. Her friends were all skinny. How could your daughter have a weight issue?

A. This was not a lazy child. She didn’t eat unhealthy food. People make assumptions about obese children or their parents. She was a child with an enormous appetite… She has a brother a year younger, same parents, same food, who doesn’t want to eat sweets.

No one can accuse Weiss of neglect, or of failure to make an attempt at providing a healthful food environment. And still the daughter was obese and the mother felt judged. Then, when she tried to fix it, the whole world came down on her. Where is the justice?

The author of The Heavy learned one thing — an article about putting your child on a diet attracts more emotional and negative reaction by appearing in a fashion magazine than it would have done in the pages of a more domestic- and parenting-oriented publication. On the home front, the Weiss advice for parents of obese children is to not ignore the problem or hope it will just go away. Sometimes, she says, parental love involves “being the heavy and doing unpopular things that you know are right,” and goes on to describe one of the changes a conscientious parent will make:

Let’s bake cookies! Let’s go get cupcakes. It’s a real switch — a challenge — to think, let’s go play in the park but not to bring a picnic or to go the movies and not get a big bag of popcorn.

The obstacles that obese children and their parents are up against are unthinkable. You don’t know the access children have to food, the size of the portions, the numbers of times a day that you are presented with food because it’s a celebration or a reward. It’s so difficult to be part of the event but not to allow food to be involved.

Your responses and feedback are welcome!

Source: “In ‘The Heavy,’ Dara-Lynn Weiss on childhood obesity,” USA TODAY, 01/15/13
Image by Oneras (Mario Antonio Pena Zapateria).

Sometimes it seems like research is just one big landscape of shifting sands. A unit of knowledge that seems airtight can be reversed within months. Another possibility is for empirical evidence to be conclusive, but nobody is quite sure what it’s conclusive of. For example, here is an intriguing paragraph from MedicalXpress.com:

It seems improbable that a baby born underweight would be prone to obesity, but it is well documented that these children tend to put on weight in youth if they’re allowed free access to calories. Now, researchers believe they understand why this happens.

Mattel Children’s Hospital in California was the place, and Dr. Sherin Devaskar was the lead author of a study whose results were published in the Journal of Neuroscience Research. The subjects were not human infants, but “rodent models that mimicked small human babies.” It has to be done this way because intentionally allowing a human fetus to suffer from malnutrition would be totally unethical, so that limits the options.

Inadequate nutrition is not the only reason for a baby to have low birth weight. If the mother smokes cigarettes, or uses alcohol or drugs, or has an infection or illness, a baby can be born at a weight that is considered dangerous. But it is not only a matter of pounds and ounces. This is where the new understanding comes in. It’s all about disruption of the “homeostatic balance of appetite-controlling neuropeptides,” which causes the hypothalamus to get all mixed up and forget how to experience a sense of satisfaction. In other words:

Growth restriction before birth may cause lasting changes in genes in certain insulin-sensitive organs like the pancreas, liver and skeletal muscle. Before birth, these changes may help the malnourished fetus use all available nutrients. After birth, however, these changes may contribute to health problems such as obesity and diabetes… In low-birth-weight babies whose growth was restricted in the womb, the level of appetite-producing neuropeptides in the brain’s hypothalamus — the central control of the appetite — is higher, resulting in a natural tendency among these children to consume more calories.

And then there is the matter of blood pressure, where an example of “dueling experts” can be found. What’s up with the apparent contradiction? A United Press International story last summer reported:

Pediatric hypertension-related U.S. hospitalizations nearly doubled from 12,661 in 1997 to 24,602 in 2006, researchers found. Lead author Dr. Cheryl Tran of the University of Michigan in Ann Arbor and colleagues used data on discharge records from the Healthcare Cost and Utilization Project Kids’ Inpatient Database, from 1997, 2000, 2003 and 2006. Tran and colleagues hypothesize the increasing hospitalizations may be due in part to the rise in childhood obesity.

The title of that story was “Kid hypertension hospitalizations double.” In the same month, another headline appeared from an equally reputable source — “Despite obesity rise, kids’ blood pressure dipped: U.S. Study.” This Reuters story said:

Researchers at the U.S. Centers for Disease Control and Prevention (CDC) found that while the obesity rate among children in the state of Louisiana nearly tripled between 1974 and 1993, their blood pressure actually improved a bit. Among nearly 11,500 children and teens assessed over the 20 years of the study, which appeared in the journal Pediatrics, the rate of obesity rose from 6 percent to 17 percent. But blood pressure, on average, remained fairly stable.

The current study cannot show the reason why blood pressure didn’t rise along with obesity. In theory, it could have something to do with improvements in early childhood nutrition, such as rising breastfeeding rates – but that is just speculation at this point.

Your responses and feedback are welcome!

Source: “Why underweight babies become obese: Study says disrupted hypothalamus is to blame,” MedicalXpress.com, 05/02/12
Source: “Kid hypertension hospitalizations double,” UPI.com, 06/19/12
Source: “Despite obesity rise, kids’ blood pressure dipped: U.S. Study,” Reuters, 06/06/12
Image by slopjop (Clay Junell).