The Weird World of Childhood Obesity

Some Big Drummers

Yesterday, Childhood Obesity News asked what it means that children’s clothes are getting more “wide” and “robust.” It seems bad enough that manufacturers are profiting from the obesity epidemic by selling plus-size pants, shirts, and dresses.

Even more objectionable is the idea of carving up the kids to fit into the clothes. In Great Britain, taxpayers are alarmed because the National Health Service (NHS) has been paying for teenage girls to have breast reduction surgery. Someone asked a question in Parliament, which is what the British do when they want to attract public attention to an abuse, injustice, or potential scandal. The Daily Mail reported that at least one hundred girls had undergone government-sponsored breast reduction, and then George Edwards looked into the issue and wrote about it for

A member of Parliament named Diane Abbott originally posed the question to the government body, so Edwards asked Abbott where her numbers came from, which turned out to be a chart from the NHS itself. The way the information is presented makes it difficult to interpret, but it seems that over a five-year period, somewhere between 108 and 160 girls, from age 14 to 16, and maybe even younger, have been operated on for this purpose.

At first glance, there seems to be a direct relationship between these surgeries and the childhood obesity epidemic. For one thing, obesity brings on puberty earlier. Since it is recommended that breast reduction surgery only be done after the transformation to adolescence is complete, this may only show that young ladies who formerly would have been eligible for this operation at 18 are now eligible much sooner.

But there is a twist in the story. The most obese girls won’t be having breast reduction surgery, because if their BMI is more than 30, the risk of surgical complications is greater, so doing this elective surgery is not medically sound practice and the National Health Service can refuse. The most qualified candidates are the moderately obese, with BMI under 30.

Children’s clothing manufacturers are not the only ones who will have to retool their factories. The makers of military uniforms are in for big changes, too. According to Jim Gourley, the accounting department does not include the cost of oversize chemical warfare suits and other uniform items when calculating the price of obesity in the armed forces.

Also, other costs apparently are not charged up to obesity, but ought to be. Gourley says:

The military still fails to grasp the true scale of the problem so long as comorbidities of overweight and obesity remain unexamined. There were more than 42,000 service members affected by hypertension and another 5,700 by diabetes in 2011. Hypertension alone ranks in the top thirty conditions affecting active duty service members… Adding in specific military job training, logistics, equipment and the cost of lost duty days brings the annual price tag of overweight service members to about $1.5 billion. That exceeds the military’s budget for Predator drones in 2010.

Of active duty military personnel today, many are overweight or obese, though reportedly not as many as a few years ago. One reason is that a lot of large people were “involuntarily separated” from the military. In 2008, for instance, 4,555 service members were thrown out for exceeding even the relaxed weight standards.

How do the branches stack up against each other? Gourley says:

Comparing the relative percentages of overweight/obese service members, the Navy is the fattest service at 62.7 percent, followed by the Army at 61 percent, the Air Force at 58.8 percent. The Marines register the fittest at 55.1 percent, still substantially more than half overweight. Closer examination shows that more than 12 percent of active duty service members in each service are obese. The Marines break the trend more significantly in this category with a 6.1 percent obesity rate.

Teenagers might let themselves slide into obesity for all sorts of reasons, one of which might be to avoid military service. But it won’t work. This is one of the great paradoxes of the military: Although there are a million regulations, a service member soon finds out that any rule can be negated by a piece of paper called a waiver. In one recent year, the Army wrote waivers for 1,500 recruits who were technically too fat, but who were accepted anyway.

For anyone who worries that there will not be a viable pool of youngsters to join up, the answer is simple. Waivers. So the threat of an empty military, Gourley says, is:

[…] not imminent, but existential… The preponderance of our young military members come from the most ponderous states.

Plenty of waivers will be needed. The writer also ascertained that in all the states where the most inductees come from, the childhood obesity rates are more than 15%. In three of those states, the childhood obesity rate is presently between 20% and 25%.

Your responses and feedback are welcome!

Source: “Are obese children getting breast reduction surgery?,”, 08/28/12
Source: “The Best Defense: Super-sizing the soldier: Is obesity going to pose a huge recruiting problem?,”, 10/09/12
Image by Tobyotter (Tony Alter).

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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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