Helpers Face Roadblocks

One last point needs to be made about the life experience of fitness icon John Stone. As we have seen, unhappiness can be fuel for the transformative fire. One day, climbing out of the shower, rather than ignoring the image in the mirror, he decided to apply some careful scrutiny. He hated what he saw, and got mad, and changed his life.

But taking a step backward, what caused him to make the decision to stop and look? Life had been a drag for quite some time, and Stone realized he was miserable. But… an adult. Children and teens are even less equipped than adults to get in touch with their feelings. Often they don’t have the references, the vocabulary, or the emotional freedom to open up.

A while back, Dr. Pretlow wrote in regard to his research while developing the W8Loss2Go program:

In our three real-world studies we observed a marked disconnect between the miserable personal stories/struggles written in the app by the obese participants, versus what they said at the in-person group and phone meetings, where they claimed that everything was fine with no struggles.

It was nearly impossible to get them to talk about their angst or struggles from being obese. Only one child, out of the 123 obese youth in our three studies, expressed the misery and struggles of being obese, and she expressed this in only one phone meeting and never again. Two other teens broke into tears and hung up, when the subject of their struggles was broached in their phone meetings.

It’s also a mystery to me why the kids in our study won’t acknowledge their life difficulties from their obesity. Afraid of losing their drug? Afraid of admitting that they are out of control? We need to figure out how to tap into their angst to motivate them to change (go through withdrawal).

Online, responding to Dr. Pretlow’s poll asking about their satisfaction with life, young people will say things like “i hate my life,” “im going slash my wrists if i dont lose weight,” “i get teased everyday for being so fat,” and “no one wants to be my friends and also my parents hate me too.”

Dr. Pretlow wanted to hear more about the importance of food consumption as a coping mechanism. The unwillingness of kids to describe their struggles in person was strangely at odds with their outpourings to the website message board. In person, it seems as if their relationship with food is “so deep and so critically important that it is very scary for them to talk about it.” They are miserable, but somehow not miserable enough to embrace the alternative, the discomfort of withdrawal. Dr. Pretlow writes,

Why would obese young people so vehemently resist measures to decrease their obesity? The rub of course is that any approach requires decreasing food intake. It would seem that they fear loss of food more than they are bothered by being obese.

Withdrawal symptoms (grouchiness, depression), tolerance (needing to eat more and more for the same effect), loss of a stress coping mechanism, and giving up food’s pleasure as their main relief from life’s pain are likely factors. Moreover, as with other addictions, obese youth may be compelled to overeat just to feel normal.

For professionals who deal with patients who are not free agents, such as children, another layer of complexity is involved. A doctor or therapist who sets out to modify a child’s physical state is interfering in the most fraught relationship ever invented: the one between parents and children.

When a child is admittedly miserable and/or angry, there are bound to be thoughts and feelings, no matter how inaccurate they may be, about who is responsible for what. A therapist is not in the business of being judgmental, no matter how bad the parents may look. Parental feelings of guilt may flourish nonetheless, and with one thing and another, the whole process can get awkward.

Your responses and feedback are welcome!

Source: “Obese Youth and Motivation,”, 01/02/14
Image by Keith Rowley/CC BY-SA 2.0

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Profiles: Kids Struggling with Weight

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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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