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Halloween Tips and Tricks to Minimize the Candy

Tatyana Meshcheryakova October 30, 2024 No Comments

With Halloween only one day away, let’s take a quick look at the advice pediatric obesity experts are giving to minimize — or at least control — the deluge of candy. Between the parties and trick-or-treating it’s very possible for parents and guardians to lose track of how much candy and processed, unhealthy food the kids are eating.

However, with these tips, parents streamline the fun without having kids overindulge. Yes, much of this advice is obvious — and it’s easier said than to follow — but it’s worth revisiting. In an interview with Fox News Digital, Dr. Dyan Hes, medical director at Concorde Pediatrics of Northwell Health in New York City, along with a few other experts, shared these tips.

Don’t banish all candy, set limits

Dr. Hes rightly pointed out that families that are overly strict about candy consumption can lead to kids sneaking “forbidden food.” Instead, set the limit on how many pieces of candy your child or children can have on Halloween night and any satellite events and parties.

The Fox News Digital article author, Lifestyle Reporter Angelica Stabile writes:

The American Heart Association recommends that kids don’t consume more than 25 grams of added sugar per day.

That’s the equivalent of about four to five mini Milky Ways, three fun-size Snickers or three bags of M&Ms, according to registered dietitian nutritionist Ilana Muhlstein.

“Knowing there’s a clear and fair allotment ahead of time will minimize any friction later on,” the Los Angeles-based expert told Fox News Digital.

“It will also encourage them to prioritize their favorite candies, eat them more slowly and savor them more mindfully,” she went on.

“It’s a great opportunity to demonstrate moderation and balance.”

Dr. Hes also suggests storing leftover candy out of sight after Halloween and give out only two treats max per day (the fewer the better). Even better, donate the candy.

Serve balanced meals

Before trick-or-treating, serve your kids healthy, nutritious food with plenty of veggies, protein, and fiber. You can have fun with it, too, by keeping the Halloween theme throughout. Muhlstein told Stabile:

This will help the kids feel full, balance their blood sugar levels, improve their energy and reduce the likelihood of overindulging in candy later on.

“Treats” don’t have to be just candy

Treats don’t equal only candy. Think about getting or giving out trinkets, stickers, temporary tattoos, toys, and other items.

Muhlstein said:

It’s a great way to help your kids foster a healthy relationship with the holidays, so they see that there are more ways to treat yourself and celebrate, beyond food.

Consider non-candy activities

Whether you are hosting or attending a party, instead of filling up on candy, think about activities that involve movement, like a dance party, a costume fashion show or a contest, or a scavenger hunt. Not into that? Suggest a DIY art project (the internet is full of themed suggestions, with printable instructions and handy materials).

To quote Muhlstein again:

Alternative celebrations like these also help prevent the risks of overindulging in sweets, including upset stomachs, hyperactivity and cavities.

Think about gut health

In his article for The Conversation, gastroenterologist and gut microbiome researcher at the University of Washington School of Medicine Christopher Damman also warns to stay away — or at least limit — sugar-laden treats, choosing more microbiome-friendly offerings:

Not all Halloween treats are created equal, especially when it comes to their nutritional value and effects on gut health. Sugar-coated nuts and fruit such as honey-roasted almonds and candy apples rank among the top, offering whole food benefits just beneath the sugary coating. Packed with fiber and polyphenols, they help support gut health and healthy metabolism.

On the opposite end of the spectrum are chewy treats such as candy corn, Skittles, Starbursts and Twizzlers. These sugar-laden confections are mostly made of high fructose corn syrup, saturated fat and additives. They can increase the unsavory bacterial species in your gut and lead to inflammation, making them one of the least healthy Halloween choices.

Pure chocolate candy, especially dark chocolate, are a better option than candy that contains only a small amount of chocolate (we’re looking at you, Twix, Three Musketeers and Milky Way).

Well, there you have it. Hopefully, armed with this expert advice, you’ll have a fun, safe Halloween! We’ve been discussing and doling out Halloween-related advice on this blog for years, so if you’re interested, just type “Halloween” on our homepage in the search box, and a treasure trove of posts dating years back is all yours!

Your responses and feedback are welcome!

Source: “Halloween candy overload: 5 ways to keep kids from overindulging,” Fox News Digital, 10/28/24
Source: “Halloween candy binges can overload your gut microbiome – a gut doctor explains how to minimize spooking your helpful bacteria,” The Conversation, 10/23/24
Image by Mary Jane Duford on Unsplash

Almost Half a Ton

Pat Hartman October 29, 2024 No Comments

Is it exploitative to pass along the story of an extremely obese person? How could it be, if the subject voluntarily signs a contract and is appropriately compensated? On the other hand, there have been some TV programs, for instance, that did not really need to be made; some shows centering on obesity which the world could have happily gotten along without.

Before even thinking about spreading some types of news, this is what publishers, editors, and journalists would do well to pause and consider: Does the public really need to be told this story, and if so, why? Are we just going for cheap sensationalism here, or what?

In many cases, however, the motive is obviously sincere. For instance, not long ago journalist Kati Blocker wrote for UCHealth.org a very comprehensive biographical piece about one Katie Peterson, who at age 44 weighed nearly 900 pounds. Raised in a tiny midwestern town, Katie felt chronically stressed by negative emotions caused by traumatic life events. Despite having been adopted as a baby, she was aware of at least some of her genetic medical history, including proneness to obesity and heart disease.

Katie was a chubby baby and a heavy child. She was raised to believe that “it was something you were doing wrong. Obesity was your fault. It wasn’t hereditary. You ate too much.” She told Blocker,

I’ll be the first to say I have a food addiction. But at (a young) age, you don’t want to hear that. I started at age 12 seeing a therapist, my parents telling me there must be some tragic thing that happened for me to eat the way I ate.

In 2001, Katie married her first husband and gave birth to a son. She kept on gaining weight and was up to 646 pounds when she became pregnant again. For that high-risk delivery, she traveled to a neighboring state. A few years later, she traveled to yet another state for lap band surgery. She was able to lose 250 pounds in a year, but still could never get below 400.

Still, she felt pretty good, relative to how things had been. But life happened. There was a divorce, an attempt at college that failed, and another marriage. She met her biological father and began to build a relationship, but he died soon after. Other life reversals and family disasters followed, some of which caused her to feel guilt.

Following the classic tropes of eating the feelings or stuffing them deep inside, her consumption only increased. She says,

I dove into food like it wouldn’t be there anymore. I kept eating large amounts of things. It was horrible.

Blocker described Katie’s very circumscribed life, moving “with help from her then fiancé and her 17-year-old daughter” from the bed to the living room sofa, then back to bed at night. She wrote of her subject,

Like many people with a food addiction, eating made Peterson forget about life, so she’d have half of a pizza rather than a few slices. Chips and dip, cookies, candy — she didn’t care what it was.

Is it universally accepted that an addict just doesn’t care? Is it an immutable truism that a hooked person will ingest or inject anything, led on by even the faintest hope that it will put their head where they want it to be? Just throw any old substance in there, and hope for the best? Is this why so many die from fentanyl?

At any rate, the agony of existence was not purely mental. Carrying around all those pounds caused Peterson constant pain in the back, hips, and legs.

(To be continued…)

Your responses and feedback are welcome!

Source: “900 pounds and hopeless: Katie’s weight-loss story,” UCHealth.org, 01/17/23
Image by Pete Markham/Attribution-ShareAlike 2.0 Generic

A Very Unusual Case

Pat Hartman October 24, 2024 No Comments

Ed Cara of Gizmodo.com recently reported on a medical situation in Ecuador involving a 24-year-old woman who sought help because of severe stomach pain along with frequent vomiting. Barely able to eat or drink, she had lost a considerable amount of weight.

Upon examination of her midsection, a hard mass could be felt from the outside. During a 45-minute procedure, surgeons removed from the patient’s stomach a compacted two-pound lump of hair whose 16-inch length included an incursion into the small intestine. (Yes, there is a photo). Her doctors estimated that the accumulated hair had been eaten over a period of at least two years.

Hair-pulling disorder, or trichotillomania, is classified as a body-focused repetitive behavior (a topic which Dr. Pretlow has addressed) and also as a mental health condition. Although the head is most often involved, a sufferer might pluck hair from any part of the body. There may be a ritualistic element, like choosing a certain hair that feels just right. Victims describe the urge to pluck hairs as irresistible, and they are often impelled to bite, chew, or even swallow the extirpated hair.

Hair-pulling may relieve negative feelings or even generate positive ones. An internal conflict or other psychological, or emotional issue is always presumed to be involved. The habit usually shows up between the ages of nine and 13, and some people coexist with it throughout their lives. It is unlikely to just go away, and an ignored, untreated hairball that causes intestinal blockage can be fatal.

The childhood obesity connection

Trichotillomania is often classified as a co-occurring disorder, which means that it typically develops along with another illness; chiefly anorexia, bulimia, or binge eating. Consequently, the two disorders must both be treated at the same time:

[O]ptions for treating both of these conditions include psychosocial methods, such as the use of cognitive-behavioral methods, as well as the utilization of medications. Ideally, all implemented strategies for addressing these issues should be under the guidance of a comprehensive treatment team of eating disorder specialists.

Along with psychological and behavioral therapy, SSRI drugs may help, though no specific drug to knock out trichotillomania has been discovered or developed. This condition has been seen often enough that the compacted mass of hair removed from the Ecuadorian woman and similar patients has a name: It is a bezoar.

The term, referring to any indigestible mass found in an animal’s gastrointestinal system, has ancient connotations. Historically, a bezoar was valued for its alleged curative power, for instance as an antidote to the poison that an enemy had dropped into one’s goblet. A bezoar could typically be worth several times its weight in gold, and might be embellished with precious metals and jewels. But a person unable to afford their own could rent an unadorned bezoar (or a fake one, made of polished stone) from the local alchemist.

Your responses and feedback are welcome!

Source: “Doctors Pulled a 2-Pound Hairball From a Woman’s Stomach,” Gizmodo.com, /07/19/24
Source: “Trichotillomania (hair-pulling disorder),” MayoClinic.org, undated
Source: “Trichotillomania and Eating Disorders,” EatingDisorderHope.com, 06/12/12
Images by Dr. Alexey Yakovlev and Gee Hair/Attribution-ShareAlike 2.0 Generic

How Thinking on Obesity Has Shifted Over Time

Tatyana Meshcheryakova October 23, 2024 No Comments

Over the years, the way society thinks about obesity has undergone a profound transformation. What was once viewed as a simple issue of personal responsibility has now evolved into a more nuanced understanding of a complex, chronic condition influenced by various factors beyond individual control. This shift in thinking has far-reaching implications for public health, healthcare, and the well-being of individuals living with obesity.

From personal failure to a complex condition

For much of recent history, obesity was seen as the result of poor lifestyle choices — too much food and too little exercise. It was commonly viewed as a moral or personal failing, with public health campaigns often focusing on slogans like the “war on obesity” or the “obesity epidemic.”

These messages reinforced harmful stereotypes of larger-bodied people as lazy or lacking self-control. As a result, many people with obesity experience stigma, discrimination, and shame, not only from society but also within the healthcare system. (We’ve written plenty about fat shaming alone over the years.)

This narrow view of obesity failed to consider the broader range of factors that contribute to weight gain. In recent years, research has increasingly shown that obesity is influenced by a variety of complex factors, including genetics, socioeconomic status, psychological well-being, medications, and the environment. While diet and physical activity remain important, they are only part of the puzzle.

Is the word “obesity” offensive?

A recent article for The Conversation, “How we think about ‘obesity’ and body weight is changing. Here’s why,” Executive Editor Stephen Khan used the word “obesity” with an asterisk (“ob*sity”) throughout his article, explaining,

Historical reflections on the word “obesity” reveal its offensive origins, with advocates suggesting the term ob*sity should be used with an asterisk to acknowledge this. To show our respect, we will adopt this language here.

He also noted that in 2014, the American Medical Association classified obesity as a chronic disease, sparking debate about whether this label pathologizes natural body changes and fuels discrimination.

Why we should fight stigma

A lengthy article by the American Psychological Association by Zara Abrams cites plenty of research to back up the notion that stigma can lead to serious consequences in the person’s physical and mental well-being, quoting a few experts, including Sarah Novak, Ph.D., an associate professor of psychology at Hofstra University in Hempstead, New York, who says,

There’s a perception that weight stigma might feel bad but [that] it’s tough love and it’s going to motivate people… But research shows that this isn’t true.

Citing this and this research on the subject, Abrams writes,

Like other forms of bias and discrimination, weight stigma, also called sizeism, leads to suffering and psychological distress. Sizeism increases a person’s risk for mental health problems such as substance use and suicidality.

Perception of sizeism has been difficult to change

Sizeism is one of the most deeply entrenched stigmas in today’s society, partly because of “sociocultural ideals tying thinness to core American values such as hard work and individualism.” Abrams also notes that “weight-based bullying is more common than bullying based on race, sexual orientation, or disability status” among children, according to some research results published in the Journal of Adolescence. Sadly, family members are “high on the list of perpetrators.”

Psychologists have tested various interventions to reduce sizeism, including empathy-building and education about body weight. However, these approaches have had little effect on anti-fat biases. Unlike racism and sexism, weight discrimination remains legal in most places, with only a few states and cities banning it. This lack of legal protection allows weight-based discrimination in hiring, promotions, and wages to persist. Though public support exists for stronger protections, policy changes have been slow.

Shifting public health approaches

As our understanding of obesity has grown, so too has the way public health professionals approach the issue. The previous weight-centric model — where weight loss was the primary health goal — has come under scrutiny. Many experts now believe that focusing solely on weight loss can lead to negative outcomes, including weight cycling (repeatedly losing and regaining weight), increased stigma, and negative mental and physical health effects.

In response, a new weight-inclusive approach to health has gained momentum. This perspective promotes healthy behaviors — such as balanced eating, regular physical activity, and mental well-being — regardless of whether they lead to weight loss. This approach aims to reduce the harm caused by weight stigma and support people in improving their overall health, rather than fixating on a number on the scale.

The role of healthcare providers

Healthcare providers play a critical role in how obesity is addressed in medical settings. Historically, larger-bodied patients often experienced weight bias, even from their doctors. This stigma can lead to worse health outcomes, as patients may avoid seeking care or feel blamed for their condition rather than supported.

Today, there is a growing recognition of the need for more compassionate and inclusive care. Health professionals are encouraged to use person-first language (e.g., “person living with obesity”) to avoid reducing individuals to their weight. Additionally, clinicians are urged to shift their focus from weight to health behaviors, helping patients set goals around physical activity, nutrition, and mental well-being without making weight loss the central objective.

Your responses and feedback are welcome!

Source: “How we think about ‘obesity’ and body weight is changing. Here’s why,” The Conversation, 9/18/24
Source: “The burden of weight stigma,” American Psychological Association, 3/1/22
Image by RDNE Stock project

Teal-o-Ween Catches On

Pat Hartman October 22, 2024 No Comments

It appears that pumpkin aficionados will be spotting more teal pumpkins this year. The color does not simply mean “no candy,” although that concept in itself is quite valid — but there is a lot more to it.

A few years back, in a relatively quiet American state, a revolutionary movement began with the Food Allergy Community of East Tennessee (in particular, Becky Basalone.) The Teal Pumpkin Project has spread because this broad issue touches children in every state. In the USA alone, around six million children (roughly one out of 13) suffer from food allergies, and nearly half of those affected have experienced at least one serious allergic reaction.

Commercially available candy, and this goes double for the specialized Halloween variety, is very likely to include in its recipe one or more common allergens. These include milk, eggs, wheat, soy, peanuts, tree nuts, and sesame. Also, as has been widely publicized over the past few years, any type of candy is likely to contain unhealthful amounts of sweeteners with serious downsides.

A worldwide sensation

FARE, the organization concerned with Food Allergy Research and Education, says that…

Kids with food allergy are not the only ones who benefit from non-food treats. Many other medical conditions make candy off-limits, such as food intolerances, eosinophilic esophagitis (EoE), celiac disease, food protein-induced enterocolitis syndrome (FPIES), diabetes, and having a feeding tube.

Now in its 10th year, the Teal Pumpkin Project has been catching on in other countries, too. Even more significant, its core principle has encompassed other groups, such as kids with autism spectrum disorder, who encounter their own set of difficulties. This area is a bit controversial, however.

While allergic children can collect treats in any receptacle of their choosing, autistic children are encouraged to carry a blue hollow plastic pumpkin or some other blue container, as a signal that they may be unable to make the traditional “Trick or Treat!” request. The notion is problematic from the start, because in the minds of many observers, teal is blue, and vice-versa. And this goes double after dark.

On the psychological level, this self-labeling can easily be interpreted as different from the other kind, and among children, adults, neighbors, and medical professionals, the response to the concept is mixed. Other controversies exist too, of course, and some grouches enjoy telling the parents of differently abled children that “Your kid’s problem is your problem. Not mine.”

FARE’s website is a place to download signs to print out at home or at school or wherever, that part does not matter as long as people are inspired to use them. “Non-food treats available here” is a friendly, neighborly, inclusive message. As for what those treats might be, this page offers a very comprehensive list, compiled by Maria Chamberlain, of possible alternatives to sweets. (A few more suitable items not included on that list are key rings, mini notebooks, mini puzzles, and fidget toys.) The page also offers the official posters available for download and print.

To be a good Teal host…

— Please register ahead of time with the Teal Pumpkin Project Map, if your community offers this amenity. If it does not, find out how to promote the movement locally. In the Age of Social Media, there is very little we can escape knowing about, so jumping on board with this trend should be easy.

— Parents can also pass out flyers at school events, well ahead of time, to alert others to the possibilities. Workplaces can educate their employees about the idea, and you know that retail stores will jump right on it and promote it if they sell anything relevant, from teal paint to little non-food prizes.

— For everyone’s convenience, have the non-food treats in a separate container from the food treats, this just goes without saying.

— Display a Teal Pumpkin Project sign from a window, porch step, or in some other visible area.

— A person doesn’t even need to have a house from which to operate, but, depending on the environment, can get together with one or two like-minded adults, set up a “Trunk-or-Treat” car, and distribute treats from any available space. If the weather or the neighborhood’s ambiance is likely to be too harsh, get together with other parents and responsible adults to plan an indoor event.

— Have big fun.

Your responses and feedback are welcome!

Source: “Bring Magic to Halloween With the Teal Pumpkin Project,” FoodAllergy.org, 10/15/24
Source: “Here’s what the Teal Pumpkin Project is and why it matters,” NBCNewYork.com, 10/18/24
Image by Jen Reeves/Attribution 2.0 Generic

How to Survive Halloween

Pat Hartman October 17, 2024 No Comments

Some very ambitious activists envision the possibility of a society-wide adjustment in the theory and practice of Halloween. It is almost as if adding on pounds has become the national sport, and they are determined to resist this trend. In recent years, to the point where politics often become involved, the holiday has increasingly attracted the notice of people who would like to see (and help) the entire landscape improve.

Former First Lady Michelle Obama poured a lot of energy into trying to end childhood obesity, or at least to make a dent in it. But what happened in Washington? “White House M&Ms” were the presidential treat, inviting snide comments from some members of the press. Today, one shudders to imagine the photo-worthy costumes that might hit the streets, which celebrating the holiday so close to Election Day will no doubt inspire.

Why the concern? As the first of a series of occasions where food is the signifier of love, togetherness, hospitality, generosity, and, in too many cases, regret, Halloween kicks off the eating season. As first in line, this quaint holiday can be a horror for an overweight kid. It’s all about doing the exact thing she or he is not supposed to do — acquire and consume a bunch of sweets.

Here’s a thought: Let’s figure out how to reduce the amount of junk the kids collect, how much they hold onto, and how much of it they ultimately consume. The goal is to minimize the acquisition, retention, and consumption of candy. Mainly, the first. The method is to offer, and even create, alternatives that are more desirable.

So much angst

Critics say those industrial-size packages of candy appear on supermarket shelves earlier every year. (Maybe. Is Easter too early?) Worse yet, some wary folks suspect that most of it is left over from last year. Can you tell the difference between a fresh bag of candy corn and a superannuated one?

Even people who don’t want to abolish the holiday altogether would like to radically change its nature. Plenty of parents are nervous about the whole trick-or-treat concept. All year, kids are told “Never take candy from a stranger” and suddenly, the rule is ignored. Every autumn, rumors circulate about shady neighbors who are said to tuck razor blades or various substances into the treats they distribute.

As the wisecrack goes, “That’s crazy. Nobody gives away perfectly good drugs.” Above that is a layer of cosmic humor. The candy, stuffed with not only sugar but high fructose corn syrup, food dyes, and all sorts of additives, is capable of doing more damage than some drugs. Childhood obesity, as many news items remind us, is growing by leaps and bounds.

Look to the future

Why? Because it might make a big difference in the outcome — that outcome being your child’s or children’s health for the rest of their lives. Okay, so maybe you missed the boat this time. Maybe you already bought the jumbo bags of sweet treats, weeks ago on the way home from a day at the outdoor swimming pool, on the theory that the price would rise as Halloween approached. Maybe some hungry family member has already depleted the stock. It might be a good idea to check, as there is still time to get more.

None of this needs to happen

Look to the future, parents, but first think back to previous Halloweens, especially last year. Did you make any notes to yourself about doing things differently? Maybe it is not too late. And there is always next year.

Meanwhile, set aside some time in the months that lead to Halloween 2025, to have a look at a little story of how things could be. For further inspiration, check out one or several previous Childhood Obesity News posts on the subject.

Things don’t have to stay the way they are! The future is ours to create.

Your responses and feedback are welcome!

Image by Da Puglet/Attribution-ShareAlike 2.0 Generic

How Are Weight Loss Medications Covered Globally?

Tatyana Meshcheryakova October 16, 2024 No Comments

We’ve been following the developments in the realm of GLP-1 agonists for a while now, including their potential to treat various conditions, risks, and availability. Let’s take a quick look at the recent headlines.

France is the latest European nation to decide against covering weight loss medications through its national insurance program. While the anti-obesity drug Wegovy is now available in the country, the French government is not offering enthusiastic support for it.

Novo Nordisk, the Danish pharmaceutical company that also manufactures the popular diabetes drug Ozempic, announced that Wegovy is now on sale in France for individuals struggling with obesity. According to a company representative, 10,000 people in France have already accessed the drug through an early access program.

Wegovy is expected to cost patients between €270 and €330 per month, but France’s national health insurance won’t cover the cost, meaning users will need to pay out-of-pocket. The drug is recommended only as a secondary option for those whose weight loss efforts through diet and exercise have failed.

Additionally, France’s drug safety agency mandates that initial prescriptions for Wegovy must come from an obesity specialist to prevent misuse, such as by individuals without weight-related health problems who may seek it for cosmetic purposes.

Elsewhere in Europe

Despite the widespread popularity of these anti-obesity drugs, which are predicted to generate global sales of $131 billion (€117.4 billion) by 2028, there have been shortages in the European Union since 2022. However, some experts, such as Dr. Jens-Christian Holm from Denmark’s University of Copenhagen, remain skeptical.

Dr. Holm said that the medications are “not the Holy Grail,” adding:

There are problems there. They cost a lot of money. There are side effects, and they are not working when you stop using them.

France is not alone in its cautious stance. For example, Germany’s national health system is prohibited by a 1980s law from covering drugs aimed at “lifestyle” conditions like obesity, smoking cessation, or hair loss. Therefore, while Wegovy has been available in Germany since 2023, only privately insured patients or those who pay out-of-pocket can access it, with the highest dose costing €302 per month.

In Denmark, where Novo Nordisk is based, the drug is also not typically covered. The Danish health authority has estimated that it would cost around 6 million Danish kroner (€805,000) to prevent a single cardiovascular event, a major factor in its decision not to cover the medication.

Meanwhile, in the United Kingdom, the health service recommends that Wegovy be used for a maximum of two years, refusing to fund longer-term use due to concerns about its cost-effectiveness. Given that many patients regain weight after stopping the medication, there is an ongoing debate among researchers, policymakers, and pharmaceutical companies about extending this usage period.

Wegovy is also available in other countries such as Norway, Spain, Switzerland, Italy, Iceland (where usage “increased by more than twenty-fold in five years,”) Australia, Brazil, Canada, Japan, the U.S., and the UAE, with further international launches planned.

Some nations are waiting to observe the effects of the drug before introducing it. For instance, while Wegovy is not yet available in the Netherlands, Dutch officials are already wary of the potential financial strain. Last year, Novo Nordisk requested that Wegovy be included in the Netherlands’ basic health insurance program. However, a government advisory panel expressed concerns in July about the drug’s long-term effects and the potential €1.3 billion annual cost, deeming it “socially irresponsible.”

These financial concerns might shift in the future, as Novo Nordisk has indicated that it could offer flexible pricing to encourage broader adoption of the drug. Additionally, new medications entering the market in the coming years could help reduce prices.

A Novo Nordisk spokesperson told Euronews Health that the company is continuously exploring ways to collaborate with healthcare systems to make its products more accessible, particularly for patients with significant unmet needs.

The U.S.: cost vs. benefits

Also in recent news, according to the U.S. Congressional Budget Office (CBO), the cost of paying for obesity drugs would be greater than the economic benefits. The CBO estimates that Medicare would spend $35 billion more on obesity drugs from 2026 to 2034, but the savings from improved health would be small.

Here are some details from the CBO’s analysis:

The CBO estimates that the federal government would pay an average of $5,600 per user in 2026, and $4,300 per user by 2034.
The CBO estimates that the savings from improved health would be less than $50 million in 2026, and increase to $1 billion in 2034.
The CBO projects that expanded use of obesity drugs would improve beneficiaries’ health, mainly by reducing the incidence of obesity-related chronic diseases.
The CBO continues to monitor trends in the use of obesity drugs, including their prices, effects on health, and coverage by insurance plans.

Your responses and feedback are welcome!

Source: “France won’t pay for weight loss drug Wegovy. What about other European countries?,” EuroNews Health, 11/10/24
Source: “Iceland Sees Sharp Rise in Use of Weight-Management Medications,” Iceland Review, 10/9/24
Source: “How Would Authorizing Medicare to Cover Anti-Obesity Medications Affect the Federal Budget?,” CBO.gov, October 2024
Image by Jakub Żerdzicki on Unsplash

A Halloween Retrospective

Pat Hartman October 15, 2024 No Comments

The trick-or-treat ritual boils down to three elements: First, prepare a costume in which to collect candy. Next, collect candy. Finally, decide what to do with the candy. Send it to our troops overseas? Donate it to dentists who offer something useful or philanthropic in return? Take it downtown and give it to the first person whose worldly goods are in a shopping cart?

Most likely, kids are going to opt for eating all of it. Otherwise, why did they go to the trouble? Often, the only choice parents have — if any — is to decree that their offspring should ration the goodies over a period of days. Good luck with that, by the way.

Through the years, Childhood Obesity News had offered numerous suggestions to help bring some sanity into the proceedings. “The Most Fun with the Least Sugar” is our motto, or would have been if we had thought of it sooner.

But seriously, this blog has touched upon many topics with the potential to bring on more smiles while minimizing the tummy aches, not to mention the calories. The holiday is a danger zone for kids who are in good shape. For those who are conscious of being overweight or obese, or at risk, it can be an ordeal.

Something else to focus on

Not surprisingly, a lot of anti-Halloween sentiment centers around the health aspect. The whole point and purpose of these suggestions for fun is to turn the spotlight away from the sugar treats and shift the emphasis to creativity and participation. Figuring this out could be an opportunity for family togetherness so memorable that even sweets are forgotten. At least temporarily.

For instance, if you plan to distribute trick-or-treat goodies from the front porch, there are very good reasons to switch over to non-food items. Of course, your kids will be expert consultants on this decision. Go out and get some exercise walking around in a store, or shop online for inexpensive but desirable objects to distribute. Pencils with miniature jack-o-lanterns on top, or even some non-Halloween-related gadgets that can be bought in bulk.

Parents, this is a secret worth remembering. What your kids really want is your attention, and generally the younger they are, the more true this is. Entertaining activities can go a long way toward persuading little ones to do what you want, which is to forget about candy for a while. Make up a game that could become a treasured tradition. Incidentally, check out this little tale depicting what could so easily become a normal way of doing things.

Is there an infant in the house?

An ever-popular Halloween sub-category is costumes for babies. A very young minor child is granted no say in the matter, and might turn up disguised as a taco, a banana, a chili pepper, a hamburger, a slice of pizza, a lobster, a hot dog, a roast turkey, a packet of ketchup, a candy bar, or a gingerbread man. (That last choice is economical, as it can be recycled for Christmas.)

In a dystopian vision, it is possible that some far-sighted disreputable second cousin might smell future profit and encourage the silliest costumes and snap plenty of photos, with an eye toward growing a nice passive income stream by blackmailing those former babies when they reach an embarrassment-prone age.

Just kidding. But seriously, this might be the year to adopt a new paradigm. Take a look at one or all of the previous posts on this topic. Try substituting attention for treats, and encourage activity rather than consumption. If the results are not what you hoped for, we have the whole year to construct and refine a plan for next year. Refuse to accept discouragement, and remember, because individuals and families vary greatly, nothing works for everybody. It is equally certain that nothing works if we don’t try it.

Your responses and feedback are welcome!

Image by Theo Crazzolara/Attribution 2.0 Generic

It’s That Scary Time Again

Pat Hartman October 10, 2024 No Comments

Well, almost. We still have a couple of weeks to plan and stock up for Halloween. In many segments of American society, this occasion represents the starting gun, the opening act, the ground zero, the kickoff, the onset, of the anticipated and dreaded Winter Holidays. Pretty soon, edible and drinkable treats will be coming at us from many directions. Sharing festival food is one of humanity’s most ancient, honored, widespread, and deeply ingrained cultural characteristics.

In these times, how we “do” Halloween tends to set the tone for the rest of the holidays that cluster around the end of any year and the beginning of the next. If we can get through this one with relatively little damage, maybe we can survive the rest of the ordeal-by-temptation and emerge in February with heads held high, and without extra inches around the waistlines.

Non-food fun

Parents and others who are called upon to do something constructive with children are often eager to pursue the greatest possible entertainment value with the least possible caloric intake, and Childhood Obesity News has just discovered a treasure trove. The Reader’s Digest website publishes several lavishly illustrated Halloween fact collections, each one of which could provide an evening of family amusement.

Journalist Melissa Mills quotes Halloween expert Lesley Bannatyne:

The celebration of Halloween often illustrates what’s going on in our culture. Halloween feeds on zeitgeist in a way that other holidays can’t. It’s expressive of who we are and what we value, what we’re thinking about or are afraid of or love…

Take, for instance, “The Most Popular Halloween Costume the Year You Were Born.” This particular collection begins with 1950, so it’s a great opportunity for children to see what their nearest ancestors were up to in the spooky season, back in the day. What a great opportunity to spend some time sitting around and just talking with the kids — rather than eating.

To learn that Grandma’s first celebrity crush was a guy in a fur hat (Fess Parker as Davy Crockett) could be an anthropological treat. To see what Mom or Dad wore (or refused to wear, or were thwarted from wearing) for trick-or-treat at age 10 might be quite illuminating, and possibly even form new bonds between the generations.

At least a few of the entries are bound to stir up curiosity, and lead to personal reminiscences as well as interesting and possibly useful exchanges of information about pop culture figures of the past, both real and fictitious. That particular collection ends with 2005, but never fear, the most popular costumes in each American state are spotlighted by a similar article, which in turn could spark family-oriented conversation about relatives in those states, or to a phone call or two, or to some historically informed speculations about why people in different parts of the country tend to enjoy certain costumes.

If by chance the family anticipates a new member, another article offers “27 Best Pregnant Halloween Costume Ideas to Show Off Your Baby Bump.” The kangaroo is very tempting. It is easy to follow links to the other related collections, such as 38 ideas for the whole family to all dress in related outfits; 45 funny costumes; 55 scary ones; and a whopping 83 inspirations for large groups. Needless to say, any or all of these journalistic efforts can provide something Halloweeny for kids and parents to do together, other than eat.

Actually, for the ambitiously crafty family, there is still time to make some simple costumes, either imitating those seen in any of these collections, or totally different ones inspired by all the creativity on display. Any activity that diverts attention from the collecting and consuming of a ton of sugar and additives, is a win.

Your responses and feedback are welcome!

Source: “The Most Popular Halloween Costume the Year You Were Born,” RD.com, 10/04/24
Source: “Here Are the Most Popular Halloween Costumes in Every State,” RD.com, 10/24/22
Source: “27 Best Pregnant Halloween Costume Ideas to Show Off Your Baby Bump,” RD.com, 01/20/24
Image by City of Greeley/Public Domain

Best Practices in Childhood Obesity Weight Management

Tatyana Meshcheryakova October 9, 2024 No Comments

Three publications recently discussed the challenges of pediatric obesity treatment and agreed that biological and environmental factors play a big role. Behavioral interventions, while certainly helpful when used a standalone, aren’t as effective as when also involving GLP-1 medications in weight management of children and teens. Let’s take a quick look.

In an interview with Morgan Ebert, Managing Editor at Contemporary Pediatrics, Kay Rhee, M.D., medical director of the Medical Behavioral Unit and research director in the Division of Pediatric Hospital Medicine at the University of California San Diego School of Medicine, highlighted the biological and environmental factors that make fighting childhood obesity management difficult. These include genetic predisposition, food cravings, and limited access to healthy resources in some communities.

Dr. Rhee emphasizes the role of behavioral interventions in helping children and teens adopt healthy eating and activity habits, often involving the whole family. Combining these interventions with medications like GLP-1 agonists can enhance weight loss by reducing appetite and cravings, making it easier for children to learn and stick to healthier behaviors.

She said:

Behavioral weight programs can really help teens/children learn to develop new healthy eating and activity habits. These programs usually involve the parent or caregivers too, so they help the whole family develop new routines and patterns with the hope that these behaviors become second nature to them.

Learning these new skills alongside the use of medications like GLP-1 agonists can be helpful because the medicines can decrease the cravings or decrease appetite to the point where children and youth can focus on learning the new behaviors. Then if they start to be successful in their weight loss efforts, they feel proud and energized because they have successfully learned a new skill that can be linked to these positive outcomes. This sense of pride and accomplishment can really reinforce the new behaviors, and it becomes a great positive feedback loop.

Dr. Rhee suggested practical strategies like removing unhealthy foods from the home to promote better choices. When addressing weight with patients, Dr. Rhee advises providers to focus on the link between obesity and metabolic risks rather than cosmetic concerns, and consider family history to guide conversations about potential health risks.

At the 2024 American Academy of Pediatrics (AAP) National Conference & Exhibition, Tanya Altmann, M.D., a UCLA-trained pediatrician and AAP spokesperson, discussed the growing problem of pediatric obesity in the United States. Her opinions were also published in Contemporary Pediatrics. According to Dr. Altmann, the availability of weight management medications, such as semaglutide, has provided a critical new tool for fighting childhood obesity.

She said:

It really helps those kids no longer be completely focused on what their next meal and snack is, and they’re not constantly hungry… They are able to focus more on eating a balanced meal with the rest of the family, exercising, they’re more self-confident, they can focus more in school and do better.

The article also emphasized that, according to a research letter published in JAMA in May of 2024, “the amount of adolescents and young adults receiving GLP-1 receptor agonists including semaglutide (Ozempic) and tirzepatide increased approximately 6-fold from 2020 to 2023.” Pretty impressive, isn’t it?

Finally, Caissa Troutman M.D., DABOM, CCMS, the Physician Founder of WEIGHT reMDy, a Direct Care Wellness practice in Pennsylvania, discussed the guidelines for evaluating and treating children aged 2-12 with obesity, provided by the Obesity Medicine Association in a new Clinical Practice Statement. She addressed the complex factors behind childhood obesity, including societal and genetic influences, with lifestyle interventions being the cornerstone of weight management.

At the same time, Dr. Troutman noted that intensive health behavior and lifestyle treatment often results in only modest weight changes (1-3%), making early identification of non-responders crucial for timely referrals.

According to Dr. Troutman, the Clinical Practice Statement outlines pharmacotherapy options, including FDA-approved anti-obesity medications and those approved for other uses that affect weight. In other words, multidisciplinary care may be required in “early, intensive treatment to prevent the progression of obesity and improve long-term health outcomes.”

Your responses and feedback are welcome!

Source: “Overcoming pediatric obesity: Behavioral strategies and GLP-1 support,” Contemporary Pediatrics, 10/4/24
“Special considerations for the child with obesity: An Obesity Medicine Association (OMA) clinical practice statement (CPS) 2024,” ScienceDirect, September 2024
“Highlights of OMA’s Clinical Practice Statement on Obesity in Children,” MedPageToday.com, 10/1/24
“Tanya Altmann, MD, discusses childhood obesity, lifestyle changes, and medications,” Contemporary Pediatrics, 10/2/24
Image by Kelly Sikkema on Unsplash

Halloween Tips and Tricks to Minimize the Candy

Don’t banish all candy, set limits

Serve balanced meals

“Treats” don’t have to be just candy

Consider non-candy activities

Think about gut health

Almost Half a Ton

A Very Unusual Case

The childhood obesity connection

How Thinking on Obesity Has Shifted Over Time

From personal failure to a complex condition

Is the word “obesity” offensive?

Why we should fight stigma

Perception of sizeism has been difficult to change

Shifting public health approaches

The role of healthcare providers

Teal-o-Ween Catches On

A worldwide sensation

How to Survive Halloween

So much angst

Look to the future

None of this needs to happen

How Are Weight Loss Medications Covered Globally?

Elsewhere in Europe

The U.S.: cost vs. benefits

A Halloween Retrospective

Something else to focus on

Is there an infant in the house?

It’s That Scary Time Again

Non-food fun

Best Practices in Childhood Obesity Weight Management

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations