The Quality of Life Conundrum

The Grim ReaperOnce they have become obese, children may experience a diminished quality of life for many reasons, some of which are more obvious than others. A lot of things in the material world are too small for their comfort — clothes, school desks, airplane seats, and restaurant booths, to name a few. They tend to be teased or bullied. Relatives are always bugging them to turn off the video game and go run around the block. A large number of quality-of-life issues arise as a consequence of carrying extra weight.

But there is another dimension to quality of life. Namely, what degree of quality existed in the life they had prior to gaining weight? Because that life contained the seeds of whatever psychological and emotional challenges sent them off the rails seeking happiness through food consumption.

When the patient is a child, his or her unhappiness is inextricably linked to the relationship with one or both parents, or the relationship between the parents, or to the lack of any parental attachment. The biggest predictors of any child’s quality of life are the parents or caregivers. When something is wrong at home, the child usually is not the problem, but is instead a living, breathing symptom of a dysfunctional family.

Back to Square One

Every type of intervention or treatment for childhood obesity takes for granted that the parents will be happy to have somebody straighten them out, and grateful for the guidance. In practice, things don’t always go smoothly, because some parents resent what they see as interference. When shown the need to help a child struggling with obesity, parents might be relieved and eager to respond. Or they might be totally indifferent or even actively hostile.

A child might be awarded a scholarship to the best residential rehab facility or most innovative camp, and make wonderful progress. The trouble is, this child cannot go forth into the world and start a new life. Because of her or his status as a minor and a dependent, this child will be returned to the exact same environment where the problem originated, under the care of the same responsible adults.

Heavy on Denial

The thought-provoking story of Hector Garcia included a quotation from his mother:

He himself told me, “Mom, you do know that that I’m gonna die of COPD.”
I said, “Don’t talk like that Hector.” I hated to hear him talk about that.

At the time, Garcia weighed over 600 pounds and could barely move. His mother presented him with a birthday cake topped with a single candle and said:

We’re not counting any more, right? No, we won’t count no more.

Avoiding talk of death staves off mortality, and by not counting the years, the Grim Reaper can be vanquished. The strategy didn’t work, of course. But although steeped in denial, Elena Garcia’s remark turned out to be strangely prophetic. What the news camera recorded was the 49-year-old’s final birthday. The story included another quotation, this one from Hector himself:

A lot of the times we’re like this not because we want to be, but because certain circumstances in our life have set the table in a certain way. This is a path that we’ve almost been forced to follow, and we don’t know how to get out of that path.

Those words are disturbingly reminiscent of something Dr. Pretlow wrote:

Several youth in our studies reported that they have been overweight so long that they are accustomed to it. They are fatalistic that they will always be that way and don’t know how to change.

Your responses and feedback are welcome!

Source: “A Life Apart: The Toll of Obesity,”, 12/27/14
Image by Maxwell Hamilton

Leave a Reply

Your email address will not be published.

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

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.

Food & Health Resources