Coronavirus Chronicles — The Perfect Is the Enemy of the Good

For The New York Times, Perri Klass, M.D., wrote about the current state of tension that exists around the new coronavirus and childhood obesity. As pediatrician Dr. Sandy Hassink says,

Obesity itself as a disease presents a risk for more severe Covid infection. If I substituted the word asthma for obesity, people would not be blaming people for having asthma, they would be saying, let’s make sure your environment doesn’t have allergens, let’s make sure you get the right meds, the right medical care, but not blaming the child.

Dr. Hassink, a childhood obesity expert, is affiliated with the American Academy of Pediatrics and the Institute for Healthy Childhood Weight. When it comes to weight issues, Dr. Michelle White, who teaches pediatrics at Duke University, emphasizes that family may be as important as either diet or exercise. She says,

Some families reporting significant impact by Covid-19 are still able to demonstrate resilience to stress and behaviors such as physical activity and healthy diet. I think we have a lot to learn from these families.

The opposite is also true. Dr. Mary Jo Messito, of the N.Y.U. School of Medicine and the venerable Bellevue Hospital, speaks of families who, because of the COVID-19 danger, can only dream of healthy exercise. In New York City, there is widespread food insecurity and stress by the ton. She describes patients as being unable to meet their goals because of unaddressed mental health needs, and frankly says, “My patients are suffering terribly.”

Dr. Elsie Taveras, pediatrician, and professor of nutrition aligned with two prestigious institutions, is adamant about the importance of realizing how much the pandemic increases the risks already inherent in obesity. She sees the need to call upon the resources of mental and behavioral health experts, and transcend “surface counseling”:

If a patient with obesity comes in for a visit and I also know the family is living in a motel or they’re food insecure, I need to adapt my plan to circumstances rather than say, “increase fruits and vegetables.”

Over at the Duke Center for Childhood Obesity Research, families tell Dr. Eliana Perrin and her colleagues what works, and they in turn pass suggestions along to other families. Always, getting enough sleep is recommended, along with as much physical activity as possible within limited circumstances.

For a lot of parents, at present, the whole “limit screen time” ambition is pretty much a losing battle. In many places, kids are expected to learn and do schoolwork remotely, which involves plenty of sitting in front of a screen. And in the winter, with everything closed and a pandemic raging outside, what else is there, realistically, for them to do but entertain themselves with games or movies?

A parent can try to broker a deal, like five minutes of walking briskly around the room in return for each hour of screen time. (Good luck with that.) Encouraging movement is important, and it seems as if doing a little bit every day is one key to providing an atmosphere of continuity and stability. Parents are asked to not blame themselves for less than a complete success.

They are encouraged to look for any opportunity to congratulate kids for good decisions and healthy behaviors and are reminded to always look after mind, body, heart, and spirit. Dr. Perrin says,

Forget what “needs” to get done for physical activity goals and “perfect” meal goals. As always, try to focus on behaviors, not weight.

“The perfect is the enemy of the good” means, among other things, that striving for impossible perfection can discourage parents into such a negative frame of mind that they quit trying altogether. Sometimes we need to accept “good” as the best we can do under the circumstances, and let good be good enough.

Your responses and feedback are welcome!

Source: “There’s No Easy Fix for Children’s Weight Gain,”, 01/25/21
Image by Pat Hartman

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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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