A Clear and Present Danger

Kitten watching a police chase
Not long ago, the American Academy of Pediatrics (AAP) issued a policy statement titled “Children, Adolescents, Obesity, and the Media,” which addressed those subjects with the organization’s usual thoroughness. The Introduction begins,

Obesity represents a clear and present danger to the health of children and adolescents.

Can’t argue with that. Unfortunately, some of the other concepts leave room for doubt. In all fairness, the statement also says,

Considerable research has shown that the media contribute to the development of child and adolescent obesity, although the exact mechanism remains unclear.

“Unclear” is putting it mildly. The Abstract section briefly gives the possible reasons why TV, video games, etc., are presumed to exert a cause-and-effect relationship on childhood obesity:

Screen time may displace more active pursuits, advertising of junk food and fast food increases children’s requests for those particular foods and products, snacking increases while watching TV or movies, and late-night screen time may interfere with getting adequate amounts of sleep, which is a known risk factor for obesity.

TV and other screen-related activities count for something. In Overweight: What Kids Say, Dr. Pretlow writes,

Why do kids eat while watching TV? Could it be simply because there are so many food commercials? Or is it something else? Watching TV tends to be an escape from reality. Perhaps kids are periodically jolted back to their painful reality, while they’re absorbed with TV. Do they overeat to cope with these jolts back to reality? TV food commercials directed at children and teens may take advantage of kids’ vulnerability to comfort eating and stress eating while watching TV.

What can be done to prevent kids from overeating while watching TV? Engaging in other activities while watching TV, such as knitting, putting together a puzzle, or even walking on a treadmill, may help to relieve stress, maintain a connection with reality and avoid TV comfort eating and stress eating.

Video games are frequently incriminated as a contributor to childhood obesity. Playing video games may also be an escape from painful reality by kids, and similar to watching TV, kids are intermittently jolted back to their reality. Thus, comfort eating and stress eating while playing video games may be another reason kids overeat.

One of the Weigh2Rock polls confirms that nearly half the children and teens who responded eat while watching TV.

All the reasons for condemning TV are at least plausible, and efforts to change these conditions are worthy. However, the chances that advertising can be curbed to any significant extent range from nil to zero. Not everyone buys the sleep-deprivation theory. Snack limitation creates the forbidden-fruit syndrome. Chasing kids outside to play will not cure the childhood obesity epidemic. But none of it matters much, because all these things are sideshows.

The main event is the human tendency to succumb to addiction. The foods known as “hyperpalatable,” “hedonic,” “more-ish,” and so on, are in many cases deliberately engineered to be addictive. People do get hooked on them, and they need the same kind of help as people who get hooked on nicotine or methamphetamine.

The AAP statement also says,

It is increasingly clear that the media, particularly TV, play an important role in the etiology of obesity. As a result, many countries are now establishing new regulations for advertising to children on TV, and many government health agencies are now issuing recommendations for parents regarding the amount of time children spend watching TV. Unfortunately, there are currently no data relating other media to obesity.

No data, eh? In other words, chasing down all these fascinating leads could amount to nothing more than a lot of misdirected energy and wasted effort, as well as a waste of scarce financial resources.

Indeed, obesity does represent a clear and present danger to the health of children and adolescents. Everybody knows this, and almost everybody is putting a lot of energy into avenues of research that are fun for scientists to satisfy their curiosity about. Possibly, that energy would be better spent on focusing through what Dr. Pretlow calls “the psychological food dependency-addiction lens.”

The AAP policy statement winds up with five recommendations for pediatricians, all having to do with their young patients’ screen time, none mentioning the possibility of addiction. Their interest lies in investigating the precise mechanisms by which screen time might cause obesity. While it is all very interesting, they are quite possibly barking up the wrong tree. Maybe too much TV doesn’t cause obesity. Maybe obesity causes too much TV, and something else causes the obesity.

Your responses and feedback are welcome!

Source: “Children, Adolescents, Obesity, and the Media,” Pediatrics, 07/01/11
Image by eamoncurry123 (Eamon Curry), used under its Creative Commons license.

Leave a Reply

Your email address will not be published.

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources