More About Cacomorphobia

The topic is still the condition described here by Jacob Olese:

Cacomorphobes are terrified of fat or obese people; they simply cannot control the terror they experience around such individuals. They often realize that they are being judgmental (often downright mean), and yet they are unable to control the panic attacks they experience…

Many phobics, for example, reveal feeling nauseated upon seeing fat people eating or bingeing on high calorie foods at restaurants.

The writer of this page knew a woman who, when out with friends in public, would invariably point out a morbidly obese person. It became a private joke. Others in her group would give each other knowing looks that meant, “How long until Phobie mentions that lady in the green dress?” It never failed. But at least she never moved on to the next possible step mentioned by Olese, that of avoiding malls, restaurants and other public venues altogether.

Cacomorphobia is relatively rare. In everyday life, anyone emotionally disturbed by fat people has a pretty wide latitude in which to navigate and avoid them. But medical professionals, unless they take measures ahead of time to prevent encountering overweight patients, are vulnerable to having a morbidly obese person appear before them at any moment. Olese writes,

Size discrimination […] only leads one to discriminate against a fat person. Many doctors, for example, are known to be “disgusted” by fat people and often refuse to accept them as patients. Cacomorphobia, on the other hand, is the extreme and constant fear of overweight or very large people, and is normally seen in anxious high strung individuals.

That author seems uncomfortable with diagnosing doctors as suffering from a full-blown phobia, and seems to suggest that, at most, they feel aversion based on cultural indoctrination. But whether a care professional has a diagnosable condition or just doesn’t like obese people, the result is the same. Patients may be turned away, or given less-than-adequate treatment.

What makes this happen?

The origin story behind these feelings might be that the person was, in childhood, inadvertently intimidated by an obese person, or even intentionally bullied. Or the general depressed mindset experienced by some obese people might cause anybody to be turned off by their personalities. The “culturally induced” explanation seems almost too easy, although it is true that in public discourse, overweight people are often referenced with either disgust or “humorous” derision.

One fertile source is, “You spot it, you got it.” People who react in a phobic way might have previously been fat themselves, or else they constantly fear that outcome. Somehow, their inner logic dictates that the way to avoid obesity is by, metaphorically, throwing obese people under the bus. This pro-active stance is somehow felt to construct a barrier.

The discomfort can bring upside issues and complications and reactions, like a need to overcompensate. As one anonymous comment put it, “I seem to have the need to create a long string of compliments and excessive flattery to large/obese women. I think it’s because I either feel vulnerable and scared.” Another online commenter says, “I cringe if someone touches me by accident who is obese. I feel like a monster. I wish I could just get over this.”

Your responses and feedback are welcome!

Source: “Fear of Fat People Phobia — Cacomorphobia,” FearOf.net, 08/13/14
Image by Mike Kline/CC by 2.0

What’s Up With Cacomorphobia?

The thing about phobias is, they are not all irrational. A tiny little spider, for instance, can kill a human being. Caution and avoidance, when applied to spiders, make a certain amount of sense. Likewise, iatrophobia, or the fear of doctors, is totally rational when validated by the life experiences of people who have been dissed (disrespected, dismissed, disregarded,) and missed (mischaracterized, misdiagnosed, and mistreated.)

But how rational is cacomorphobia, which in the original Greek means “fear of ugly shape”? In practical terms, it translates to an aversion to fat or obese people. While that mental condition is unpleasant enough in civilians, the place where it is really a problem is in the head of a medical professional. Cacomorphobia turns out to be a direct cause of iatrophobia, and the source of anecdotes about why many obese people avoid doctors.

Blinded by the fat

A phobia is an anxiety disorder; an extreme, irrational, illogical, persistent, excessive, overpowering, inexplicable, unreasonable, debilitating, exaggerated, and/or unrealistic fear or aversion. A phobia, like any other perceived threat, can cause a fight-or-flight reaction. It is easy to see how patients develop iatrophobia.

When someone seeks health care and is greeted with disrespect and disbelief, it is natural to feel like returning the perceived hostility, or running away, or both. Especially when the cause of the anxiety is not actually irrational or unreasonable or unrealistic. Obese people really have suffered actual consequences because some medical personnel has bad attitudes.

Doctors who just say no

What happens when a patient who desperately needs help manages to set aside their trepidation and seek that help? Believe it or not, it might be the doctor who says no! Some have outrightly banned obese patients. Michael Hobbes reported that, just 10 years ago…

[…] the Sun-Sentinel polled OB-GYNs in South Florida and discovered that 14 percent had barred all new patients weighing more than 200 pounds.

This is especially disturbing because, in the obstetrics/gynecology specialty, such refusal is a disservice to not one but two patients — the expectant mother and her unborn child. Previously, Childhood Obesity News discussed a Reuters article about physicians with negative attitudes toward obese patients, and some of the stereotypical mental images they hold, and the specific complaints voiced by patients.

The writer known as Your Fat Friend speaks of…

[…] an experience that is largely unique for very fat patients: doctors’ outright refusal to treat us at all… I am talking about the way individuals and institutions treat me, regardless of what I say or how I feel about myself.

(To be continued…)

Your responses and feedback are welcome!

Source: “Everything You Know About Obesity is Wrong,” HuffingtonPost.com 09/19/18
Source: “The Way We Talk About Our Bodies Is Deeply Flawed,” Medium.com, 04/23/19
Image by George Ian Bowles/Public Domain

How Iatrophobia Became a Problem

We have been looking at the ways in which trying to get health care extracts a high emotional price from some patients. Iatrophobia, or an intense fear of doctors, is sadly founded in reality. A person might need months to accumulate the courage to even make an appointment. They show up to find their worst fears realized: a medical professional disregards everything they say, and declares that all problems originate in the extra weight they are carrying.

Writer Solar Bean collected some more horror stories, like that of a woman who sought help for a sinus infection and instead got scolded for her weight. Another was condescendingly told that her years-long severe cough was weight-related “when in actuality, her lung was rotting.”

An overweight but consistently active woman was told by a doctor that she would just have to live with her chronic knee pain forever, and then was fortunate enough to connect with a personal trainer who worked with her to banish the knee pain within six months. Another, who was tired of being told that her severe exhaustion was caused by her weight, avoided doctors until anemia sent her to the hospital for an emergency blood transfusion.

Fifty shades of betray

Hopefully, the sweet-treat custom has died out by now, but in the past, a surprising number of children instinctively recognized the cognitive dissonance involved in being rewarded with a lollipop at the end of their appointment with a pediatrician. An overweight teen girl wrote of being repelled when her doctor came up with the clearly inadequate response of suggesting that she dance in her bedroom at night.

Another writer, Michael Hobbes, noted that people are sensitive enough to pick up on clues, like when fat patients are allotted shorter appointments because a doctor can save a lot of time by just saying “Lose weight. Next patient, please.” They feel the lack of emotional rapport, and understand what it means when a health care professional won’t make eye contact.

They certainly feel it when a physician believes that shame is the most effective way to motivate weight loss. Shame-based medicine can have devastating long-term effects. Overweight and obese girls grow into women who avoid pap smears, mammograms, and other routine screenings because of embarrassment.

Here is a depressing quotation from Tracey Folly:

The thing my doctor didn’t realize was that I’ve been working out regularly for years despite being obese for most of my life. My doctor couldn’t tell I was active by looking at me because my body doesn’t look like the body of an active person. I am certain my doctor knows a body can be both active and fat. However, I do think he assumed my body was inactive and fat, and that’s a problem I’ve been working to solve for as long as I can remember.

Of course, being ignored and patronized can turn a person off even if they don’t wind up in the ER through what can only be described as neglect. Sometimes, the patient feels victimized by simple disrespect, the sense of not being listened to or believed. Sometimes, the patient has innate awareness that all they are getting is what, in polite society, is called baloney. That kind of treatment gets old real quick. That sort of emotional abuse, while technically not malpractice, is certainly far from best practice.

Your responses and feedback are welcome!

Source: “The Reason You Hate Fat People Isn’t Because You Care About Their Health,” Medium.com, 02/09/20
Source: “Everything You Know About Obesity is Wrong,” HuffingtonPost.com 09/19/18
Source: “What My Doctor Doesn’t Know About My Obesity,” Medium.com, 02/26/20
Image by Neelesh Bhandari/CC BY 2.0

The Fat Tax, Both Tangible and Invisible

Many obese people have made the same point in various ways, like Devika Menon:

Even when you go to a doctor for medical aid, some of them will point out that whatever illness you’re going through is in your head and it will all get better when you lose some weight.

Yesterday’s post recounted two obese people’s negative experiences with the medical world, and the literature contains many more. The prolific Aubrey Gordon (aka Your Fat Friend), who has weighed as much as 400 pounds, has written many articles describing the judgment, rejection, disrespect, bullying, and outright disdain she has been subjected to. She also provides readers with facts like these:

62% of fat women report that they’ve experienced inappropriate or stigmatizing behavior at the doctor’s office.

The American Journal of Public Health concluded that anti-fat bias leads to “serious risks for psychological and physical health, generates health disparities, and interferes with the implementation of effective obesity prevention efforts.”

Even seeking treatment for ear infections has led to lengthy weight loss lectures from my providers.

That seems to be a common complaint. Of course, if it’s a weight-loss clinic or an obesity specialist, the patient’s size is fair game. But a person who shows up to, for instance, have a severed finger reattached might not want to talk about their Body Mass Index on this particular day.

Your Fat Friend has spoken of what she calls the Fat Tax, a fee that is both tangible and metaphorical. Being disbelieved and discounted are items on the psychic “fat tax” list, parts of an extra layer of difficulty that the obese need to overcome in order to obtain life-saving help. She writes,

The fat tax finds us in health care too. If we see a doctor who doesn’t dismiss our symptoms out of hand, brushing them off with a simple “just lose weight,” many of us will be required to seek care out-of-network and pay out-of-pocket just to access the same health care as thinner people.

The writer points out how travel might be necessary to find an MRI or CT scanner that can accommodate a large body. Insurance does not cover the extra expense. For a fertile woman over 175 pounds, the “morning-after pill” will probably not work. Wheelchairs, walkers, and crutches for overweight patients are very expensive. Life insurance costs more if it can be gotten at all, and an oversize casket might cost twice as much as a standard one.

Your responses and feedback are welcome!

Source: “Woman Loses 75 Pounds So That Doctors Would Finally Diagnose Her Instead Of Blaming Her Weight,” GoMcGill.com, 02/26/21
Source: “10 Requests from a Fat Patient to Her Health Care Providers,” Medium.com, 02/10/20
Source: “The Fat Tax Is Real — and It’s Getting Worse,” Medium.com, 04/09/19
Image by Sergio Santos/CC BY 2.0

Blinded by the Fat

Far too many people have refused to interact with health care providers because they have experienced misdiagnosis by doctors who have gotten hold of the idea that when an obese patient shows up, every problem is directly traceable to the patient’s weight.

In the world of “anecdotal” health reportage, Reddit.com is a useful platform for people to share their horror stories. Recently, correspondent u/YukiBean recounted how…

[…] every single thing I went to a doctor for, it got blamed on my weight. Severe cramps? Weight. Feeling sleepy during the day? Weight. Numbness in my fingers, headaches, memory problems, balance problems? Weight.

She worked hard to lose 75 pounds, which took a year. On her return to her doctors’ they ordered tests appropriate to her various symptoms, and found a chronic pain-causing brain condition called chiari malformation; and narcolepsy; and so much endometriosis…

I lost both of my ovaries and a portion of my colon and lower intestines. If it had been taken seriously a year ago, I might not have lost them.

In another publication, Laura Fraser wrote:

Several studies have shown that many physicians consider the time spent with obese patients a waste, and they don’t hesitate to broadcast their biases in the examining room. Fat people are less likely to seek medical treatment because they know the stigma and lectures that await them.

Fraser used to have a sister, Jan, whose obesity caused concern. When she lost 60 pounds, the occasion seemed to call for congratulations — except that it didn’t.

Jan had not been making an effort to reduce her weight but had been eating less for a while because her appetite was suppressed by pain, and over-the-counter medications did not help. Her gynecologist did a routine exam but, as Jan described the experience, “He just saw me as a fat, complaining older woman.”

She took proactive measures, cutting down on dairy products and gluten, but that didn’t help. At her sister’s urging, she made an appointment with an internist where she was examined by a physician assistant who apparently had read a bulletin from the DEA or something, and concluded that this was a case of drug-seeking behavior, and refused to write a prescription for effective painkillers. Laura writes,

Jan arrived at the visit weak and wracked with pain. She came out of it in tears, with no answers and no relief.

But the internist, like any good mentor, reviewed his PA’s work, and consequently called Jan the next morning and told her to go to the emergency room. Turns out, she had cancer. A gynecologic oncologist removed “the largest endometrial tumor he said he’d ever seen, the size of a volleyball. It had peppered her pelvis with cancer, infiltrating her bladder and other organs.”

Chemotherapy was tried, but it was too late, and Jan only lived another six months, wearing a wig and looking sick. But, as she lost another 100 pounds, people complimented her reduced size!

Your responses and feedback are welcome!

Source: “I lost 75 pounds so doctors would stop blaming everything on my weight,” Reddit.com, February 2021
Source: “My sister’s cancer might have been diagnosed sooner — if doctors could have seen beyond her weight,” StatNews.com, 08/15/17
Image by Tony Alter/CC BY 2.0

Obesity and Iatrophobia

Doctors and other medical professionals make tremendous sacrifices and devote years of their lives to learning the necessary skills, to achieve the credentials they seek in order to serve humanity. And yet they often “miss the boat” when it comes to dealing with patients who are obese or headed toward obesity. Too often, the result is that patients stay away from the very people who are ostensibly there to help them.

Sometimes, all it takes is one traumatic experience to turn a person off for years, to the point where they will put up with any amount of pain and dysfunction rather than make an appointment to strip down and put on an exam gown. For Tracey Folly, the first painful incident in her youth was not even the doctor’s direct fault, but an adjacent complication.

The first person to officially label her obese was a pediatrician who referred her out for testing, to see if her thyroid was in good working order. When the lab bill came, her mother was understandably upset by the expense, and of course, a child feels guilt for contributing to the family’s financial burden. But the insurance company was adamant, because “obesity is not a disease.”

Once burned, twice shy

For that and other reasons, as soon as she reached 18, Folly took advantage of her adult status to swear off annual checkups for many years. When romance entered her life, she went to see about contraception. The exam started, reasonably enough, with a pap smear. This procedure brought on a truly phobic reaction of “complete and total breakdown during the examination… crying, screaming, and hyperventilating.”

Documenting a patient’s vital signs is important, and the alert follower of Childhood Obesity News will recall, from yesterday’s post, how another writer advises putting off the blood pressure reading until the end of the visit, when the patient has had a chance to calm down. But in Folly’s case, on that particular occasion, after a 24-carat panic attack, it was the exact wrong thing to do:

[S]ince they didn’t check my blood pressure reading until after the exam, the nurse practitioner declined to give me birth control pills, which were the one and only reason I had subjected myself to such humiliation and torture in the first place.

Of course, this resulted in her adopting less reliable methods, which could have led to an unplanned pregnancy that would have created a whole new set of problems. The boyfriend situation was already precarious and anxiety-producing, since he was of the controlling type and liked to keep a tight rein on every aspect of his girlfriend’s life, except, oddly enough, her eating habits. All the resulting recent stress had been channeled into even more pervasive food abuse, and a 50-pound weight gain. Clearly, the needs of this vulnerable young woman came nowhere close to being met.

Your responses and feedback are welcome!

Source: “What My Doctor Doesn’t Know About My Obesity,” Medium.com, 02/26/20
Image by Jeff Eaton/CC BY-SA 2.0

Obesity Problems That May or May Not Go Away

Today’s essay actually belongs in a time capsule. The previous post suggests that the coronavirus pandemic will inevitably change the practice of medicine in ways we are not even able to foresee at this moment. While it would be futile to make predictions, it will be interesting to revisit this list of problems at some future time, and marvel over how much things have changed. So, what are some of the discouraging obstacles that obese patients face?

One, obviously, is making the decision whether or not to even go to a doctor. But why on earth would anyone hesitate? Maybe because they know that the Patient History notes entered into their medical charts will include negative vocabulary like non-compliant, overindulgent, and weak-willed.

Maybe they have heard rumors that medical personnel in the operating room will take advantage of the opportunity to make rude remarks about the zonked-out patient’s body. And why not? There are enough recorded instances of doctors saying inappropriately judgmental things to conscious patients. Why be sensitive toward someone who is unconscious?

Journalist Michael Hobbes spoke with a patient whose doctor had asked her, “How could you do this to yourself?” and one whose surgeon had pointed to the image from her MRI scan, saying, “Look at that skinny woman in there trying to get out.” Hobbes also quoted an incriminating line from obesity counselor Ginette Lenham:

A lot of my job is helping people heal from the trauma of interacting with the medical system.

Another interviewee, a teenager with stomach pain, had consulted a doctor who managed to incorporate both fat-shaming and a racially-tinged insult in the same sentence, by suggesting that her problem was eating too much fried chicken. Unfortunately, he overlooked the dangerous inflammatory condition in her internal organs.

Shaunta Grimes, in a piece subtitled “This is Why Fat People Don’t Go to the Doctor,” told of visiting a chiropractor for help with her back pain after an exhausting pregnancy. This sweetheart took one look at her size and said, “Well, of course your back hurts.” While she was on the table having her spine manipulated, he remarked, “This would be a whole lot easier if you weren’t such a whale.”

The same author also mentioned times when she had gone in to be examined “for strep throat or a sprained ankle or a fever and left with a xeroxed low-carb diet.”

Like police officers, realtors, and members of other professions, medics also invent disrespectful slang terms for the civilians they deal with. Probably everyone has heard the acronym “gomer,” which stands for Get Out of My Emergency Room. During one office visit, Grimes was less than delighted when a technician dictated, “The patient is a 33-year-old obese.” That is not a bad word in itself, as the adjective, it is meant to be — but when employed as a noun, it is inexcusably offensive.

Your responses and feedback are welcome!

Source: “Everything You Know About Obesity is Wrong,” huffingtonpost.com 09/19/18
Source: “That One Time my Doctor Called Me a Whale,” medium.com. 02/19/19
Image by 2il org/CC BY 2.0

Coronavirus Chronicles — The Virus As a Driver of Change

Doctors and other medical personnel are definitely the heroes of the year 2020. Due to circumstances and urgent public need, many doctors, nurses, and other highly trained people have filled roles and met challenges they have never expected. Careers have changed course, and professionals are expanding their horizons to meet needs.

A huge societal disruptor, like a pandemic, can bring about totally unforeseen changes, trends, and movements. It can create new professions and new opportunities. Public education, for instance, is under such tremendous stress that it is doubtful whether schools will be able to return to their previous form. And it is already obvious that many aspects of medical care will increasingly be delivered online.

What the future holds

It will be interesting, five or 10 years from now, to take a retrospective view of how COVID-19 changed the medical field. Some problems have been around for a while. Change is impossible to predict, of course, but it will be fascinating in the future to look back and see how the forces already in play, and that have not even become apparent yet, change the practice of medicine.

As an example, let’s take a very precise controversy that concerns people who are overweight and obese. That is the problem of attitudes exhibited by medical personnel, that the patients perceive as uncomprehending and even hostile.

There is no shortage of material, and the field has its heavy hitters. One is Aubrey Gordon, who until very recently published her work under the pseudonym Your Fat Friend. This one writer has reported a lot of experiences and expressed a lot of feelings. Some of her essays are titled, “How Health Care Bias Harms Fat Patients,” “When your fat friend goes to the doctor’s office,” and “Weight Stigma Kept Me Out Of Doctors’ Offices for Almost a Decade.”

The history of this problem is lengthy and, apparently, slow to change. Here, for instance, is a quotation from a “Your Fat Friend” piece published a year ago, just before the pandemic swooped in to change every aspect of American life:

[A] 2003 Obesity Research study found that 50% of doctors described fat patients as “awkward, unattractive, ugly and noncompliant.” A 2009 study in the Journal of Clinical Nursing found that a majority of nurses thought that fat patients patients “liked food, overate, and were shapeless, slow and unattractive.” And a 2004 study in Obesity found that 74% of medical students exhibited some level of anti-fat bias.

At the time, progress had been so slow that the author still had 10 urgent requests, summarized here:

1. Make your office physically accessible
2. Ask for consent before discussing a patient’s weight
3. Adjust your language
4. Don’t assume — ask
5. Test blood pressure at the end of the visit
6. Reassess your approach to conversations about size and weight loss
7. Look into effective and emerging frameworks for fat patients
8. Research fat people’s social determinants of health
9. Inventory the ways anti-fat bias may show up in your practice
10. Don’t withhold care until fat patients lose weight

Each one of these points is of course exhaustively discussed. For instance, the blood pressure request notes that visiting a doctor is, for an obese person, baseline stressful and frightening. The author says, ” Try taking (or retaking) fat patients’ blood pressure at the end of the office visit, after you’ve established trust and set us at ease.”

Naturally, all the caveats are not on the professional side. Patients are encouraged to do their part to promote understanding. For instance,

If you don’t have a choice about adhering to weight loss guidelines around particular treatments, explain why and what those barriers are in concrete terms. If you do have a choice, take a moment to reassess your practices.

Your responses and feedback are welcome!

Source: “10 Requests from a Fat Patient to Her Health Care Providers,” Medium.com, 02/10/20
Image by Dennis Sylvester Hurd

Coronavirus Chronicles — The Approximate Anniversary

As the coronavirus pandemic celebrates its first anniversary in the USA, the American Academy of Pediatrics recently hosted a virtual panel discussion on the topic, “What’s Happening to the Children?” Of the subject matter, journalist Alyson Sulaski Wyckoff says,

Mental health, academic under-achievement, food and housing insecurity, racial discrimination and obesity were top of mind.

Housing is so basic and fundamental to everything else. Here is an interesting digression: If you search a string of terms like percentage + income + rent, a number of websites will say that you should spend 30% of your income on rent. “Should” is a very bossy word, and the concept is even called the 30% “rule.”

However, back in the 1960s, young girls in Home Economics class were taught that a family should spend no more than one quarter of its income on rent. It was a known thing, like washing hands after going to the bathroom. If you were a prudent, responsible, sane head of household, 25% of income was the socially acceptable upper limit for rent.

Chicanery in action

Over the years, that very important goalpost has been moved and then obliterated. Now we have situations where people are paying half their income to share a room with six others. Housing insecurity is a huge problem, because not having a place to live makes every other problem exponentially worse. Millions of people have been evicted or face eviction. Some rules are in place, but so are greedy strategies, invented by ill-intentioned minds that specialize in circumventing and ignoring rules.

In addition to getting people kicked out of living spaces, the pandemic has strangled the traditional workarounds. It used to be possible to live in a car and buy a gym membership to use the shower facilities. Then, gyms closed. It used to be possible to politely, unobtrusively spend the day in a public library. Then, libraries closed. It used to be possible to find the occasional free meal, until the pandemic messed up all those programs. Food banks that used to have block-long waiting lines, now have miles-long lines that are not even accessible by people who don’t have wheels.

Food insecurity

Food insecurity is, to put it bluntly, the state of not knowing where the next meal will come from, and one of the panel members noted that in households with children, food insecurity has doubled in this notorious year. Childhood Obesity News has explored this subject as well as the deadly confluence between poverty, race, COVID-19, and, of course, obesity.

Wyckoff wrote,

Childhood obesity is another ongoing issue. With shelter-in-place and remote learning, physical activity levels have fallen, said Dr. Eneli, associate director of the AAP Institute for Healthy Childhood Weight. In addition, chronic stress triggers responses in the body that can negatively impact weight regulation. Modeling studies predict at least a 3%-4% weight gain in children during the pandemic.

Among the suggested interventions are partnerships with schools and community groups, and more support for children and families.

Your responses and feedback are welcome!

Source: “Experts weigh in on top pediatric concerns a year into pandemic,” AAAPPublications.org, 02/22/21
Image by visuals on Unsplash

Coronavirus Chronicles — More About Schools and the COE

The COE is the “complex obesogenic environment” in which the paramount complicating factor currently is the pandemic that keeps people anxious, frustrated, and sometimes almost immobile. Lack of exercise messes up adults and children alike, and in America, millions of children are also being hurt by changes in how and what a federal nutrition program offers them.

Through no fault of their own, a lot of kids changed their eating habits when schools closed or went part-time. As the government loosened up previous rules about how and what America’s less prosperous youth are fed, officials had to scramble to figure out a logistical nightmare.

Journalist Sam Bloch explained,

Some of the waivers loosened requirements around congregate feeding, and gave schools permission to run socially distanced pick-up sites in parking lots and on sidewalks, or enlist idled bus drivers to deliver meals to homes and community centers…

A much-applauded change allowed schools to serve free meals to all children, regardless of where they lived, their income status, or what school they attended.

All good, but there was a not-so-good trade-off — a reduction in quality that could not be avoided. Many factors contribute to this, including uncertainty. From one day to the next, no one knows what disaster or hitherto undiscovered danger will affect the ability of people to move around freely.

For schools to adhere to the fresh food rules might be impossible simply because the food isn’t being harvested, processed, or shipped. Or if the food is available, all kinds of circumstances can dictate how many children show up each day at the distribution points. Produce only stays fresh for so long, and an enormous amount of expensive waste could take place if the people in charge of ordering guessed wrong.

Rules? What rules?

Also, all that stuff about fruits and veggies, whole grains, limited salt, etc., just went out the window. The schools have enough problems, and it’s still better for America’s children to have something than nothing. Rules were rescinded — and not just for the temporary emergency.

The author notes that “the Trump administration hasn’t just issued waivers that free schools from nutrition guidelines. It’s permanently overturned restrictions on sodium and the fat content in milk, and loosened whole-grain requirements.”

There are less cooking and more distribution of frozen and shelf-stable edibles. So, instead of starvation, we have an ever-decreasing amount of true nutrition going into children, whose bodies respond by adapting to the obesogenic diet and lifestyle.

One thing that matters here is the ability of grownups to make it to the distribution point, and their need to take home several days’ worth of supplies if at all possible. Another is that the problem becomes self-perpetuating. As Bloch clarifies,

When kids stop showing up, their budgets start to shrink; as budgets shrink, schools are less able to offer high-quality food or innovative pickup and delivery options.

Additionally, many schools apparently had not yet gotten around to refitting their facilities to switch from heat-and-serve meal preparation to actually cooking fresh ingredients from scratch — and now with this relaxation of standards, it is unlikely that they ever will.

Endless summer

It is well known that in “normal” times, kids gain inappropriate amounts of weight in the summer, and often are lucky enough to shed it during the school year. The pandemic year has been described as the “endless summer,” and not in a good way.

Bloch adds,

Schools have never been closed this long, and this extended period of heightened food insecurity may result in changes that no one can foresee. Still, it’s likely that when the pandemic ends, schools and communities will need concerted efforts to counter the obesity trends that worsened while students were stuck at home.

Your responses and feedback are welcome!

Source: “The childhood obesity crisis started before Covid-19,” TheCounter.org, 01/19/21
Image Adrian Sampson/CC BY 2.0

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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:

Presentations

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