Hot Hydration

drinking water
Sticking with the summer theme, let’s talk about water. Not to be climate chauvinists, but in this country it’s now summer pretty much everywhere, and imbibing sufficient water is a high priority, or should be.

A brand new, hot-off-the-presses study from the University of Michigan’s Department of Family Medicine reconfirms the importance of water in pushing back against obesity. For, Marcia Frellick writes:

Researchers have found a significant association between inadequate hydration and both elevated body mass index (BMI) and obesity, even after controlling for confounders…

If obese people are not hydrating properly or are eating when they think they are hungry, but are actually thirsty, education may help differentiate the cues…

People with higher BMIs need a lot of water, because the body’s need for hydration is connected to weight, surface area, and metabolic rate. This report includes the shocking news that weight management guidelines handed out by primary care physicians are usually silent on the subject of adequate hydration.

Dr. Pretlow’s book, Overweight: What Kids Say, contains samples of how kids support each other with advice and empathy. A lot of the young folks who successfully battle obesity mention the importance of drinking plenty of water. On the crudest, most obvious level, it can create the illusion of a full stomach. Some of the kids even recommend drinking only water — which is good advice for everyone of any age.

Water weight

The search for health often provokes perplexing questions about seemingly contradictory principles. Over and over, we hear about the importance of hydration. On the other hand, we have also heard of “water weight” — and we dread it.

A person might retain 20 (or more) pounds of unnecessary water. Fitness expert Mark Sisson explains that carbohydrate is stored in the body as glycogen, and along with every gram of stored glycogen, the body stores three or four grams of water — both in and amongst cells.

A low-carbohydrate diet may produce immediate weight loss, but it will be the water saying goodbye. Sisson says:

[…] Often within just a week of decreasing grains and other simple carbs and sugars, as well as cutting omega 6s and the huge amounts of sodium found in the Standard American Diet, the body no longer needs to hoard all this water. Understand that this was water you never really needed in the first place; it was just there because agents in the diet sent signals to different systems to hold onto it.

In one post, we named water as an obesity villain — but that is only a figure of speech. Sometimes water is polluted with toxins — but that isn’t the water’s fault. Generally, some agency, corporation, or individual is responsible. When the lack of decent drinking water drives people to make do with sugar-sweetened beverages, that isn’t the water’s fault, either.

Even where the tap water is undrinkable, most people have the choice of buying water instead of SSBs. Americans are fortunate to live, by and large, in places where drinking water is available for free. Many people all over the world don’t even have the luxury of asking these questions or entering the debate; or any hope of influencing their governments to step up and make things better.

Indirect influence on obesity

Inadequate hydration can affect mental and emotional health, including attention and memory. It can also cause headaches, unpleasant mood states, and impaired kidney function. All these things make a person feel lousy. What happens to some people when they feel physically, mentally, or emotionally bad? They try to eat the world.

Your responses and feedback are welcome!

Source: “Poor Hydration May Contribute to Obesity, Study Suggests,”, 07/12/16
Source: “Dear Mark: Rapid Weight Loss,”, 08/24/15
Photo credit: Darwin Bell via VisualHunt/CC BY

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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.

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