Childhood Obesity — Causation and Change

father and son on beach

Childhood Obesity News looked at management consultant Steve Tobak’s advice for high-powered executives, and noticed that wisdom about change applies across the spectrum of humanity, affecting even obese children.

In a piece titled “Change Your Ways? 3 Things You Must Do First,” Tobak laid down condition #1: “You have to feel the need to change.” For anybody in the helping business, that fundamental truth is the most frustrating thing about the job. As institutions of every kind (including residential treatment centers for addicts) have demonstrated, people can be made to change overtly and temporarily. And sometimes it sticks! When it does, it’s because the person felt the need for change. Without that felt need, long-term change doesn’t happen.

Tobak’s second condition is “You have to have courage to face your fear.” In that necessity, several potential problems are inherent. The person must acknowledge that fear exists. Generally, people who are trying to be strong, or at least to appear strong, don’t go around admitting to fear. Other than a few outstandingly healthy exceptions, most people are incapable of either identifying or admitting fear, even to themselves.

Tobak relates a story about a CEO who lost out big-time in the business world because he let his fear get in the way. The author also mentions a characteristic of people who don’t have the courage to face their fear — a tendency to blame external factors. This is one of the basic problems with the philosophy behind trying to end the childhood obesity epidemic.

If the truth is “You can fix yourself,” on a deep level that reads as blame, and the natural reaction against blame is to defend and resist. On the other hand, if the truth is “You can’t fix yourself,” everybody might as well just go home and forget about it.

Only you

A more nuanced guideline is “Only you can fix yourself,” which takes us back to #1. While other people might feel a need for you to change, they can’t make it happen in any real and permanent sense. Your need for change can only effectively be felt by you. Nobody can take your place. Don’t beam out the Bat signal, because even Batman can’t help. You are the unique superhero with the power to save someone — that someone being you. Only you can rescue yourself. You are the only person in the universe who has the power to do that.

And you can’t do it unless you face your fear, and you can’t face your fear unless you identify it. Not many grownups are capable of doing that, and when it gets down to the kid level, how many children have the self-awareness to see what’s going on? Sure, a kid knows, “I’m afraid Daddy will go away,” and is certainly able to articulate the thought. But it isn’t the actual feared outcome, only a circumstance that could bring it on. A lot of different causes could be underneath. One possibility is, “If Daddy goes away, there won’t be any money and we won’t have enough to eat.” With such an underlying premise, a kid could develop an unconscious drive to stockpile body mass, to protect against the caloric deprivation caused by paternal desertion.

Another possibility is “If Daddy goes away, Mama might fall apart and be all clingy, and dump her emotional baggage on me, and expect me to fill the emotional void left by her spouse’s absence. For goodness sake, I’m only eight years old.” Is any child capable of either knowing or saying that? Let’s hypothesize further. What if an eight-year-old boy is getting fat, unconsciously but on purpose, to make himself repellent to his mother? Can he admit that he’s trying to dislodge an emotional vampire from feeding on him?

Questions like this seem to indicate that it is vital to get to the root cause of childhood obesity in each individual case.

Your responses and feedback are welcome!

Source: “Change Your Ways? 3 Things You Must Do First,”, 12/04/12
Image by Macgyver101

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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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