Everything You Know Is Still Wrong, Part 2

Kids playing in San Clemente State Beach

Yesterday, Childhood Obesity News mentioned the discouraging words heard from the C.S. Mott Children’s Hospital. A study originating there showed that, of parents whose kids went to a school with an obesity intervention program, 30% of those parents were nervous. They thought their children showed signs of developing an eating disorder, and feared that the program was somehow responsible.

“Obesity intervention program” is a pretty general term. It could mean anything from weighing and measuring the kids to an innovative garden-based nutrition curriculum to a new locker room. There are many kinds of intervention and it seems unfair to tar them all with the same brush.

And anyway, isn’t exercise supposed to be good, and to prevent obesity? The belief is widespread, and the argument has many nuances. For example, it may or may not be directly provable to everyone’s satisfaction that gym class, participation in sports, biking to school, etc., are directly responsible for a decrease in obesity. But that does not mean there are no benefits.

Indeed, the indirect benefits that seem minor or secondary could add up to an enormous amount of obesity prevention. How? By providing the opportunity to develop personality, character, discipline, coping skills, and all kinds of other splendid positive attributes. And, as we know, a happy child with a healthy amount of self-esteem and some degree of the childhood equivalent of “success” is much less likely to become a food addict, or any other kind of addict.

Under the auspices of Peninsula College in Great Britain, statistician Brad Metcalf, head of the department of endocrinology and metabolism, did a meta-study whose sources included 30 reports from other researchers in several countries. The data concerned 14,000 children, but there is controversy about the scope and significance of the research consulted and the methods of interpreting it. Journalist Kalen Smith writes:

Previous researchers relied on formal interviews to gauge children’s level of physical activity. Metcalf said those studies were not very reliable. His team focused their study on children who wore motion sensors, which he felt would yield more accurate data… Exercise programs don’t help children become active enough to reduce their body mass indexes.

But what about the study published in the August 2012 issue of Pediatrics? Joining a sports team and sticking with it is the recipe for a healthy body weight, according to the Dartmouth University research team led by Keith Drake. Their conclusion is that:

[…] teens who played on three or more teams in the past year were 27 less likely to be overweight and 39 percent less likely to be obese compared with their peers who did not play on any teams.

Yet, as Childhood Obesity News recently mentioned, Richard Louv has his reasons for saying:

It’s important to acknowledge that the greatest increase in child obesity in our history occurred during the same decades as the greatest increase in organized sports for children.

Leaving the area of physical activity for the realm of surgery, we find the puzzling statement:

Tonsillectomy leads to weight gain in children, but does not increase the likelihood of overweight or obesity, report researchers.

This changes some previously held ideas, and the seeming discrepancy has to do mainly with age. Sally Robertson picks out the relevant parts of what a team from the DuPont Hospital for Children found:

‘These data could suggest that younger children, who are more likely to undergo tonsillectomy for sleep-disordered breathing or dysphagia (possibly associated with growth failure), are gaining weight after surgery once the obstruction is relieved,’ comment the researchers.

On the other hand, ‘older children, who are more likely to undergo tonsillectomy for chronic tonsillitis and who are already at a higher BMI [percentile], have less change in weight.’

The team suggests that a prospective study could help elucidate these issues.

In the meantime, otolaryngologists should appreciate that postoperative weight gain does occur in children after tonsillectomy, although it is unlikely to cause an increased risk for obesity after surgery.

Your responses and feedback are welcome!

Source: “Exercise Programs May Not Be Effective for Fighting Childhood Obesity,” HiveHealthMedia.com, 10/01/12
Source: “An Antidote to Childhood Obesity?,” LifeGoesStrong.com, 07/16/12
Source: “Tonsillectomy does not lead to unhealthy weight in children,” News-Medical.net, 10/23/12
Image by jakesmome (Vicki Watkins).

2 Responses

  1. It is Interesting they brought up the tonsillectomy as a cause of gaining weight, My mother and I were both normal weight until each of us had our tonsils removed when we were about 5 years old which was followed by obesity. I’m thinking the weight gain could be caused by antibiotics messing with the gut flora rather than he surgery itself. My daughter first began gaining excess weight after she was treated for an abscess with strong antibiotics.

    1. And your contribution is interesting! Yes it certainly looks like antibiotics can be a mixed blessing. Thank you for writing to Childhood Obesity News.

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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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