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Genetics May Shape the Future of GLP-1 Medications

Tatyana Meshcheryakova April 22, 2026 No Comments

Childhood obesity treatment is entering a new and highly personalized era. As GLP-1 receptor agonists gain traction as effective tools for weight management in adolescents, emerging research suggests that genetics may play a key role in determining who benefits most (and who experiences side effects).

This evolving intersection of obesity medicine and precision health could transform how providers treat pediatric patients. But it also raises important questions about cost, access, and equity.

The rise of GLP-1 medications in pediatric care

GLP-1 (glucagon-like peptide-1) receptor agonists, including semaglutide and liraglutide, have rapidly become a cornerstone of modern obesity treatment. Originally developed for type 2 diabetes, these medications help regulate appetite, slow digestion, and improve blood sugar control. In adolescents with obesity, clinical trials have demonstrated significant reductions in body mass index (BMI), often far exceeding results from lifestyle interventions alone.

A major study published in The New England Journal of Medicine found that teens treated with semaglutide experienced an average 16% reduction in BMI over 68 weeks. These results have fueled growing adoption in pediatric care and prompted updated treatment guidelines from the American Academy of Pediatrics, which now include pharmacotherapy as part of comprehensive obesity management.

While GLP-1 medications have shown impressive results, not all patients respond the same way. Some adolescents lose significant weight, while others see more modest changes, or struggle with side effects like nausea and vomiting. Recent research highlights a possible explanation: genetic variation. Studies suggest that certain genetic differences may influence how the body regulates appetite and metabolism, how strongly GLP-1 receptors respond to medication, and the likelihood and severity of gastrointestinal side effects.

In fact, new findings reported by Reuters indicate that specific genetic markers may be linked to both greater weight loss outcomes and increased side effect risk in patients taking GLP-1 drugs. This opens the door to a more tailored approach, where treatment decisions are guided not just by BMI or medical history, but by a patient’s genetic profile.

What is personalized (precision) medicine?

Personalized medicine, also known as precision medicine, is an approach that uses individual factors like genetics, environment, and lifestyle to guide healthcare decisions. The National Institutes of Health defines precision medicine as a way to “optimize medical care by tailoring it to individual characteristics.”

In the context of pediatric obesity, this could mean identifying which children are most likely to benefit from GLP-1 medications, predicting who may experience side effects before treatment begins, and adjusting dosages or selecting alternative therapies based on genetic insights. This approach has the potential to make treatment more effective, safer, and more efficient.

Potential benefits for pediatric patients

If successfully implemented, genetically guided obesity treatment could offer several advantages:

Improved Outcomes. Children could receive medications that are more likely to work for their specific biology, increasing the chances of meaningful weight loss and improved health.
Reduced Trial-and-Error. Providers could avoid prescribing medications that are less likely to be effective, saving time and reducing frustration for families.
Better Side Effect Management. Identifying genetic risk factors for side effects may help clinicians proactively manage or avoid adverse reactions.
More Efficient Use of Healthcare Resources. Targeted treatment could reduce unnecessary costs associated with ineffective therapies.

Ethical and equity considerations

While the promise of personalized medicine is compelling, it also introduces new challenges, particularly around access and equity, such as cost barriers, a risk of widening disparities, and data privacy concerns. Genetic testing can be expensive, and insurance coverage is inconsistent. Combined with the already high cost of GLP-1 medications, this could limit access for many families.

Also, communities already disproportionately affected by childhood obesity, such as low-income and minority populations, may have the least access to advanced testing and treatments. And, the Centers for Disease Control and Prevention continues to report higher obesity rates among underserved populations, making equitable access a critical concern. Plus, genetic testing raises questions about how sensitive health data is stored, shared, and protected (especially for children).

The integration of genetics into pediatric obesity treatment represents a major step toward more individualized, science-driven care. However, experts emphasize that medication, personalized or not, should always be part of a broader, holistic approach.

As research continues, the key challenge will be ensuring that innovation does not outpace accessibility. Personalized treatment has the potential to improve outcomes, but only if it is available to all children who need it.

Your responses and feedback are welcome!

Source: “Once-Weekly Semaglutide in Adolescents with Obesity,” The New England Journal of Medicine, 11/2/22
Source: “Semaglutide Treatment Effect in People With Obesity — STEP TEENS,” American College of Cardiology, 12/20/22
Source: “Genetics may help explain why results from weight-loss jabs vary, say scientists,” The Guardian, 4/6/26
Source: “Researchers move closer to matching patients with GLP-1 drug that works best for them,” Reuters, 11/19/25
Source: “The Promise of Precision Medicine,” NIH, undated
Source: “New CDC Data Show Adult Obesity Prevalence Remains High,” CDC, 9/12/24
Image by Tara Winstead/Pexels

Ultra-Processed Foods Cover-up? Part 2

Pat Hartman April 21, 2026 No Comments

Recommended at this point is to catch up by reviewing Part 1, “Is There an Ultra-Processed Foods Coverup?” What makes information about Dr. Dhruv Khullar’s controversial article even more interesting and relevant is this quotation published less than four months previously:

Robert F. Kennedy, Jr., who may soon lead the U.S. Department of Health and Human Services, has made common cause with some lawmakers by railing against ultra-processed food, pledging to remove it from public schools and limit the use of pesticides, artificial dyes, and, perhaps more dubiously, seed oils.

So apparently, Kennedy underwent some changes of opinion about the matter during the few weeks between that publication and his being made head of the Department of Health and Human Services.

Meanwhile, National Institutes of Health investigator Kevin Hall was recalibrating some of his theories based on the advanced work that he had been doing with volunteers, testing four different diets in turn. Dr. Khullar explains:

When the team served ultra-processed foods that were neither calorie-dense nor hyper-palatable — for example, liquid eggs, flavored yogurt and oatmeal, turkey bacon, and burrito bowls with beans — people ate essentially as much as they did on the minimally processed diet. They even lost weight.

Hall had no choice but to conclude that “Weight gain is not a necessary component of a highly ultra-processed diet,” to which Dr. Khullar appended, “He had, in a sense, refuted his hypothesis again.” And that is exactly what any genuine and honest scientist is delighted to do — to discover that he or she had guessed wrong, or drawn conclusions from incomplete data. A true scientist does not care how many times research has to start over, or how often his or her theories need to be revised, as long as truth is reached in the end.

Dr. Khullar also spoke with the venerable Marion Nestle, and introduces her to readers with this description:

[…] a molecular biologist and nutritionist who started the country’s first academic food-studies program, at N.Y.U., helping to bring attention to the roles that culture, capitalism, and politics play in what and how much we eat.

That apparently is exactly the crux of the whole food policy problem: the role being played by factors politely termed culture, capitalism, and politics, when the clashes of opinion are worthy of cruder but more accurate terms for controversy, that some critics would prefer to use. Dr. Khullar recounts how Nestle reminded him of a historical fact:

During the Second World War, U.S. military leaders were alarmed that many recruits, having grown up during the Great Depression, couldn’t join the war effort because of conditions caused by a lack of nutrients, such as rickets, scurvy, anemia, and tooth decay. “That came as a shock, and the military became heavily concerned with nutrition.”

This is very significant in the light of today’s situation, which includes the ineligibility of many young Americans to join the military because they are simply too fat.

At any rate, Nestle is not entirely on board with heaping blame upon ultra-processed food; but is not a big fan of it, either. (She is, incidentally, enthusiastic about Shredded Wheat, and even dusts it with a bit of sugar — to celebrate the fact that she, and not some corporation, is in charge of deciding the amount.)

Together, the two visited some places where food is produced, learning incidental facts, like how giant blocks of cheese should only be grated at the last minute, because “Pre-shredded cheese spoils faster. This way we can avoid preservatives.” This is exactly the sort of knowledge that leaves in the grim landscape some space for hope.

Your responses and feedback are welcome!

Source: “Why Is the American Diet So Deadly?”, Archive.is, 01/06/25
Source: “RFK Jr. aides accused of censoring NIH’s top ultra-processed food scientist,” CBSNews.com, 04/17/25
Image by DanielaElenaTentis/Pixabay

Is There an Ultra-Processed Foods Coverup?

Pat Hartman April 15, 2026 No Comments

Today’s post carries on from “The Nutrition That Never Arrived,” which discusses the work of Dr. Dhruv Khullar, as well as his referencing of Dr. Kevin Hall’s highly-regarded study of ultra-processed foods.

The alarming aspect of this topic is that, almost exactly one year ago, CBS News published a piece titled “RFK Jr. aides accused of censoring NIH’s top ultra-processed food scientist.” That scientist of course was Dr. Hall, described therein as “The National Institutes of Health’s top researcher on ultra-processed foods.”

Hall had announced that, after 21 years at his dream job, he was retiring early because, apparently, the NIH is no longer a place where unbiased science can be conducted. The details are rather shocking, according to journalist Alexander Tin:

Hall told CBS News that he was blocked by the department from being directly interviewed by a reporter from The New York Times, asking about recent research on how ultra-processed foods can be addictive.

Apparently, the NIH leadership did not want any comparison made between being hooked on ultra-processed foods and, for instance, your average meth habit — unless the disease manifests in exactly the same way and causes exactly the same effects as hard-drug addiction.

Hall was allowed to reply to The Times with written answers which “were then edited and sent to the reporter without his consent.” This behavior, needless to say, is normally considered highly unacceptable among professionals in the fields of both medicine and journalism.

Then the situation deteriorated even further when the government denied tampering with Hall’s words, and accused him of untruthfulness about the interference, and acted like the material wasn’t very good or worth being concerned about. Hall, however, maintained that his work on the effects of ultra-processed food on carefully observed subjects…

[…] was the largest study of its kind and no previous study had the same level of dietary control, much less admitted them to a hospital to ensure diet adherence…

Meanwhile, the NIH officials maintained that no censorship was in effect, and that any attempt to portray the government’s position as false would be deliberate distortion. In order to avoid being contradicted, the government agency also prevented Hall from participating in a conference on the subject.

At the same time, Susan Mayne, who had formerly been in charge of the food safety and nutrition center run by the Food and Drug Administration, spoke up for Hall’s research.

This whole controversy surprised many observers because just a few months earlier, reporters were writing passages like this one, published in January of 2025 in The New Yorker:

The dirty little secret is that no one really knows what caused the obesity epidemic. It’s the biggest change to human biology in modern history. But we still don’t have a good handle on why.

That was Dhruv Khullar, quoting what had been said to him by Dariush Mozaffarian, a dean at the Tufts School of Nutrition Science and Policy. The implication is that ultra-processed foods have “probably contributed to rising obesity rates,” although other factors also are involved — like changes in the human microbiome and general metabolism, as well as (probably) epigenetics.

Of course, as always, the possibility exists that the situation is influenced by factors that have not even been suspected yet.

(To be continued… )

Your responses and feedback are welcome!

Source: “RFK Jr. aides accused of censoring NIH’s top ultra-processed food scientist,” CBS News, 04/17/25
Source: “Why Is the American Diet So Deadly?,” The New Yorker, 01/06/25
Image by geralt/Pixabay

The Rise of GLP-1 Medications in Pediatric Obesity: Breakthrough or Barrier?

Tatyana Meshcheryakova April 15, 2026 No Comments

Childhood obesity remains one of the most urgent public health challenges in the United States, affecting roughly one in five children and adolescents. According to the Centers for Disease Control and Prevention, the prevalence of obesity among U.S. youth is about 19.7%, with higher rates among certain racial, ethnic, and low-income populations.

While lifestyle interventions, such as improved nutrition, increased physical activity, and behavioral counseling, have long been the foundation of treatment, a new class of medications is rapidly transforming the field: GLP-1 receptor agonists. These drugs are generating both excitement and debate, especially as their use expands into pediatric care.

So, are GLP-1 medications a true breakthrough, or do they risk widening existing gaps in care?

What are GLP-1 medications?

GLP-1 (glucagon-like peptide-1) receptor agonists are medications that mimic a naturally-occurring hormone involved in regulating appetite, insulin secretion, and digestion. By slowing gastric emptying and increasing satiety, they help reduce food intake and promote weight loss.

Two of the most widely discussed GLP-1 medications are semaglutide and liraglutide. Originally approved for type 2 diabetes, both medications are now FDA-approved for chronic weight management in certain adolescent populations aged 12 and older. Their growing popularity reflects a broader shift toward recognizing obesity as a chronic, biologically complex disease, not simply a result of lifestyle choices.

Clinical trials have demonstrated significant results in adolescents using GLP-1 medications. A landmark study published in The New England Journal of Medicine found that teens treated with semaglutide experienced an average 16.1% reduction in BMI, compared to just 0.6% in the placebo group. Similarly, trials involving liraglutide showed meaningful reductions in BMI and improvements in metabolic health markers.

Beyond weight loss, GLP-1 medications may improve insulin resistance, blood pressure, and lipid profiles (cholesterol levels). These benefits are particularly important given that childhood obesity is strongly linked to long-term risks such as type 2 diabetes, cardiovascular disease, and even certain cancers.

Despite their clinical promise, GLP-1 medications remain out of reach for many families. Without insurance, these drugs can cost $900 to $1,300 per month, a significant financial burden. Even for insured patients, access is often delayed by prior authorization requirements, step therapy protocols, and inconsistent coverage policies.

According to the American Academy of Pediatrics, disparities in access to obesity treatment, including medications, mirror broader inequities in healthcare. Children from underserved communities, who are already at higher risk for obesity, are often the least likely to receive advanced treatments.

Additional barriers include limited availability of pediatric obesity specialists, geographic disparities in care access, and stigma surrounding obesity treatment. This raises a critical concern: Could a breakthrough therapy unintentionally widen health disparities?

While short-term outcomes are encouraging, long-term safety data in pediatric populations is still evolving.

Common side effects include nausea, vomiting, diarrhea, or constipation. In most cases, these symptoms are mild to moderate and improve over time. However, there are still unanswered questions about long-term use in developing bodies, potential impacts on growth and development, weight regain after discontinuation, and more.

Early evidence suggests that stopping GLP-1 therapy often leads to partial or full weight regain, highlighting the chronic nature of obesity and the potential need for ongoing treatment. Experts emphasize that medication should not replace foundational lifestyle interventions but instead serve as part of a comprehensive, multidisciplinary care plan.

The emergence of GLP-1 medications marks a turning point in pediatric obesity treatment. For adolescents who have struggled with traditional approaches, these therapies offer meaningful, evidence-based results, and in many cases, renewed hope. However, their full potential will only be realized if systemic barriers are addressed.

Expanding insurance coverage, improving provider access, and reducing stigma will be essential to ensuring equitable care. As research continues and policies evolve, the challenge is clear: How do we ensure that this medical breakthrough benefits all children, not just a select few?

Your responses and feedback are welcome!

Source: “Once-Weekly Semaglutide in Adolescents with Obesity,” The New England Journal of Medicine, 11/2/22
Source: “Prescriptions for Obesity Medications Among Adolescents Aged 12–17 Years with Obesity — United States, 2018–2023,” CDC, 6/5/25
Source: “Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity,” Pediatrics, February 2023
Source: “New Institute for Clinical and Economic Review Report Shows Significant Jump in Launch Prices, Exceeding Inflation and GDP Growth,” ICER, 10/23/25
Image by Leeloo The First/Pexels

The Nutrition That Never Arrived

Pat Hartman April 14, 2026 No Comments

Pause to visualize a little scenario, a random moment from the days when many young folks actually did pause to rethink their eating habits. The place: a college cafeteria. The girl who has just finished a very healthful lunch blots her lips with a napkin, sighs, and says thoughtfully, “That made me feel… fed.”

It’s a thing that happens now and then, in the presence of genuine nutrients. On the chemical level, the body gets the message: “Something just arrived that will make me healthy, wealthy, and wise.” Millions of tiny cells perk up, and flock to greet and engulf the molecules sent to deliver actual sustenance. A person’s body feels fed. It is an unmistakable sensation, and once felt, never forgotten.

Imagination helps

We have probably all seen something like this in a movie — the scene where a character gets a snootful of an enlivening drug, and shows the immediate effect, so powerful it borders on satire. We can tell that something special just happened. It is the same, on a micro-mini scale, inside the body when an allotment of genuine nutrition manages to get in. Imagine a zillion tiny nutrition junkies suddenly enraptured by a hit of genuine food. It’s the same rush on a different scale of measurement.

Or maybe it is like the scratching of some intolerable itch. Or like the difference between when a baby first wails in frustration, then suddenly latches onto the nipple. Peace at last. Given the opportunity, the body can tell that something extraordinary has just happened — a tsunami of joy, flooding every cell with atoms of pure goodness. When a person gives the body a chance, it can tell.

A closeup view

That is basically what a previous post expressed, in discussing the revolutionary work of Kevin Hall, which “has been cited nearly two thousand times” (as of early 2025, and certainly more by now).

As Dr. Dhruv Khullar wrote in “Why Is the American Diet So Deadly?”,

Hall’s original study […] was the first randomized trial demonstrating that ultra-processed foods disrupt our metabolic health and lead people to overeat. It was hugely influential and is widely recognized as the most rigorous examination of the subject so far.

This is the other side of the coin — the terrible disappointment the body feels at being duped. At being tricked and made a fool of, led to believe that something necessary would be provided, had been provided. Being misled by a scent or even just by a fragment of long-forgotten hope, and then betrayed. Thanks to a scent or a flavor, the anticipation of joy welled up and lasted for a golden instant before being crushed.

Not surprisingly, that work recognizably “sparked controversy and opposition.” The debate over extensive meddling with food began to attract the interest of more scholars, like Dr. Chris van Tulleken. In his book, Ultra-Processed People, these words appear:

With a physiological confusion that barely makes it to the surface of our conscious experience, we find ourselves reaching for another — searching for that nutrition that never arrived.

Sometimes, a phrase absolutely resonates: “Searching for that nutrition that never arrived.” The body has been betrayed. Thanks to the aroma, the bright packaging, the texture of the crispy treats in the plastic bag, and finally their taste… something was promised, but not delivered. That is the junk food experience, which is almost identical to the ultra-processed food experience, because in many cases both categories are applicable.

The experience might be compared with trying to slake thirst with salt water. No matter how dehydrated a person is, that stuff just isn’t going to do the job. In fact, the more of it you drink, the thirstier you will become. Every cell in the body knows the difference, just like it knows the difference between an apple and a merchandised abomination of ingredients that no one in their right mind would want to pronounce or spell, much less ingest.

Disparagement

A critic of Kevin Hall’s work, Walter Willett, led a Harvard study that drew information from “survey data from more than two hundred thousand people,” which resulted in the classification of ultra-processed foods into two major categories. The first contains sugary sodas and processed meats, which increase the risk of cardiovascular trouble.

The second category encompasses “breads and cold cereals, certain dairy products such as flavored yogurts, and savory snacks” that, strangely, apparently decrease cardiovascular risk. (An additional five types of ultra-processed foods apparently do neither.)

When the time came for the government to update its recommendations and endorse or deprecate various food groups, it merely suggested that processed meats be avoided. On the question of whether any amount or impressive source of new information will change American eating, Dr. Khullar seems doubtful:

Our food environments — the type and quality of food that pervades our schools, workplaces, and neighborhoods — influence our diets as much as our tastes do. And our food environments are shaped by our incomes, our government’s choices, and our desire for convenience, as well as active manipulation by the food industry, through things like marketing campaigns and lobbying for agricultural subsidies.

In other words, against what goes on in our neighborhoods, homes, schools, and workplaces — cautious warnings and common sense don’t stand a chance.

Your responses and feedback are welcome!

Source: “Why Is the American Diet So Deadly?”, Archive.is, 01/06/25
Image by tulajbila/Pixabay

Spectacular Obesity Costs Spotlighted

Pat Hartman April 9, 2026 No Comments

This is a continuation of “Unacceptable Obesity Costs Suspected.” About a decade ago, medical specialists and public health authorities were noticing more and more suspicious correlations between a substance known as bisphenol A (BPA) and various undesirable effects on humans. Chiefly, BPA seemed to be causing childhood obesity, and in some quarters, great interest was generated in the notion of discontinuing its use in products that might ever introduce the stuff into the bodies of children, orally or via any other route.

At the same time, concern grew about the costs that the use of this industrial chemical exacted from society in terms of both human suffering and financial impact. A ton of money was being spent to repair the ravages of BPA on kids, and on young people and adults who had encountered it in early life. Of course, it didn’t do adults any good either, even if, as children, they had managed to escape it.

Neither the first warning nor the last

Late in 2016, amid a climate of escalating suspicion, The Lancet published a report that brought up in no uncertain terms the price tag, in actual money, for tolerating BPA. By then, research had determined that the cost of disease and dysfunction caused by endocrine-disrupting chemicals, familiarly known as EDCs, amounted to more than 1% of the European Union’s annual gross domestic product, familiarly known as its GDP. (In American dollars, this amounted to the equivalent of around $217 billion.)

According to the report,

Exposure to EDCs varies widely between the USA and Europe because of differences in regulations and, therefore, we aimed to quantify disease burdens and related economic costs to allow comparison… Estimates were made based on population and costs in the USA in 2010. Costs for the European Union were converted to US$ (€1=$1·33).

In the United States, the costs accruing to EDCs were calculated to be around 2.33% of the gross domestic product, or around $340 billion. Experts utilized studies from the fields of epidemiology and toxicology to reckon the “probabilities of causation for 15 exposure–response relations between substances and disorders.” The scientists also had much to say about American societal expenses. They determined that…

The difference was driven mainly by intelligence quotient (IQ) points loss and intellectual disability due to polybrominated diphenyl ethers (11 million IQ points lost and 43,000 cases costing $266 billion in the USA vs 873,000 IQ points lost and 3290 cases costing $12.6 billion in the European Union).

The pesticides containing the dangerous chemicals were much more responsible in Europe, implying a need for improved screening there, for “chemical disruption to endocrine systems and proactive prevention.” The known effects of these chemicals on various body systems were already quite concerning, but the discoveries about their ability to wipe out IQ points definitely suggested a need for more awareness in that department. In 2018, PubMed had this to say about a small study:

This is the first study reporting the presence of bisphenols in two distinct regions of the human brain. Bisphenols accumulation in the white matter-enriched brain tissue could signify that they are able to cross the blood-brain barrier.

More recent publications

Another report (among many) supported the idea that exposure to BPA analogues is strongly connected with not only obesity, but also other undesirable health effects, especially in children. Then another one caused a stir by confirming that…

[…] endocrine-disrupting chemicals negatively affect a wide range of systems throughout the human body and have consequences at every life stage.

By now, professionals interested in this question were accustomed to hearing BPA and its relatives described as “forever chemicals,” meaning that once present in the body, they refuse to leave. The chemicals were deemed responsible not only for obesity but also for diabetes and reproductive disorders in both sexes.

On the policy front, the good news was that some substances had been banned; the bad news was that equally harmful chemicals were recruited to take their places. In no sane vocabulary could this be defined as progress.

Two years ago, a Spanish study of 106 children between ages 5 and 10, about half each of girls and boys, indicated that BPA “impacts the gut microbiome of children differently, with normal-weight children showing greater bacterial diversity compared to those who are overweight or obese.” In other words, this endocrine disruptor affects the gut microbiome adversely, leading to a variety of undesirable results.

Yet, the situation is very complicated, with many unclear connections and relationships among various factors. Still, enough is known to create certainty that this chemical and others like it should ideally be kept out of the body altogether — especially in the case of children and even more particularly where babies are concerned.

Your responses and feedback are welcome!

Source: “Exposure to endocrine-disrupting chemicals in the USA: a population-based disease burden and cost analysis,” TheLancet.com, December 2016
Source: “Possible Obesogenic Effects of Bisphenols Accumulation in the Human Brain,” Ncbi.nlm.nih.gov, 05/29/18
Source: “Bisphenol A Analogues in Food and Their Hormonal and Obesogenic Effects: A Review,” Ncbi.nlm.nih.gov, 09/06/19
Source: “Common Plastic Chemical Linked to Increased Childhood Obesity Risks,” SciTechDaily.com, 03/09/24
Images by Kalle_89 and OpenClipart-Vectors/Pixabay

Simple Daily Changes That Can Help Prevent Childhood Obesity

Tatyana Meshcheryakova April 8, 2026 No Comments

Childhood obesity remains one of the most pressing public health challenges in the United States. With rates still affecting roughly one in five children, experts increasingly agree that prevention doesn’t require extreme measures. It starts with small, consistent daily habits at home.

Recent research and updated guidance from organizations like the CDC highlight a powerful truth that simple lifestyle adjustments can significantly reduce a child’s risk of obesity when practiced consistently over time. Here are some practical, evidence-based changes families can make anytime to support healthier growth and long-term well-being.

Prioritize sleep as much as nutrition

Sleep is often overlooked, but it plays a major role in a child’s weight and overall health. Studies show that shorter sleep duration is a risk factor for obesity, especially when combined with high screen time.

Children who don’t get enough rest are more likely to experience hormonal changes that increase hunger and reduce energy levels. Over time, this can lead to weight gain. Even small improvements in sleep consistency can have measurable health benefits.

Simple daily changes can include:

— Setting a consistent bedtime (even on weekends)

— Creating a calming bedtime routine

— Keeping screens out of bedrooms

— Aiming for age-appropriate sleep (8 to 12 hours depending on age)

Reduce screen time and replace it with movement

Screen time has become one of the most influential lifestyle factors affecting children’s health. Recent CDC research shows that high daily screen use is linked to lower physical activity and increased obesity risk.

Additionally, excessive screen time is associated with poor sleep and sedentary behavior, the two major contributors to weight gain. Even reducing screen time by 30-60 minutes a day can create more opportunities for physical activity.

Simple daily changes can include:

— Turning off screens at least one hour before bedtime

— Setting daily limits on recreational screen use

— Replacing screen time with family walks, sports, or outdoor play

— Encouraging hobbies that involve movement (biking, dancing, playing outside)

Make healthy eating a family habit

Children are far more likely to adopt healthy eating habits when they see them modeled at home. Nutrition doesn’t have to be restrictive — it’s about balance, consistency, and accessibility.

Experts emphasize that a healthy diet should include:

— Fruits and vegetables

— Whole grains

— Lean proteins

— Low-fat dairy options

At the same time, limiting ultra-processed foods, sugary drinks, and frequent snacking can help reduce excess calorie intake.

Simple daily changes can include:

— Eating meals together as a family when possible

— Keeping healthy snacks visible and accessible

— Limiting sugary drinks and replacing them with water

— Avoiding keeping high-calorie junk foods in the house

Build daily physical activity into the routine

Regular movement is one of the most effective ways to prevent childhood obesity. However, many children today fall short of recommended activity levels due to increased screen use and sedentary lifestyles. Health experts recommend making activity a natural part of the day, rather than a chore. Even unstructured play, like running, climbing, or playing tag, can significantly improve physical health.

Simple daily changes can include:

— Walking or biking to nearby destinations

— Scheduling outdoor playtime every day

— Encouraging participation in sports or active hobbies

— Using active family time instead of passive entertainment

Create a healthier home environment

Children’s habits are shaped by their surroundings. A home environment that supports healthy choices makes it easier for kids to maintain a healthy weight without feeling restricted.

Research shows that family routines, structure, and environment all influence obesity risk.

Simple daily changes can include:

— Keeping a regular schedule for meals, sleep, and activity

— Removing TVs and devices from bedrooms

— Encouraging family-based activities instead of isolated screen use

— Being consistent with expectations and routines

Focus on consistency over perfection

One of the biggest misconceptions about preventing childhood obesity is that it requires dramatic lifestyle changes. In reality, consistency matters far more than perfection. Daily habits like going to bed on time, eating balanced meals, and staying active build on each other. Over weeks and months, these small changes create meaningful, lasting health improvements.

Easier said than done, but when families focus on these simple, sustainable changes, they give children the foundation they need for healthier futures — physically, mentally, and emotionally.

Your responses and feedback are welcome!

Source: “Prospective associations of sleep duration and screen time with transition from overweight/obesity to normal BMI in U.S. adolescents,” NIH, 1/23/26
Source: “Associations Between Screen Time Use and Health Outcomes Among US Teenagers,” CDC, 7/10/25
Source: “Obesity in Children: How Parents Can Help,” NationwideChildrens.org, 9/1/25
Source: “Multilevel Determinants of Overweight and Obesity Among U.S. Children Aged 10-17,” Arxiv.org, 2/23/26
Image by Atlantic Ambience/Pexels

Unacceptable Obesity Costs Suspected

Pat Hartman April 7, 2026 No Comments

About a decade in the past, an article published in The Lancet attracted quite a bit of attention, being reprinted or commented on in many related publications. Unlike the vast majority of news about medical research, this piece unashamedly mentioned money, and a spectacular amount of it. Of course, its subject matter was not a complete surprise, having been brought up many times in various contexts, of which a few typical examples follow.

Quite some time ago, it was determined that among the known thyroid system disruptors are PCBs, flame retardants, heavy metals, phthalates, and a manufactured chemical called bisphenol A, familiarly referred to as BPA. This potentially hazardous substance was commonly found in canned food, bottled liquids, infant-care products, dental resins, and other locations, having been put there on purpose with apparent disregard for any adverse results.

As far back as 2012, it was no longer surprising to encounter headlines such as “Association between urinary bisphenol A concentration and obesity prevalence in children and adolescents.” This particular piece of journalism noted that elevated urinary concentrations of BPA were associated not only with obesity but also with coronary artery disease. At the time, it was common for medical writers to note that exposure to BPA was linked to childhood obesity, although hard proof was difficult to come by.

In 2016, journalist Rebecca Lee wrote for CBS News,

The controversial chemical was removed from baby bottles and sippy cups almost four years ago, but is still found in the packaging of many popular food products. Of the items sampled, BPA was found in 100 percent of the Campbell’s products, 71 percent of Del Monte’s and 50 percent of the General Mills cans.

A 2014 study looked at “the effects of long-term paternal exposure to a ‘safe’ level of BPA” in adult male lab rats and their adult descendants, finding that such exposure “disrupted glucose homeostasis and pancreatic function,” but did not seem to affect body weight. Yet there was enough evidence to support a strong suspicion that chronic exposure to supposed “safe” amounts of it was not actually all that safe.

A year later, BPA was being mentioned as deserving high priority for further study as a health risk for humans because of the high degree of exposure that seemed bound to affect people of all ages, one way or another. Suspicion involved not only reproductive toxicity, but other side effects, “including liver damage, disrupted pancreatic β-cell function, thyroid hormone disruption, and obesity-promoting effects.”

Early in 2016, BPA was still a food industry favorite to improve food can linings and water bottles. Science writer Bailey Kirkpatrick described how, if only grownups were affected, that would be serious enough, but the stuff was also extensively used in baby feeding bottles and toys that toddlers famously gnaw on. Not to put too fine a point on it, BPA was going into their mouths and from there to other parts of their bodies. Apparently, not much thought had been expended on that aspect of the manufacturing trend.

Even though not proven at the time to affect body weight, there were plenty of other issues, like how the chemical could affect the human reproductive system by “mimicking estrogen, binding to nuclear estrogen receptors and even androgen receptors.” There were also issues and suspicions concerning connections to diabetes, cardiovascular disease, cancer, brain damage, prostate gland trouble, and rising obesity rates.

It was also noted, with alarm in many quarters, that BPA disperses into the air and, equally concerning, into the water, which, as any classroom globe will demonstrate, knows few borders and embraces the planet from every angle. Concerned professionals also spoke of lax oversight, the absence of adequately transparent labeling, and, as always, insufficient data. Still, the available evidence was enough to move the Food and Drug Administration to forbid the presence of BPA in the packaging of baby formula, even if it did prevent metal corrosion.

(To be continued…)

Your responses and feedback are welcome!

Source: “Association between urinary bisphenol A concentration and obesity prevalence in children and adolescents,” Pubmed.ncbi.nlm.nih.gov, 09/19/12
Source: “Study finds BPA in cans of many popular food products,” CBSNews.com, 04/11/16
Source: “High-fat diet aggravates glucose homeostasis disorder caused by chronic exposure to bisphenol,” Ncbi.nlm.nih.gov, April 2014
Source: “BPA, an energy balance disruptor,” Pubmed.ncbi.nlm.nih.gov, 2015
Source: “Could Common Chemicals Tip the Epigenetic Balance and Program Someone for Obesity?,” WhatIsEpigenetics.com, 05/24/2016
Image by LillyCantabile/Pixabay

The Case of the Politically Incorrect Teacher

Pat Hartman April 2, 2026 No Comments

There is more to know about the incident in which a high school teacher caused quite a stir by inserting questions that referenced obesity into an exam that the students were, of course, required to take. An understandable first reaction might be, “Just a moment, are we to understand that the gent educates young people about an obesity-related field, like nutrition or exercise? Is he perhaps the gym teacher?” But no: Tom Chan teaches math.

To digress for a moment from that odd discrepancy, it should be noted that the entire San Francisco United School District, where Lowell High School is located, enjoys an apparently well-functioning mechanism for conscientiously feeding children of all ages, several times per day if necessary. The menus, published via a special website, include such details as the calorie content of upcoming meals.

The financial details are unclear, but it seems to be free for most or all students. That is a topic for another day.

The intriguing question that comes to mind, the real head-scratcher, is, “How and why would a teacher of mathematics insert material, whether intended as humorous or not, about obesity, into a compulsory test?” Learning more about the circumstances of the accusation of wrongdoing and its consequences does little to clear up that question.

The status quo

All along, in the course of a more than 20-year teaching career, most of Mr. Chan’s kids have rated him highly, to the point where…

For many of us, Mr. Chan was not just a teacher; he was a source of encouragement and someone who genuinely believed in our success.

A former student wrote to the San Francisco Chronicle that Chan “went above and beyond in ways that are rare.” A report from SFist.com noted that many students “brushed his humor off as being ‘bad dad jokes,’ which the students interpreted as Chan’s way of making math more fun.” (Just to be clear, the phrase “bad dad jokes” denotes corny humor, not abusive fathers.)

Recently, for some reason, talk was going around about particular test questions that bothered some students, and consequently some parents, and the authorities. Two items were of particular concern, problems that involved “a ‘fat kid’ punted into the air and the cost of dating girls based on their weight.” As more individuals within the system became aware of the disturbance, more of them agreed that Chan’s language and behavior were perceived and received as fat-shaming, and also sexist.

When the press informed the public, the feathers hit the fan. Some students had never been comfortable with their math teacher’s style all along, and the ensuing publicity encouraged them to speak up. With public attention focused on the matter, the authorities had no choice but to suspend him pending further investigation.

Meanwhile, additional evidence was brought forward. Both teens and adults who had previously not felt that they needed to strictly follow the “See Something, Say Something” policy hardened their attitudes and added their observations and experiences to the pile. One report mentioned a 9th-grade algebra quiz question that had something to do with giving candy to a “fat kid.”

But then word got around, not only about this particular test, but earlier ones, as well as language that had been used in the classroom and elsewhere. A citizen remarked in an online forum that Chan had been known to “make gross generalizations about people who speak Cantonese,” which is not a positive quality.

Yet at the same time,

Hundreds of former and current students immediately defended Chan after the Chronicle’s coverage, signing a petition and urging officials to reinstate him.

A parent named Caimán Dorado wrote to SFist.com,

My kids, 2 girls!! …remember Mr Chan’s quirky jokes and say WAS NOT A BIG DEAL. He was popular to the kids boys and girls, a good creative teacher… These almost adult high schoolers who spend their lives online, understood Mr Chan was just trying to make calculus more creative interesting and fun.

Another parent wrote,

To be fair, when my kids were going to Lowell, the math and science teachers used a lot of goofy examples like that to keep the students engaged, although that was more in Physics and Calculus, as I recall.

But some current and former students went the other way, recalling additional details that made them uncomfortable, and sharing them with the student newspaper. Worse yet, the school authorities also cited as a reason for the suspension “other behaviors,” which various publications have mentioned, hinted at, or confirmed as fact.

It was common knowledge to anyone who frequented the same social media sites that Chan commented on some female students’ posts and sent them direct messages. (The journalist did not mention whether any male students received the same extracurricular attention.) Apparently, he had been heard to say, “Girls are either pretty, or they can do math,” which sounds pretty sexist, or at the very least, unnecessary and inappropriate.

This item does not sound good at all. As stated by SFist.com,

Some parents are also unhappy that he posted “Grades vs. Dignity” videos on YouTube of students dancing in exchange for extra credit.

At any rate, the authorities placed Chan on “indefinite leave,” and by March 25, he had resigned.

Your responses and feedback are welcome!

Source: “Find Your Menu,” SFUSD.edu, undated
Source: “S.F. teacher accused of sexist quizzes quits,” PressReader.com, 03/27/26
Source: “Lowell High School Teacher on Leave After Giving Students Quizzes Demeaning Girls, ‘Fat Kids’,” SFist.com, 03/03/26
Source: “Lowell High math teacher resigns amid probe into sexist, fat-shaming quiz questions,” Yahoo.com, 03/25/26
Image by Mohamed_hassan/Pixabay

Transforming Teen Health With Pediatric Lifestyle Medicine

Tatyana Meshcheryakova April 1, 2026 No Comments

It’s an established fact that childhood and adolescent obesity has become one of the most pressing health challenges in the United States. A new, more personalized approach is offering hope.

At Kaiser Permanente and the Mid-Atlantic Permanente Medical Group, a Pediatric Lifestyle Medicine Program is helping teens take control of their health in ways that go far beyond traditional advice. And the results are already proving that meaningful change is possible.

A new approach to teen health

Led by pediatrician and obesity medicine specialist Christina Brown, the program focuses on more than just weight loss. It’s designed to empower teens to build sustainable, lifelong habits that improve both their physical and emotional well-being.

In just a few months, the program has delivered impressive outcomes. One teen significantly improved their blood sugar levels, moving out of the prediabetes range. Another lost 20 pounds while gaining strength, confidence, and a renewed sense of control over their health.

But for Dr. Brown, the real success goes deeper. She said,

These teens are choosing their health habits and how they are going to spend the rest of their life.

Why adolescence is a critical window

Teenage years are a pivotal time for shaping lifelong behaviors. Habits formed during this stage often carry into adulthood, influencing long-term health outcomes. By addressing weight management issues during adolescence, programs like this can change an entire health trajectory, potentially preventing decades of chronic illness.

Moving beyond “eat better and exercise more”

Traditional pediatric visits often rely on general advice like eating healthier and being more active. While well-intentioned, this approach can feel vague and difficult to follow, especially for teens navigating complex social, emotional, and environmental challenges.

Dr. Brown said,

There’s some back and forth, but it tends to be very prescriptive. Then at the next visit, the patient has gained 20 to 50 pounds, and it’s very frustrating for both the patient and the doctor.

This program flips that model. Instead of prescribing one-size-fits-all solutions, it focuses on personalized care plans, collaborative goal setting, and ongoing support and accountability. Teens are treated as active participants in their care, not passive recipients of advice.

A personalized, whole-person strategy

Every participant begins with a deep dive into their health history, lifestyle, and emotional well-being. This includes understanding factors like eating patterns and nutrition habits, physical activity levels, sleep quality, stress and mental health, and social environment and support systems.

This approach recognizes a key truth: Health is interconnected. For example, poor sleep can affect energy levels, stress can influence eating habits, and social isolation can reduce motivation.

The power of small, achievable goals

One of the program’s most effective tools is the use of SMART goals — specific, measurable, achievable, relevant, and time-bound objectives. Rather than overwhelming teens with drastic changes, the program encourages manageable steps, such as taking a short walk once a week, reducing sugary drinks, and eating breakfast consistently.

Addressing emotional and social challenges

For many teens, obesity is not just a physical issue; it’s deeply tied to emotional experiences. By creating a supportive, judgment-free environment, the program helps teens rebuild confidence and reconnect with their lives.

Dr. Brown said,

I was shocked to see how many teens isolate themselves due to bullying, anxiety or depression that they’re experiencing related to obesity and social pressures… When I asked one of my patients what her goal was, she said she wanted to be able to go back to school and not be bullied. It breaks your heart.

Nutrition and habits

Food plays a major role in the program, but the focus goes beyond “what” teens eat. It also examines when, where, and why they eat. For example, skipping meals or consuming high-calorie beverages can significantly impact overall health. By identifying patterns, teens can make informed, realistic changes. Optional food tracking can also help increase awareness, revealing habits that might otherwise go unnoticed.

A team-based approach

Because obesity is a complex condition, the program brings together a network of specialists, including dietitians, behavioral health professionals, sleep medicine experts, and health coaches.

One surprising discovery has been the prevalence of sleep apnea among teens in the program. Many didn’t show obvious symptoms but were experiencing fatigue and low motivation due to poor sleep quality.

Dr. Brown said,

Most of these kids don’t have the classic symptoms of sleep apnea, such as snoring or hypertension. But their parents may say, ‘He’s lazy, unmotivated and napping all the time…’ Then we figure out they have sleep apnea and are not getting enough oxygen to their brain while sleeping. So, they’re actually not lazy at all. They have a medical condition we need to treat.

Real and lasting health improvements

Even in its early stages, the program is delivering measurable health benefits, including improved cholesterol levels, lower blood sugar, better liver health, and reduced symptoms of hormonal conditions like polycystic ovary syndrome (PCOS). These changes can influence not only current health, but also future outcomes, including reproductive health and pregnancy risks later in life.

Changing the future of pediatric care?

Programs like this represent a shift in how the medical community approaches obesity. Rather than treating it as a lifestyle issue alone, it’s being recognized as a complex, chronic condition that requires comprehensive, evidence-based care. Dr. Brown is also working to expand this model by training other physicians, helping integrate lifestyle medicine into pediatric care more broadly.

The goal is clear: Make this level of support accessible to more teens, and ultimately, change the trajectory of an entire generation. In a time when childhood obesity continues to rise, initiatives like this offer something powerful: not just treatment, but transformation.

A relevant reminder

Dr. Pretlow, the creator of BrainWeighve, a weight loss app for overweight and obese children, is conducting a BrainWeighve clinical trial at UCLA. The trial has expanded to include 10 subjects currently taking GLP-1 medications. This addition aims to help researchers understand how lifestyle and behavioral tools enhance medication or possibly even reduce the need for medication over time.

The program is designed for obese teens and uses a self-directed, physician-supervised approach to tackle overeating one “problem food” at a time. By helping participants rechannel emotional urges into healthier coping mechanisms, BrainWeighve aims to support sustainable weight loss — and reduce dependence on willpower alone.

Your responses and feedback are welcome!

Source: “How pediatric lifestyle medicine is transforming obesity care,” AMA, 3/26/26
Source: “Kaiser Permanente Launches Pediatric Lifestyle Medicine Program,” Kaiser Permanente, 10/13/25
Image by Gustavo Fring/Pexels

The rise of GLP-1 medications in pediatric care

What is personalized (precision) medicine?

Potential benefits for pediatric patients

Ethical and equity considerations

What are GLP-1 medications?

Imagination helps

A closeup view

Disparagement

Neither the first warning nor the last

More recent publications

Prioritize sleep as much as nutrition

Reduce screen time and replace it with movement

Make healthy eating a family habit

Build daily physical activity into the routine

Create a healthier home environment

Focus on consistency over perfection

The status quo

A new approach to teen health

Why adolescence is a critical window

Moving beyond “eat better and exercise more”

A personalized, whole-person strategy

The power of small, achievable goals

Addressing emotional and social challenges

Nutrition and habits

A team-based approach

Real and lasting health improvements

Changing the future of pediatric care?

A relevant reminder

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations