Choose What You Chew


The title “Choose What You Chew” is swiped from one of the sayings of Dr. David Katz, because it is such an apt rule for just about anybody, any time, anywhere. Childhood Obesity News praised the engaging music video, “Unjunk Yourself” and agreed that healthful eating and physical activity are both fine things, as far as they go. But they don’t go far enough, unless an awareness of the reality of food addiction is included.

Sometimes an idea sounds good on paper, but even the most well-conceived program can run aground on the rocky shores of logistics. Dr. Pretlow has mentioned the drawbacks of exercise for children who are already obese. Being heavy makes moving around more difficult in every way. Overweight can equal clumsiness, and a child who is not nimble is more easily injured. Last year the American College of Emergency Physicians and many others mentioned a study showing that obese children tend to break their arms:

A retrospective study of Washington, D.C.-area children and adolescents who were treated for an isolated forearm fracture in the emergency department of Children’s Hospital National Medical Center showed that kids with a forearm fracture resulting from a standing-height fall were 2.4 times as likely to be at or above the 95th percentile for weight for age and sex than were kids whose forearm fracture resulted from major trauma

Chafed thighs may sound like a comical problem, but it’s still a painful one. The discomfort of vigorous exercise, the shortness of breath, the knowledge that your fat is jiggling up and down and every which way, to the amusement of your peers — none of this is any incentive toward exercise.

There is always an element of social embarrassment involved. Any exercise that burns significant calories will involve sweat. If the exercise includes an opportunity to change into gym clothes and then shower and change back to street clothes later, there are some massive opportunities for humiliation. Or, a kid could stay in the same clothes and go around smelling sweaty all day.” Tubby” is bad enough; who wants to be called “Stinky” too?

Dr. Pretlow is not opposed to exercise, only to the notion that it’s a panacea. For instance, a change in physical dimensions may happen too slowly to give a child a sense of progress or reward. This is an emotionally traumatic event, the kind of drawback that can lead to what Dr. Pretlow describes:

Discouraged kids may comfort-eat more and seek help less, a vicious cycle.

In other words, sometimes there are unintended consequences. As the old saying goes, “The road to hell is paved with good intentions.” But, the world being a complicated place, sometimes good intentions actually get good results. Dr. Pretlow says,

Parts of current programs may serendipitously help food addiction. For example, fun physical activities relieve stress and depression, the underlying causes of food addiction, although striving to eat 5 servings of fruits and vegetables or walk 10,000 steps a day may not… Fun activities with other kids should be provided after school and on weekends in order to combat social isolation, a main factor. The inability of many heavy kids to participate in sports should be accommodated with activities such as hobbies, non-strenuous games, learning to play musical instruments, etc.

Still, the current focus on diet and exercise alone, does give rise to some reservations. If kids are shown a good example and set on a good path young enough, they may be so nutritionally aware and so activity-prone, they will never face the risk of becoming hooked on guilefully engineered “addictafoods.” Unfortunately, for many others, it’s much too late. Once a person’s brain gets pathologically involved with dangerous pseudo-foods, it takes a lot more effort to detach.

As always, there are miscellaneous reasons why a child can’t get a healthy amount of exercise — crowded and dangerous living conditions, bad neighborhoods, a family budget that doesn’t allow for sports equipment or uniforms. It just goes to show that multiple solutions need to be applied.

Your responses and feedback are welcome!

Source: “Pediatric Obesity Epidemic Means More Forearm Fractures,”, 05/11
Source: “Food Addiction and Childhood Obesity: Now What Do We Do?,”, 04/28/11
Image by sanchom (Sancho McCann), used under its Creative Commons license.


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Profiles: Kids Struggling with Weight

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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.

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