Childhood Obesity-Cha Ching, Cha Ching.

I wrote this article below over 15 years ago but never finished it. With the recent statement from the American Academy of Pediatrics on childhood obesity, I pulled up my unfinished article and added my ending (see below).  I’ve been in healthcare for forty years and recognize all the players-they couldn’t be more obvious. But, what are we going to do about it? The solutions involve not conforming to “their system”.

---

It’s 2:20 pm and school life for this day at John Glenn Middle School is almost over.  As I wait for my sons to walk out it’s hard not to notice that more and more of these young folks are larger than they should be.  Off they go, very much in the present and happy for the freedom that the school bell might bring.  It’s also hard not to notice how impressionable they all are, molded daily by adult decisions.  

For eleven and fourteen year old boys whose favorite foods include Kit Kats and Skittles, having a mom who is a nutritionist may seem like a child’s ultimate “kill-joy”.  But with the masses of sugary, fat temptations at our children’s fingertips and the definite risks it puts to their health, balance, boundaries and education is needed now more than ever, yet harder and harder to teach.  One visit to a middle school and it’s easy to worry about our children’s future health.

Despite the logo saying, “Life is good”, for most of Americans when it comes to their weight, clearly the message is not so good.  Although medical science is making astounding discoveries about aging, longevity and how the body responds to stress and illness, these discoveries may only benefit the depleting few who can manage to win their battle of the bulge.  If the bulge wins, a preponderance of research has been reminding us on a regular basis that we are toying with a much higher risk of premature death.  According to NIH the prevalence of obesity has more than doubled from 1960-2000 and three times more children are overweight now than 20 years ago.  Too many kids are running around with their bellies jiggling.  School aged bellies are not supposed to jiggle.  

But, you say, the Rubenesque Era marveled at the rounded shapes of women.  And even just a few decades ago, a heavier American man reflected success.  Isn’t it ones right to eat freely and if weight gain happens…so be it?  Perhaps, but the medical findings of obesity are sobering especially the connection to diabetes, heart disease and cancer -and that’s the short list.  And the precedent number of children becoming overweight/obese and developing Type II diabetes is not the kind of life we should want for our next generation. 

Baby Boomer‘s kids are developing illnesses that might have taken 30 or 40 years to happen to a Baby Boomer, exposing their vessels, heart and other organs to the wrong kind of stress for many more years than an adult who may become overweight.  So, if they don’t lose weight and keep it off, the odds are not in their favor to outlive their parents.  Once a BMI goes above 30 the incidence of chronic disease significantly rises. Nutritionists well know that even ten to twenty pounds can increase blood pressure in some people— and blood sugar enough to cause a pre-diabetes state.  

No doubt, our culture’s, over-sized, sweet daily rewards, food marts at every corner and physical inactivity are factors, but, two additional factors will hugely affect obesity’s future….parents and our food supply system. The mythical idea that a calorie is a calorie, all working equally in our body and we just have to do better at the intake/output balance is just that—a myth.  Nutrition is a science with far more variables.  Being energy efficient—the science way of saying you gain fat easily sure seems much easier than it used to be for many more people. This is not an enigma. Calories consumed are generally processed, packaged and stored with varying chemicals in mostly plastic containers, which then when entering the body have bioactive effects including contributing to fat storage far more easily than calories of old.

My fifteen year pause and now ending to this article.

The American Academy of Pediatrics’ recent statement about childhood obesity- "immediate, intensive obesity treatment to each patient as soon as they receive a diagnosis” does not make me feel any better, or that ohh, finally someone is caring or intervening.  

Hello, we’ve been here all along—the field of nutrition.  In fact, we are as popular now as ever.  I’ve counseled hundreds of kids and adults for over 35 years now—and yes, it does make a difference.  But, it’s a family affair and must also include minimal processed food, (note, not necessarily fewer calories).  I used to work with children both with and without the parent present. Back in the 90’s, while I was starting my own private practice, I worked part time for a company who was also the health insurance provider. Their insurance coverage had no limitations on nutrition visits.  You read that correctly—it was limitless. For nearly ten years, I was able to develop some strong connections with families. Looking back it was of the more rewarding periods of my career—and while making less than most cashiers do today. I saw some families for years, some checking in every few months, while others every week. Since obesity and eating behaviors are multifactorial, there was no one size fits all, but I know when started early works. One of the most important aspects of early nutrition care is the mental empowerment it can provide. Obesity robs a child of their confidence and self-esteem. Teaching children the power of nutrients and that a healthy diet being a form of self love and self-sufficiency is priceless. Unfortunately, I hear lots of pessimism that nutrition education is not effective when it comes to childhood obesity. That could not be further from my own professional experience.

So, maybe the American Academy of Pediatrics statement regarding immediate intervention should be reworded to state that every child and their family or guardian should have regular nutrition education from birth. Maybe workforce corporations need to chip in, maybe insurance coverage should be better, maybe the food supply and ingredients need to go back to the basics—you don’t think those extra processed ingredients have an effect on the gut microbiome and digestive health?  Maybe children should be educated about the farming process and how food is cultivated and grown and how to prepare a healthy meal. Lots of maybes! 

And, before I wrap up here, one question. Where are the long term safety studies on bariatric surgery on children?  Same place as the long term research on experimental vaccines, and drugs—they don’t exist.  I’m aware of some of the data showing short term benefit (though 10 years in the life of a child is not long term). And I realize there are exceptional kids who have lived a life of misery and may need more drastic measures. However, once you alter the anatomy of the digestive system, the physiology changes forever- lifelong digestive changes, which may then affect immune function.  Perhaps it would never reach the need for surgery if from birth, nutrition education was a priority in medicine and healthcare and a comprehensive part of wellness visits. 

I do worry, however, the further out we live with our processed food industry and obesogenic patterns, the more epigenetic effects we are creating, which may include a lower threshold for conditions such as mast cell activation syndrome (MCAS) or various autoimmune disorders. Our food supply and medical system have played a huge role in creating this monster.  We do not want bariatric surgeries and drugs to be the “go to” or the norm for our kids. Plain and simple, nutrition education should be a part of wellness from birth and ongoing. But, then again, prevention might actually save money and not make money for big pharma, the lobbying food industries and the hospitals. Surely our children our worth it!

Bariatrics, drugs, big food corp —cha ching, cha ching.