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Childhood Obesity Treatment Gap

Tatyana Meshcheryakova February 25, 2026 No Comments

Childhood obesity continues to rise at an alarming rate in the United States, mirroring trends seen in adults but with even more concerning long-term implications. Today, more than 150 million Americans are living with obesity, including roughly 15 million children. While most people recognize that obesity is linked to serious conditions such as Type 2 diabetes, heart disease, and sleep apnea, fewer realize that these illnesses are increasingly affecting younger populations.

One of the most troubling aspects of obesity is that its impact compounds over time. The longer the body carries excess weight, the greater the cumulative stress placed on organs, metabolism, and overall health. When obesity begins in childhood, that timeline of exposure becomes significantly longer — often leading to more severe complications in adulthood.

Evan P. Nadler, M.D., the founder of ProCare Consultants and ProCare TeleHealth, penned an article for Clinical Leader, providing his take on why excluding children from clinical trials might present obstacles in the proper treatment of childhood obesity with weight loss drugs.

He wrote:

With most diseases, the longer you have it, the worse it gets. Obesity is no different. The damage is cumulative. It’s not just about how much you weigh — it’s about how long your body has been exposed to that weight. So one would think that the imperative to find solutions for childhood obesity would be front and center for those who are involved in clinical research involving the next generation of anti-obesity medicines. Unfortunately, that isn’t the case.

Despite this urgency, children remain largely underrepresented in the rapidly advancing field of anti-obesity drug development.

The landscape of obesity treatment has changed dramatically in recent years. Breakthrough medications have transformed how clinicians approach weight management, offering new hope for patients who previously had limited options.

Recent approvals from the U.S. Food and Drug Administration have brought injectable treatments such as semaglutide and tirzepatide into mainstream medical practice, with studies showing substantial weight loss outcomes. Researchers are also developing oral versions of these medications, along with next-generation therapies like orforglipron, maritide, and retatrutide.

Some of these emerging treatments target multiple metabolic pathways at once. In clinical trials, triple-receptor therapies have demonstrated weight-loss results comparable to bariatric surgery — an outcome that was nearly unimaginable just a decade ago.

However, most of these advancements are focused on adult populations. Currently, only a limited number of GLP-1–based medications are approved for adolescents ages 12 and older. Even then, options remain restricted, and some require daily injections, which can be difficult for younger patients to maintain. Meanwhile, several promising drugs remain years away from pediatric approval.

Why children are often left out of clinical trials

A major reason for the treatment gap lies in how clinical trials are structured. Pharmaceutical companies typically complete adult trials first before expanding research into pediatric populations. While safety considerations play a role, regulatory frameworks also contribute to delays.

In the United States, pediatric studies are encouraged but not always required early in the drug development process. Companies may postpone these trials until adult approvals are secured, which often results in multi-year delays before children gain access to new therapies.

This delay can create arbitrary access gaps. For example, a medication approved for an 18-year-old may not be available for a 17-year-old — even though the medical condition is essentially identical.

Because adult markets are larger and more profitable, pediatric studies are often deprioritized. Unfortunately, this approach overlooks the long-term health benefits of early intervention.

How Europe takes a different approach

Regulatory policies differ internationally. Within the European Union, pharmaceutical companies must submit a Pediatric Investigation Plan before completing adult trials for new medications. While the pediatric studies themselves may still occur later, the requirement ensures that children are part of the development strategy from the beginning. This structured planning process has resulted in more consistent pediatric drug research compared to the U.S., where early inclusion is often optional.

Despite groundbreaking progress in obesity pharmacotherapy, many of the newest medications still lack clear pediatric development timelines. Public regulatory databases show limited planning for children in several ongoing drug pipelines, reinforcing concerns that young patients may wait years before benefiting from new therapies.

The contrast is striking. Innovation is accelerating, yet access remains uneven.

The growing childhood obesity crisis highlights the need for a shift in how treatments are developed and approved. Early intervention — whether through lifestyle programs, behavioral care, or medical therapy — can dramatically change long-term health outcomes.

As new anti-obesity medications continue to reshape treatment possibilities, experts increasingly call for regulatory reforms that prioritize pediatric inclusion from the start. Without that change, millions of children may remain on the sidelines of one of the most significant medical advancements in metabolic health.

Dr. Nadler wrote:

So what does this all mean for children with obesity in the U.S.? Despite all the GLP-1- development, children are not part of the gameplan… The time has come for the FDA to rethink how it approaches clinical trials in children for the sake of the 15 million children with obesity…

Your responses and feedback are welcome!

Source: “The Problem With Excluding Children From GLP-1 Trials In The U.S.,” Clinical Leader, 2/19/26
Source: “Obesity and Overweight: Developing Drugs and Biological Products for Weight Reduction,” FDA, January 2025
Image by Anna Shvets/Pexels

Is It All About Money?

Pat Hartman February 24, 2026 No Comments

Each day, the American public is greeted by the news that yet another product or service is becoming either painfully expensive or increasingly impossible to obtain at any price. Periodically, we are met with unwelcome surprises. For example, it has recently come to the world’s attention that to build and maintain the hardware needed for immense Artificial Intelligence citadels will raise the price of both water and electricity to levels terrifying to contemplate.

At the same time, the astute reader will have noticed that certain words occur frequently in the titles and posts here at Childhood Obesity News. Those words are “cost” and “price,” along with several other appropriate synonyms, adjectival variants, and even polite euphemisms.

This site has discussed individual costs, institutional costs, societal costs, financial costs, psychological costs, emotional costs, and more; all paid directly or indirectly by the parents of obese children and, of course, by the kids themselves.

The crux of the matter

Here is the problem. “On the ground,” as the expression goes, those different types and degrees of prices are actually paid by pretty much everybody (except for a tiny percentage of villains who design and maintain the system, and profit from it). Among the vast majority of the population, many varieties of prices are paid.

The point being pursued here is that the vast majority can also jolly well decide to do something about it. One way or another, we really all need to take some responsibility. This does not mean trying to make laws to control the behavior of individuals. (They tend not to react well, so trying is usually a waste of energy.)

However, corporations are not people and are not entitled to human rights. We humans, especially the ones who hope to prevent childhood obesity, can take it upon ourselves to discipline manufacturers. Among other points of contention, they need to stop adding certain ingredients to their purportedly edible products.

We are well within our rights to insist that corporations behave themselves. We could easily take some of the energy we use to tsk-tsk at the parents of overweight children, and apply it to curbing the worst instincts of our corporate oppressors.

Oh, those prices

The vast majority of the population consists of many more types than just obese children and their responsible adults. Directly or indirectly, recognizably or covertly, one way or another, all sorts of prices are paid — and not just by these children and their parents but, eventually, by everybody who belongs to the whole society — yes, even the skinny kids and the childless adults. Still, maybe we could recognize the futility of picking on obese people and cut them a break. A lot of that energy could be constructively redirected.

Let’s back up for a minute and glance at a very recent item of medical news, which says,

Researchers from the UK and Finland said that people with obesity were seen to have a higher risk of being hospitalised or dying due to SARS-CoV-2 infection during the COVID-19 pandemic.

According to the venerated journal The Lancet, obese people may be as much as 70% more apt to be hospitalized for — and even die of — an infectious disease like pneumonia, flu, or COVID-19. The professionals behind the study ask readers to exercise caution before generalizing, because, of course, many factors are involved.

No scientists want the public to read more into their published work than what they intentionally placed there. Still, the study did encompass well over half a million subjects and…

“As obesity rates are expected to rise globally, so will the number of deaths and hospitalisations from infectious diseases linked to obesity,” author Solja Nyberg, from the University of Helsinki in Finland, said.

Like so many other studies, this one also demonstrated the futility of being mean to obese people, who may not even be around long enough to feel the effects of that wasted negative energy.

Your responses and feedback are welcome!

Source: “Data centers for AI use huge amounts of electricity, water, driving up costs and climate concerns,” CBSNews.com, 02/13/26
Source: “ Obesity Raises Risk Of Hospitalisation, Death From Infections By 70%: Study,” NDTV.com, 02/11/26
Image by Peggy_Marco/Pixabay

Childhood Obesity on the Brain

Pat Hartman February 19, 2026 No Comments

An impartial observer from some other solar system, sent to garner facts about Earthlings, would eventually run up against the dislike of body fat that prevails among so many people in so many cultures. To the interplanetary visitors, the answer, including whether there even needs to be an answer, might seem obvious: “Don’t become obese.”

The scholar from afar would do the equivalent of scratching their head, musing… How much sheer brain power, how many thousand cumulative years of academic study have been devoted to dwelling on this mystery? How many lab animals have been sacrificed in pursuit of weight-loss knowledge?

The impulse to highlight a certain article published by Dr. Pretlow is irresistible. With every passing year, it becomes more demonstrable that the issues surrounding obesity and body image can impact a person in ways that are not only difficult for a non-professional observer to imagine but which, in some cases, lead to appalling results.

The human condition

It is not so very hard to change or disguise skin color, at least for the short term. Making the hair look different is almost laughably simple. To appear as a member of the opposite sex has largely been possible since people started wearing clothes. It may not be easy, or officially approved, but in most societies throughout history, it has been doable. As time goes on, that potentiality has grown for at least a percentage of folk, depending mostly on financial capability.

But… and it’s a big butt…

Okay, that is a lousy pun. Moving on… A person can be made to look taller, but to appear shorter requires some skillful trickery. A person can so easily be made to look corpulent, but to achieve the illusion of slimness is incontestably a challenge, involving a whole different sort of visual phenomenon. To achieve the illusion of a smaller body requires considerable effort — training in visual aesthetics, access to specialized supplies and equipment, and good lighting.

The sad fact is, it’s pretty much a one-way trick. To appear bigger and fatter is almost infinitely possible, depending only on how many pillows a person could tie on with ropes, or how clever a balloon-suit they could hide themselves in before inflating it and hoping not to sit on any sharp object.

All of which only emphasizes how relatively impossible it is to go the other way. Sure, optical illusion and an excellent tailor can do a lot to disguise a hefty physique. And let’s not start in on the possibilities offered by photoshopping and AI, which can work their seeming magic to portray a human as gigantic or svelte. Messing with images is so easy and obvious, it doesn’t even really belong in a serious discussion like this.

The logical answer

The obvious solution is to simply not be so big! Eat less than is needed. Use up a lot of energy. It will take time, and the task will be difficult for various reasons, but of all potential metamorphoses, it seems, in theory, at least, to be the most possible. Theoretically, to become a person with a smaller body ought to be the easiest transition of all.

So then, what is the problem? What is wrong with you and me and millions of overweight Earthlings who just can’t get it together and shed the pounds? How many thousands of hours of thought and experimentation have been utilized over the years to figure this out? How many words and bytes have we utilized in trying to first grasp the problem at all, and then to explain it to others?

More or less than required to figure out transportation without fossil fuels? More or less than has been spent trying to avoid (or facilitate) nuclear annihilation? Why is slimming down a human body such an imposing, vast, difficult, problematic, wearisome chore?

Groping for clarity

We could quote some dismal and/or shocking statistics about Obesity, Growth Of, but that would be needlessly boring. One more question comes to mind, a major one, and basically the most important reason for all this soul-searching. Just exactly how badly does this whole subject of weight damage young people who, truth be told, have quite a lot of other troublesome issues to deal with? (It is tempting to go with a colloquial expression there, like “These poor kids have too much on their plates already.” But, no.)

Now, veering back to the original puzzling topics that inspired the discussion, the entire point here was to pose yet another question. Despite the struggle to avoid and suppress obesity having been spectacularly unproductive so far, maybe some kind of a step back could be taken. Possibly, we could temporarily, just as an experiment, set aside many of the thoughts we have been accustomed to holding onto, about these matters.

Of course, many visitors here have already read the work authored by Robert Pretlow and Suzette Glasner, titled “Reconceptualization of eating addiction and obesity as displacement behavior and a possible treatment.” For those who are familiar and for newer readers too, some interesting notions dwell, awaiting discovery, in its pages. In particular, interested professionals and laypersons alike might meet up with ideas that could blossom into useful revelations and actual change.

Your responses and feedback are welcome!

Source: “Reconceptualization of eating addiction and obesity as displacement behavior and a possible treatment,” NIH.gov, June 2022
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The New U.S. Dietary Guidelines Spark Praise, Pushback, and Policy Shifts

Tatyana Meshcheryakova February 18, 2026 No Comments

Since their release in early January, the new U.S. Dietary Guidelines for Americans have stirred intense debate across the food industry, healthcare community, and public policy landscape. Touted by some as a long-overdue course correction and criticized by others as inconsistent or politically influenced, the updated guidance marks a notable shift in tone, particularly around refined carbohydrates and ultra-processed foods.

But while parts of the recommendations are being welcomed as progress, other sections are drawing skepticism over scientific rigor, industry influence, and practical implementation, especially in schools.

Here’s a closer look at what’s changed, who stands to benefit, and what it could mean for Americans.

A shift away from refined carbohydrates

One of the most talked-about updates involves a stronger acknowledgment of the risks associated with refined carbohydrates and ultra-processed foods.

Tim Spector, M.D., a professor of genetic epidemiology at King’s College and scientific co-founder of ZOE, a personalized nutrition program, said in an interview with The Food Institute:

For the first time in a long while, we’re seeing official guidance acknowledge something that researchers and clinicians have been observing for years: Many chronic diseases improve when refined carbohydrate intake is reduced.

For many clinicians, this represents a meaningful departure from decades of nutrition advice that emphasized low-fat diets while often overlooking the role of highly processed carbohydrates in metabolic disease.

However, Dr. Spector cautioned that the guidance may lack practical clarity. He said,

The documents don’t go into much detail on how to do this well, and that’s an important caveat. But even so, this represents a genuinely welcome shift away from nutritional advice that has dominated for the last two decades and has proven remarkably resistant to change despite mounting evidence that it hasn’t delivered better health outcomes.

In other words, while the direction may be promising, the roadmap remains incomplete.

A “mixed bag” of recommendations

Not all experts are fully on board. Evan Nadler, M.D., a childhood obesity treatment expert who previously ran the Childhood Obesity Programs at Children’s National Hospital in Washington, D.C., described the new guidelines as a “mixed bag.” He said:

The advice to limit ultra-processed food, sugar, and refined carbohydrate intake is long overdue and likely helpful for almost everybody, but the advice to increase red meat and whole milk intake isn’t evidence-based and could be especially harmful for those at risk for cardiovascular disease.

He also questioned recommendations around protein intake:

Similarly, Americans already eat plenty of protein so there is no basis to increase protein intake as advocated in the recommendations. Increased protein intake can be an issue for those with kidney disease in particular.

These concerns reflect an ongoing tension in nutrition science: balancing population-wide guidance with individual health risks.

What about gut health?

The guidelines’ recognition of gut health has also drawn mixed reactions. Fiber, prebiotics, and diverse plant-based foods are widely associated with improved gut microbiome health. Critics argue that if gut health is to be a priority, plant-forward foods should take center stage in national guidance.

Kaitlin Voicechovski, lead registered dietitian at Oshi Health, welcomes the shift but believes the emphasis could go further. She said:

If this were truly a gut-friendly food pyramid, a few things might be higher up: fiber-rich foods, whole grains, and plant-based protein sources like beans.

Which industries stand to benefit?

Beyond nutritional science, some experts are questioning the influence of powerful food industry stakeholders. Here’s Dr. Nadler’s take:

Clearly, the dairy and beef industries are the big winners here, and also U.S. [farmers] in general could stand to benefit. While RFK claims to have ‘radical transparency’ when it comes to the pharmaceutical industry, the impact of the National Dairy Council and the National Cattlemen’s Beef Association on the new dietary guidelines has been swept under the rug a bit.

Concerns about industry ties are not new in the development of federal dietary guidelines. Critics argue that transparency around financial relationships remains insufficient.

Dotsie Bausch, an Olympic silver medalist and founder of the vegan nonprofit Switch4Good, was more direct in her critique, stating that six of the nine experts on the dietary guidelines’ panel are “taking money from big meat and dairy.”

She also questioned messaging around “real food”:

They constantly repeat for Americans to eat ‘real food,’ but when in history have any of the guidelines suggested for us to eat fake food? People are well aware their trips to McDonalds and Taco Bell are not healthy choices.

This debate underscores a broader philosophical divide: Should national guidelines lean more heavily toward plant-based patterns, or maintain a more omnivorous framework?

Impact on schools

One area where many agree progress has been made is in reducing children’s exposure to sugar and artificial sweeteners. Dr. Spector described this aspect of the guidance as a “public health win,” noting that limiting added sugars in school meals could help address rising rates of childhood obesity and metabolic disorders.

However, translating guidelines into practice is easier said than done. Lori Nelson of the Chef Ann Foundation, a nonprofit that promotes scratch cooking in schools, compared assembling a school meal to a puzzle. She told NPR:

When you think about the guidelines, there’s so many different pieces that you have to meet. You have to meet calorie minimums and maximums for the day and for the week. You have to meet vegetable subgroup categories.

Infrastructure presents another barrier. Many school cafeterias were built decades ago and designed primarily for reheating pre-prepared food rather than cooking meals from scratch. Budget constraints further complicate efforts to incorporate more whole, minimally processed ingredients.

A new era for plant-based options in schools?

In a related development, the recently signed Freedom in School Cafeterias and Lunches (FISCAL) Act now requires schools to provide plant-based milk options to students whose parents request them. This would be the first time in the nearly 80-year history of the national school lunch program.

This move could signal broader flexibility in how schools interpret and implement federal nutrition policy, particularly as plant-based eating continues to gain popularity among families.

It would also be interesting to follow the news and see how the new food pyramid would compare to the WHO’s recently issued global guidelines for healthier school meals.

Your responses and feedback are welcome!

Source: “The New Food Pyramid: Pros, Cons, Potential Conflicts of Interest,” The Food Institute, 2/11/26
Source: “How the new dietary guidelines could impact school meals,” NPR, 2/5/26
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Weight-Loss Drugs Earn Piles, Boatloads, and Oodles

Pat Hartman February 17, 2026 No Comments

As a simple search reveals, what are loosely called GLP-1 drugs have been a hot topic for a long time. Many people make plenty of profit from them, but published reports indicate some dissatisfaction among companies and individuals who would prefer, rather than a mere plenitude, to reap piles, boatloads, and oodles of money instead. As one authority explains,

GLP-1 is the natural hormone that your body makes… Semaglutide is the medicine that copies what your natural hormone does… You are not taking the hormone itself. You are taking a medicine that knows how to do the exact same job as the hormone.

The Garrison Center, a renowned think tank, has been calling public attention to matters related to semaglutide, to the point where some characterize this focused attention as whistleblowing. The colorful metaphor is borrowed from sports, where when an official lets out a blast on his whistle, that constitutes a ruling that the action taken by a player on either team was outside the realm of actions permitted in the game.

The trouble started because, although Novo Nordisk holds a patent on semaglutide, when there was an officially-declared shortage, another outfit was allowed to make and sell it too. Thomas L. Knapp thoroughly explains what happened when the telehealth company Hims & Hers had the temerity to sell semaglutide at a lower price than the rightful patent holder. Given that Hims & Hers would not even be allowed to market the stuff in the first place, had an exception not been made, this was regarded as a very hostile move.

The Novo Nordisk legal team pointed out that not only was the shortage officially declared over, erasing the justification for letting the other company sell the product, but something else was glaringly wrong, namely:

The fact is that their medicines are untested, and they’re putting patients at risk.

At this point, the whole narrative takes an unexpected turn, and journalist Knapp points out an absurdity:

[T]he difference between semaglutide from Hims & Hers and semaglutide from Novo Nordisk is the name on the label.

Novo Nordisk was charging around $150 a month, and Hims & Hers aspired to sell the same amount of the identical product for about $50 a month. But that detail is minor, compared to another matter, described as follows:

The whole POINT of Novo Nordisk’s attempt to enforce its patent is to CREATE a shortage of semaglutide in pill form… The patent, if enforceable, allows Novo Nordisk to charge customers AT LEAST three times as much for its pill as the market says it can be sold profitably for. Hims & Hers wouldn’t offer it for $50 if it expected to lose money doing so.

The purpose of patents, Knapp explains, is…

[…] to create artificial shortages so that inventors don’t have to compete with others who may copy their inventions — or even independently invent similar things… While I’m skeptical for the wildest claims about the benefits of GLP-1s, they’re clearly beneficial to enough people, in enough ways, that we should ask why governments are handing out price-gouging opportunities, in the form of monopolies, on them.

This is a gnarly situation whose resolution could resonate far and wide, affecting much more than this tempest in an industrial teapot. Meanwhile, despite widespread and fanatical acceptance, it is totally possible that the entire semaglutide market, which may have promised too much too soon, could totally collapse.

Your responses and feedback are welcome!

Source: “Is GLP-1 the Same as Semaglutide?,” SemaglutideMedics.org, 11/13/25
Source: “Semaglutide: Artificial shortage is Novo Nordisk’s business model,” TheGarrisonCenter.org, 02/10/26
Image by Peggy_Marco/Pixabay

WHO: Global Nutrition Progress Is Stalling

Tatyana Meshcheryakova February 13, 2026 No Comments

A recent report presented to the World Health Organization (WHO) Executive Board delivered troubling news: global progress on maternal, infant, and child nutrition has largely stalled. In some areas, it’s even moving backward.

Despite years of international commitments and development programs, six major global nutrition targets are now officially “off track.” Rising anemia rates among women, persistent childhood stunting (being too short for their age due to chronic undernutrition), increasing childhood overweight, and stagnant improvements in birth outcomes reveal a growing crisis that experts are calling a silent epidemic, particularly across Africa and other vulnerable regions.

The implications are profound. Nutrition is not just about food — it shapes survival, lifelong health, cognitive development, economic productivity, and equity.

Let’s take a closer look at what’s happening and why it matters.

Anemia in women is a reversing trend

One of the clearest signs of regression is the rising prevalence of anemia in women of reproductive age. Global commitments under Sustainable Development Goal 2 (Zero Hunger) aim to cut anemia rates in half by 2030. Instead of declining, rates have increased from 27.6% in 2012 to 30.7% in 2023.

Anemia — often caused by iron deficiency but also linked to infections, poor diets, and poverty — reduces the body’s ability to carry oxygen in the blood. For women, this can mean increased risk of maternal mortality, higher likelihood of preterm birth, low birth weight infants, and reduced physical capacity and productivity. The rise reflects deeper systemic challenges, such as food insecurity, climate shocks, infectious diseases, gender inequality, and fragile health systems.

The double burden of malnutrition

The world is now grappling with what experts call the “double burden” of malnutrition — undernutrition and overweight existing side by side. Undernutrition remains widespread, as 150.2 million children under five are stunted.

An additional 136.3 million children could face stunting by 2030 if trends continue. Childhood wasting (dangerously low weight for height) affects 6.6% of children, well above WHO’s 5% target threshold. Low birth weight rates have barely improved, decreasing only slightly to 14.7% globally. Stunting affects brain development, school performance, and earning potential later in life. It locks families and nations into cycles of poverty.

Childhood overweight is rising

At the same time, childhood overweight has climbed to 5.5% globally. This rise is linked to food systems that increasingly provide cheap, ultra-processed foods while healthy options remain inaccessible or unaffordable. This nutritional paradox — hunger and obesity existing simultaneously — reflects structural weaknesses in global food systems.

A crisis of inequality

During WHO discussions, member states emphasized that this is not just a nutrition problem — it’s a crisis of inequality. The African region bears the highest global burden of stunting and anemia. Conflict, displacement, and climate change are worsening food insecurity.

In fragile states, entire health and supply systems are disrupted. Climate shocks destroy crops, armed conflicts displace families, and economic instability limits access to nutritious foods. The result is a compounding nutrition crisis, particularly in low-income and conflict-affected regions.

The formula marketing controversy

A heated debate also emerged over the marketing of breast milk substitutes. Several nations criticized aggressive commercial practices that promote formula feeding in vulnerable communities. Critics argue that misleading marketing undermines breastfeeding, targets low-income families, and prioritizes profits over public health.

Concerns were raised about online and cross-border marketing practices, including unregulated digital advertising and product safety recalls. Public health advocates insist that governments must strengthen monitoring and enforce international marketing codes to protect breastfeeding, which remains one of the most effective and cost-efficient interventions for infant survival.

Micronutrient supplementation

While advocacy groups pushed for stronger regulation of formula marketing, industry representatives emphasized the importance of micronutrient supplementation. Iron, folate, iodine, and calcium supplementation during pregnancy can significantly reduce anemia, maternal mortality, and preterm birth. Many experts agree that supplementation programs can be a cost-effective public health strategy, particularly in high-risk populations.

Shrinking aid in a growing crisis

Perhaps the most alarming backdrop to this discussion is declining international nutrition funding. Development assistance for nutrition is estimated to have dropped between 9% and 17% in 2025.

At the same time, no country is currently on track to meet all nutrition targets, dietary diversity is worsening in multiple regions, and vulnerable populations are expanding due to climate change and conflict. Reduced funding threatens to undo years of progress and increase preventable child deaths. Experts are calling for nutrition to be treated as an essential component of primary health care, not a secondary development issue.

The road ahead

The WHO report should be a wake-up call. Without stronger political commitment, better coordination, and sustained investment, global nutrition goals will remain out of reach.

Malnutrition may be described as a “silent epidemic,” but its consequences are anything but silent. They shape the health, survival, and potential of millions of women and children.

According to the experts, reversing the current trend will require protecting nutrition funding, strengthening primary healthcare, supporting fragile and conflict-affected regions, regulating harmful marketing practices, and building resilient and equitable food systems.

In a nutshell, nutrition is not optional — it’s foundational. And the time to act is now.

Your responses and feedback are welcome!

Source: “Maternal and Child Nutrition Backslides: WHO Report Reveals,” Health Policy Watch, 2/6/26
Source: “Maternal, infant and young child nutrition,” WHO, 12/9/25
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As the Twig Is Bent

Pat Hartman February 12, 2026 No Comments

In childhood obesity, mental and emotional health issues play a very large role because of the inherently reciprocal nature of the relationship. Often, those very same mental and emotional health issues can be partly of physical origin. We occupy flesh and blood bodies that produce vital signs, so it could hardly be otherwise.

There are all sorts of possibilities. If a problem originates and is situated in a physical location on the body, it might grow another side and manifest more seriously in the mind. Or, something going on in the mind could show up as a physical result, like obesity.

There are people who consciously choose physical habits that aren’t “good for them,” knowing full well that whatever the consequences may be, they are not as frightening as the potentially alternative conditions like nightmares, a tendency to weep spontaneously, or a socially embarrassing tic. Compared to a lot of potentially miserable situations, getting fat is not a steep price to pay for sanity.

Depending on current circumstances, a person might be very grateful to have two possibilities. Sometimes, choosing the lesser of two evils is the only way out. Remember the impossibly trite but infinitely wise saying “It is what it is”?

It is what it is

One way or another, thinking about these matters too much can be inconvenient, or even dangerous. A mental/emotional roadblock can exist, then morph into a different class of problem… like one with a physical result… like obesity.

It is unfortunate, but even someone whose head is in pretty good shape can self-sabotage by just habitually, unthinkingly eating too much unconsidered food. Then, the resulting obesity can adversely affect that person’s mental and/or emotional health. Then, the resulting stress can lead this individual to eat more… and so on, back and forth… for 50, 60, or 70 years.

Something different

The National University of Singapore recently presented the public art exhibition titled VOICE, short for “Visualising Obesity’s Impact from Childhood Experiences.” Created by researchers, artists, and college students, the event’s basic idea originated with research from highly respected institutions. The show attracted a great deal of favorable attention, and not just in academic circles. The impetus behind it was research that examined…

[…] how childhood obesity is experienced as a complex social and psychological phenomenon, and shaped by family dynamics, school environments and broader societal norms.

Not surprisingly, this ambitious goal turned out to be a tall order. It has never been easy to overcome the twisted societal expectations that impose a burden on any class of people. Such deep-seated prejudices have dimensions and aspects that are easily and often overlooked when they become a seamlessly integrated feature of the culture.

The creators told the press that the informal format “allows audiences to engage with these stories at their own pace, creating space for reflection, empathy and deeper understanding.” Interactive exhibits included one that offered the visitor an opportunity to write down a slur that might be used against an overweight person, and display it on a wire sculpture:

[T]he exhibition presents an immersive collection of photographs, 3D-printed artifacts and personal narratives. Together, these works invite reflection on how everyday language, social attitudes and intervention approaches around weight can leave lasting impressions on children as they grow up.

In other words, to bend the twig will influence the shape of the tree, just as it always has done and will continue to do.

Other layers

One aim of the free-admission art show was “to open up conversations beyond physical health.” Another was to guide viewers toward looking “beyond physical health outcomes to consider how early experiences can shape wellbeing into adulthood.”

Many participants recounted how seemingly casual remarks about weight, repeated pressure to lose weight without guidance, or public scrutiny of their bodies contributed to feelings of shame, isolation, and low self-worth. They disliked the sensation of being labeled, observed as if they were lab animals, or otherwise stigmatized.

For some reason, Singapore is perceived as a particularly dicey part of the world for obese people to live in. Dr. Jumana Hashim told the press,

While ample research has been done to uncover the risk to physical health, there is a gap in the understanding of how living with obesity can impact mental health…

This is why we dive in to understand the people, places and processes that shape these experiences so that we can inform future weight management interventions, ensuring we don’t perpetuate the risk of any unintended mental health consequences.

Attendees were invited to consider and create art about such aspects as the labels that society is all too eager to bestow upon its overweight members. Among outcomes and results that are to be hoped for and worked toward are “positive, empathetic communication by parents, teachers and others, and to avoid language and practices that reinforce stigma or shame.”

Prof. Leonard Lee noted “the importance of empathy-focused, multi-level interventions that involve families, educators and healthcare practitioners, rather than placing responsibility solely on children.” Prof. Lee also emphasized that weight management efforts need to be presented “in ways that are sensitive to children’s mental and emotional wellbeing.”

Meanwhile, afflicted humans will continue to cultivate mental and emotional resilience, formulate coping strategies, and find sources of support.

Your responses and feedback are welcome!

Source: “Shining the spotlight on the hidden mental health impact of childhood obesity,” ews.nus.edu.sg, 01/30/26
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Numerous Plus Frequent Equals Fitness

Pat Hartman February 10, 2026 No Comments

In far too many cases, weight management within the family is a tricky proposition. An existing problem might be so troublesome that just one more aggravation could be disastrous. For instance, if either the mother or father is a step-parent, psychological issues might be messing things up already — to the point where sensitivity about a child’s weight problem could only make matters worse. Even if both are the natural parents, one of them might take an unsympathetic attitude like, “Nobody in my family is fat. That comes from your side, so you deal with it.”

About a decade ago, the Journal of Nutrition Education and Behavior published a study of the program (based on Social Cognitive Theory) known as Fit Families, focused on self-perception among the child participants. The entire family-based program was delivered over seven weeks, with each session lasting nearly three hours, and it wasn’t just talk.

Sessions began with a meal as an incentive for attendance, to make attendance more manageable for busy families, and served as examples of nutritious, quick meal plans that families could replicate at home.

Following this, a registered dietician delivered nutritional information; another pro suggested and demonstrated physical activities; and a counselor talked about positive attitudes. The study’s lead author, Martha Archuleta (Ph.D., RD), wrote, “Goal-setting was stressed during the sessions and each topic included a hands-on activity and discussion.”

The key word is fitness

A different program with the same Fit Families name (which is, after all, a rather obvious choice) was begun in conjunction with the federal Supplemental Nutrition Assistance Program (SNAP) and WIC. Participating families are encouraged to follow three basic precepts: move more, make every bite count, and make every sip count.

“Move more” also encompasses the goal of watching less — in other words, of cutting down screen time, especially the passive kind. Ideally, the aim is to accomplish at least an hour of physical activity each day, while limiting TV, gaming, and other screen-oriented activities to two hours per day or less. Other goals include the consumption of more fruits and vegetables. Sugar-based beverages are definitely discouraged, while straight water, and lots of it, is strongly recommended.

This particular program is aimed at children from two to four years of age, which makes excellent sense because when they are so young, they absorb behavioral suggestions like little sponges. Of course, this tendency can be problematic, because they also regard every single thing they see their parents do as not only suggested, but mandatory.

The magic words — numerous and frequent

Some truths we just intuitively grasp, because real-life evidence makes them so obvious. Hold your hand over a fire, and barring an extremely rare and improbable circumstance, you will soon be inspired to pull it away. Duh! But science does not operate on that principle, and neither does government funding. In most cases, “It’s just common sense” is not a viable case.

For an idea to earn credibility and funding, generally the first requirement is a demonstrable fact: proven by experienced scientific experts, documented by qualified scholars, and verified by additional competent authorities.

This will hardly come as a surprise, but if the goal is obesity prevention in children (or weight loss among the already obese), efforts toward change work better if they are numerous and frequent. Consequently, a few years back, a study was performed to prove that “Interventions implemented at a greater frequency and number were associated with improved weight loss compared to less frequent sessions.”

A high-intensity program works better than the other kind, and works best if administered in a strict academic setting. That stubborn fact provides plenty of opportunity for graduate students to prove their worth, because they are expected to figure out how to turn aspiration and intention into accomplishment.

In the world, what works for everybody, all the time? Almost nothing. Even the dreaded dengue fever fails to consistently overcome its targets. It kills at least 20,000 victims every year, but at the same time, a lot of people who catch it don’t really catch it, in the sense that they fail to develop any symptoms. When even such a horrible disease “can’t win ’em all,” surely no anti-obesity program can be expected to produce guaranteed results.

Your responses and feedback are welcome!

Source: “Family-based weight management program improved self-perception among obese children,” ScienceDaily.com, 06/06/16
Source: “High intensity specialized intervention content following family-based intervention yields improved,” 2MinuteMedicine.com, 11/07/17
Image by geralt/Pixabay

Overweight Awareness Monitors at Home

Pat Hartman February 5, 2026 1 Comment

Gender roles are still very much in place, and if Mother does most of the shopping and cooking, she controls what appears on the dinner table. Or maybe Dad cooks, and Mom does the monthly weigh-in or waist measurement. A recent post pointed out how beneficial it would be if all parents in the dicey situation of being expected to keep an eye on a child’s weight were able to do that effectively.

Related posts have been picking away at the challenge of how to encourage parents to engage without arousing new instances of counterproductive behavior patterns that have already done incalculable damage.

Revolutions do happen

Several decades back, Parent Effectiveness Training (P.E.T.) began a long reign of ascendency among the child-rearing demographic in general. Grown-ups found Dr. Thomas Gordon’s advice easy to take on board, and children responded to the techniques. (As a bonus, parents found that the same precepts could often be adapted to the sometimes brutal and stifling adult world.)

P.E.T. revealed itself as being pretty close to a one-size-fits-all program. In the obesity prevention realm, what seems to be needed is a similarly effective method of dealing with the potentiality of a child developing a weight problem — without increasing the likelihood that the child will develop a weight problem.

Home, sweet what?

Where do weight problems come from? One clue is revealed by an article titled, “Children whose parents lack warmth more likely to grow up obese, study finds.” The Avon Longitudinal Study of Parents and Children has proven very useful over the years to the numerous researchers who have mined it for all sorts of raw data and suggestive conclusions. Some of the matters it looked into included…

[…] the association between parenting style during early childhood and a child’s weight later in childhood and in early adolescence, late adolescence and early adulthood.

Conscientious self-reporting by the adults originally involved helped sort them into four categories, according to parenting style:

1. authoritative (maintain clear boundaries but are also warm)
2. authoritarian (maintain strict discipline and show little warmth)
3. permissive (empathic but have few rules)
4. neglectful or uninvolved (emotionally uninvolved and have few rules)

The offspring of 2 and 4, authoritarian and neglectful, were…

[…] more likely to have a higher weight than those who experienced authoritative parenting. The results for permissive parenting were not statistically significant.

Researcher Alexa Segal told a journalist, “Authoritarian mothers are characterized by being demanding and controlling, while having low warmth and responsiveness,” said Segal. This style sounds familiar to the fans of comedian Marc Maron, as we have seen.

Prof. Louise Baur of the World Obesity Federation has pointed out the difficulty of raising healthy kids in the modern world. On the other hand,

This study highlights the fundamental importance of parents in raising healthy children.
Parents who are able to set appropriate limits for their child, while bringing warmth and sensitivity to the relationship, may be better able to help their child be as healthy as possible.

But then… There is always the risk that parental participation, or even just a reasonable level of concern, could backfire and be perceived as fat-shaming. When emotions are raw, almost anything that another person says or does is susceptible to interpretation as hostile. Despite a helpful website that offers an entire series of articles about obesity prevention, sometimes the chemistry simply isn’t right.

Perhaps the best answer is, hook the kid up with Brainweighve, then stand back and hope they figure it out.

Your responses and feedback are welcome!

Source: “Parent Effectiveness Training,” GordonTraining.com, undated
Source: “Children whose parents lack warmth more likely to grow up obese, study finds,”
TheGuardian.com, 10/18/22
Image by trthiet182/Pixabay

WHO’s New Global Guideline for Healthier School Meals

Tatyana Meshcheryakova February 4, 2026 No Comments

Children spend a large portion of their day at school — learning, eating, growing, and forming lifelong habits. That’s why what they eat in school isn’t just fuel for the day; it’s an investment in future health. The World Health Organization (WHO) recently released a landmark global guideline recommending evidence-based policies to create healthier school food environments, with the goal of shaping healthier generations who thrive both physically and academically.

As we’ve written over and over, across the world, children are facing a “double burden” of malnutrition: rising rates of overweight and obesity, alongside persistent undernutrition. In 2025, an estimated 188 million school-aged children and adolescents — about 1 in 10 — were living with obesity, a figure that now surpasses the number of children who are underweight globally. These trends have long-term implications, increasing the risk of chronic diseases like diabetes and heart disease later in life.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasizes the stakes:

The food children eat at school, and the environments that shape what they eat, can have a profound impact on their learning, and lifelong consequences for their health and well-being.

Healthy eating habits begin early — and schools are uniquely positioned to foster them. With an estimated 466 million children receiving school meals globally, schools influence not just nutrition intake but also social norms around food. Yet, until now, there has been limited global guidance on how to ensure these meals truly support healthy diets.

WHO’s whole-school approach

For the first time, the WHO is urging countries to adopt a whole-school approach, ensuring that all foods and beverages provided in schools and available throughout the broader school food environment are nutritious and support healthy dietary habits.

The new guideline highlights actionable recommendations:

Establish Healthy Food Standards (Strong Recommendation). Schools should set standards or rules that increase the availability, purchase, and consumption of healthy foods and beverages, such as fruits, vegetables, whole grains, and water. Unhealthy options high in sugar, salt, and unhealthy fats would be limited.

Use “Nudging” Strategies (Conditional Recommendation). Encourage healthier choices through subtle changes like adjusting the placement and presentation of foods (e.g., putting fruit at eye level) and changing pricing to make healthier options more attractive. These recommendations tap into behavior science to make the healthy choice the easy choice.

Policy is only the first step

Guidelines and standards are essential, but policies must be backed by effective monitoring and enforcement. According to the WHO Global database on the Implementation of Food and Nutrition Action (GIFNA), as of October 2025, 104 member states had policies on healthy school food, and nearly three-quarters included mandatory criteria on school food composition. Only 48 countries had policies restricting the marketing of foods high in sugar, salt, or unhealthy fats.

To develop this guideline, the WHO brought together international experts from diverse disciplines through a transparent, evidence-based process. It now serves as a cornerstone for WHO’s broader initiatives, including efforts to stop the global rise in obesity and promote nutrition-friendly schools. The guideline is designed to be flexible: useful for national ministries of health and education, as well as subnational and city authorities responsible for school food programs.

According to the WHO, it is committed to helping countries translate these recommendations into real change. This includes technical assistance, knowledge-sharing, and collaborations with governments and partners.

To mark the launch, the WHO hosted a global webinar last January, bringing together stakeholders to discuss how to put the guideline into action (you can watch the recording here).

Your responses and feedback are welcome!

Source: “WHO urges schools worldwide to promote healthy eating for children,” WHO.com, 1/27/26
Source: “From lunch tray to lifelong health: WHO sets global standards for school meals,” UN.org, 1/27/26
Image by Antoni Shkraba Studio/Pexels

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How Europe takes a different approach

The crux of the matter

Oh, those prices

The human condition

But… and it’s a big butt…

The logical answer

Groping for clarity

A shift away from refined carbohydrates

A “mixed bag” of recommendations

What about gut health?

Which industries stand to benefit?

Impact on schools

A new era for plant-based options in schools?

Anemia in women is a reversing trend

The double burden of malnutrition

Childhood overweight is rising

A crisis of inequality

The formula marketing controversy

Micronutrient supplementation

Shrinking aid in a growing crisis

The road ahead

It is what it is

Something different

Other layers

The key word is fitness

The magic words — numerous and frequent

Revolutions do happen

Home, sweet what?

WHO’s whole-school approach

Policy is only the first step

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations