Reflections on Dr. Pretlow’s Webinar

Seafair Indian Days

This new webinar is called “The Epidemic of Childhood Obesity: What’s Our Plan?” and although Dr. Pretlow designed it for health care professionals, it’s probably safe to say that most parents feel they are included in that group — they have certainly put in the time!

The webinar covers two major questions. How do we spot childhood obesity, and then, what do we do about it? The purported causes of the obesity epidemic are examined, and treatment options are discussed. Since the obesity epidemic is so interrelated with public financing and public institutions, there are always policy considerations. What might we expect the government to do?

In the “causes” department, Dr. Pretlow talks about the food-rich environment. If it’s around, people will eat it. At first, this seems like an obvious, “no-brainer” explanation. But does not see it as enough of a reason.

Yes, the presence of a lot of food is a necessary condition to overeating, because before any person or group of people can overeat, food has to be there. But it’s not what the old-school philosophers would call a sufficient condition. The presence of massive amounts of hyperpalatable food is not, in itself, a guarantee that a person will make bad nutritional choices, or eat too much. This is demonstrated by the fact that plenty of people don’t make bad choices, or overeat, despite the abundance of available food.

Too expensive?

There is a popular belief that healthful food is expensive and boutiquey, and too costly for the ordinary working person to afford. But what about the Native American communities where casinos have brought in unprecedented wealth, but not much improvement in good nutritional choices? The popularity of “fry bread” is undiminished, as Dr. Pretlow can attest from many shared meals near his home base of Seattle.

Despite their ability to shop for whatever they choose, humans have a tendency to stick with dishes that have traditional ethnic and cultural significance. And sometimes, with crummy junk food diets.

Aside from the wealthy and unenlightened, another group draws criticism for preferring junk food and fast food — the very poor. Cooking from scratch is something not everyone can do. It takes a working stove and refrigerator, a paid-up electric bill, some equipment, a minimal store of condiments, and so on. Without a freezer, even a responsible adult inclined to shop at the farmers’ market can’t preserve organic fruits and vegetables beyond season.

A homeless person might seem to have the ideal opportunity to go with an all-raw vegan diet and become spectacularly healthy. But for someone living in the streets, it’s difficult enough to even find clean drinking water, much less water for fancy stuff like washing veggies. To carry around a knife for peeling apples and carrots could lead to a jail sentence.

People who are homeless, or signed up for various food assistance programs, don’t have much choice about what they eat. The shelter or soup kitchen serves what it serves. Donations to food pantries must necessarily be non-perishable foods, meaning they are filled with preservatives and pretty much drained of nutritional value.

People face all kinds of problems and obstacles that can’t really be understood by others who have not participated in the same lifestyle. Unavoidably, there is a certain amount of truth in the “good food is too expensive” argument. But it’s certainly not enough to explain the entire obesity epidemic.

And neither is the “food desert” theory, which posits that in some geographical areas and urban neighborhoods, people are both undernourished and obese because good food is not available. Yes, it is true that there are such places. That unfortunate fact is contributory to the obesity epidemic. But as a major causative factor, it doesn’t hold up. Dr. Pretlow says:

The kids that I have contact with say ‘No.’ They say where they are, there is some healthy food available, but nobody wants to buy it. So it appears that the residents of those communities just don’t want to buy healthy food, for whatever reason.

Your responses and feedback are welcome!

Source: “What’s Really Behind the Childhood Obesity Epidemic?,”
Image by Joe Mabel.

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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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