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Deepak Chopra

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No More Laughing at Fat Kids

Posted: 10/26/11 09:29 AM ET

It's a paradox that a problem like childhood obesity should crop up in a country like America where we are flooded with information about nutrition. At any age, obesity is generally considered a lifestyle disorder. Only a small percentage of patients suffer from hormonal issues, for example. For everyone else, weight gain is related to choices that we can make and unmake.

The implication is that children are now making the same bad choices that adults do, joining the epidemic of obesity that is associated in the long run with considerable health risks from diabetes, hypertension and heart disease. Yet the paradox goes deeper. The world teeters on the edge of drastic food shortages in the coming decades, while at the same time childhood obesity has spread beyond the developed world.



Visualization is courtesy of TheVisualMD.com

Here's what the overall picture looks like.  In the U.S., about 17 percent of all kids (ages 2-19) are obese. In the EU, about a third of all children are overweight, and of those, 300,000 are obese. Developing nations including China, Brazil, Thailand, South Africa and many others are now facing epidemics of their own.

Prevention, as always, is the best cure. It's far better not to put on the pounds than to try and lose them afterwards. In the case of childhood overeating, starting the bad pattern early makes it all the more difficult to change. Children can't be expected to break habits on their own, or to make good lifestyle choices without guidance. Parents bear the sole responsibility along with schools.

It seems undeniable that parents are training their children to gain weight and that the body's natural balancing mechanism, which tells us when we are actually hungry, has been thrown off. Balance is automatic -- we each have a metabolic set point that regulates how many calories are burned every day -- but it can be overridden by imbalancing factors, including the following:

  • Ignoring the body's signals for hunger and satiation
  • Using food as a fix
  • Covering up unwanted feelings through eating
  • Unconscious habits like snacking at night
  • Sedentary lifestyle
  • Eating while watching TV or playing video games
  • Conforming to the family's unhealthy eating habits
  • Creeping increases in portion size at fast-food chains
  • Over-reliance on salt, which increases appetite

Getting these factors under control requires awareness, because all are gradual tendencies that over time throw off the body's natural balance. Realistically, if it takes years to grow into bad habits, it will take a considerable period to break those habits.

Let's break the problem down to see what the best approach might be.

How can you know if your child is obese?

Currently, the standard tool used to evaluate body composition is the body mass index (BMI). BMI is calculated differently for children and adolescents than it is for adults. In children, the normal amount of body fat changes with age and also differs between girls and boys, so there is no universal normal range.

A child's BMI number is calculated based on his or her weight and height. That number is plotted on the BMI-for-age growth charts to obtain a percentile ranking, which shows how the child or teen compares to others of the same age and sex. For instance, a BMI-for-age percentile ranking of 90 percent means that the child's weight is greater than that of 90 percent of other children of the same age and sex. You can find your child's BMI using the Center for Disease Control's BMI Calculator for Child and Teen.

If your child's BMI is in an unhealthy range, you should take them to a health care professional, who will probably assess your child's condition further by looking at personal and family history, plotting weight and height on a growth chart, measuring skinfold thickness with a caliper and evaluating physical activity and eating habits.

America has reached the point where we cannot take our lifestyle choices for granted. Strong social trends often have hidden or seemingly innocent causes. In the last 30 years or so, obesity has doubled in children aged 2-5 and 12-19 and tripled in children aged 6-11. Although genetics may play a part in some cases, heredity alone can't account for this explosion of overweight, and the glandular disorders some parents blame for their children's weight problems are very rare.

Up to 80 percent of obese youth become obese adults. But solving the problem is generally easier for kids than it is for adults. For one thing, they're still growing, and growing uses up a lot of energy. Also, most obese kids haven't yet developed the many chronic disorders that accompany adult obesity. They can bounce back more easily than adults can. And kids are generally more flexible than adults -- their habits aren't so ingrained.

In your child's case, look to see which factors are coming together at the same time:

  • Fast food. The rise of cheap, low-nutrition, highly-processed foods is a major factor in child obesity. Regularly eating food from fast-food restaurants, instead of home-cooked meals, has become the norm for many kids.
  • Portion sizes. The sizes of typical portions have risen drastically in the last 20 or 30 years, both in restaurants and at home. As an example, the original size of a soda bottle was 8 oz., and it contained 97 calories. Today the average size of a soda bottle is 20 oz., containing about 250 calories. The same holds true for servings of French fries, sandwiches, burgers, chips -- just about any food or drink you can name.
  • Snacking. Many kids get most of their calories they consume on a given day from snacks, not from regular meals. The snacks tend to be unhealthy chips, cookies, candy and sodas. Kids drink, on average, 24 oz. of soda a day.
  • Inactivity. The growth of unhealthy eating has been paralleled by the rise of inactivity. As every parent is aware, kids spend a huge amount of time using computers, TVs and video games these days. In the U.S., kids use these devices almost 8 hours a day.
  • Gym classes have been disappearing from schools, too: One-half of public elementary schools have PE only 1-2 days per week./li>

  • Ads. Kids are barraged with ads for unhealthy foods on TV, on the Internet, in text messages and in podcasts. The average child sees more than 40,000 commercials a year, most of them for junk food.
  • Less sleep. Kids are sleeping less than they used to, and that, studies have found, increases the risk that a child will become overweight or obese -- even for infants and toddlers.

It used to be thought that fat was inert: that its only function was the passive one of energy storage. Now, we know better. Fat is an organ, and it is very metabolically active. Fat tissue produces literally dozens of hormones, including leptin, which controls appetite, and adiponectin, which affects insulin sensitivity and blood sugar levels. The hormones and messenger chemicals fat tissue produces travel through the bloodstream and affect organs all over the body. When someone is overweight, they produce an excess of these powerful substances.

The list of disorders associated with child obesity is a long one:

  • Emotional problems, including depression and low self-esteem, especially in adolescence
  • Sleep apnea
  • Bone and joint problems
  • Early puberty in girls, delayed puberty in boys
  • Digestive disorders, such as gastroesophageal reflux disease (GERD)
  • Respiratory problems
  • Fatty liver disease

If you have an obese child, your first impulse might be to put him or her on a diet. But as any dieter can tell you, diets may take fat off quickly, but it can go back on even faster. Instead, help your child to change their eating habits. Cook meals at home as much as possible, and have dinner together. Your kid is much more likely to eat meals that they have helped to choose, shop for and prepare, so include them in those activities.  And don't make your child finish everything on the plate.

Limiting screen time -- sitting in front of the TV or computer -- to two hours a day is one of the best things you can do for your child. If they're not in front of a screen, they're much more likely to be socializing, playing games, helping out with chores and playing outside. It's reasonable to start with 20-30 minutes of outside activity per day and aim to work up to an hour. Alternatively, you could do a number of 5- or 10-minute "activity bursts" throughout the day.

Physical activity doesn't have to mean exercise for a kid. (Before adolescence a child's body isn't ready for adult-style exercise anyway.)  Focus more on decreasing inactivity than on vigorous exercise.  It helps if the whole family is involved. Go for family bike rides, walk through the zoo, fly kites, hike in the woods together. Everyone in the family will benefit, and your kid will feel supported in becoming active.

If the changes you've made at home don't help, consider a structured weight-loss program. But be sure that the program you choose aims for long-term behavioral changes, not just short-term weight loss. The program should have mental health professionals on staff, because obesity has major emotional aspects as well as physiological ones. Make sure physical activity is an important part of the program, and that it supports the whole family in making changes.

Finally, kids have one huge advantage: their parents. Kids look to their parents for guidance and encouragement, even though it might not always seem that way. When a parent is a good role model and supports a child in losing weight, he or she has a much better chance of losing weight and getting fit.  The great mistake we adults make with our kids is to project our own self-judgment on to them. This is particularly tricky with weight gain since so many Americans struggle with the negative feelings associated with their body image.

Sometimes children just don't lose weight, even when you've done everything you can to help them. If this is the case, don't blame or criticize your child. Obese kids carry a huge emotional burden. Let them know you love and support them, no matter what their size. Every positive step you take at the level of awareness will be reflected in the awareness your child absorbs and adopts, often for life.

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It's a paradox that a problem like childhood obesity should crop up in a country like America where we are flooded with information about nutrition. At any age, obesity is generally considered a lifes...
It's a paradox that a problem like childhood obesity should crop up in a country like America where we are flooded with information about nutrition. At any age, obesity is generally considered a lifes...
 
 
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02:51 PM on 11/27/2011
This commentary is looking as cosmetic issues, when the larger problem is that most Americans can barely afford to eat and tend to purchase foods that are nutritionally unsound, but affordable. Most overweight and obese Americans are also mal-nourished, meaning they are packing in high-calorie foods with little nutritional value. With the absence of fresh grocers in many rural and urban areas, it is no wonder that children, like their parents, tend to eat from corner stores, ice cream trucks, and gasoline stations. The choice is not one of being greedy, but one of being needy.
10:15 PM on 10/31/2011
Gym class did little for my generation beyond breeding contempt for this forced period of athleticism. Communities need to make after school physical activities that are enjoyable available to local children. I loved my extracurricular athletics, which allowed me to view physical fitness as a leisure activity, rather than an academic requirement.

Kids need to be involved in activities after school that are organized, and give them a sense of self esteem. In my experience, however, gym class only served to break my spirit, and cause anxiety in me ( even despite being an accomplished gymnast, dancer, basketball and softball player).
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G8RH8R
Remember Blair Mountain
09:21 PM on 10/27/2011
Has anyone read The China Study or Forks over Knives? I read the China Study and and now on Forks over Knives. Real eye openers about what we eat and what we have been told. Life changing
09:50 PM on 10/28/2011
There is an excellent book by Will Tuttle called The World Peace Diet: Eating for Spiritual Harmony and Social Justice that details the cruelties of eating animal products and the healthfulness of the vegetaian and vegan diet.

For what it is worth, I have never seen an obese vegan adult or child and rarely ever seen an obese vegetarian
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G8RH8R
Remember Blair Mountain
05:55 PM on 10/29/2011
Thanks for sharing! I will check that book out. Being we have the highest health care cost, spend more than any other country and have the sickest people, we must do it on our own. The meat and dairy industry has too much lobby power for us to get the truth through gov.
08:38 AM on 10/27/2011
Three points.
One: This is about metabolism. Humans are biologically programmed to be active but our bodies adapt to their settings. Sitting in front of televisions and sitting in cars and sitting at schools (then offices) means we have bodies that look like we sit all the time. We pretend all the time that weight is about food when weight is actually about food, movement, and metabolism.

Two: Kids now see DOZENS of food advertisements DAILY, almost always for crappy food. Like all of us adults, kids are also surrounded by constant food options every place they go. Our biological programming is no match for this.

Yale did a great story on this here: http://news.yale.edu/2010/11/08/fast-food-restaurants-dish-unhealthy-marketing-youth-researchers-release-unprecedented-re

Three: There must be a connection between the consumption of processed food and this obesity trend. I am not a nutrition scientist so won't go too far down this road, but wouldn't the consumption of processed food not explain the second more global "paradox" she mentions? As these foods have spread, so have the problem.

Overall: we cannot simplistically blame fast food companies or advertisers--just as blaming parents, "kids these days," or any other single group is wrong. We have created an entire social system in which kids and adults get obese for a variety of reasons, and only looking at all of these factors will help us move in the right direction.
KarasudaJay
My micro-bio is empty.
01:31 PM on 10/27/2011
Actually we can blame the parents, they decide what children eat. Companies sell crap food, because people buy it. It's not that it's cheaper, that's a laughable lie to promote the idea of victims being something other than victims of their own sloth. A 16oz bag of peel carrots costs the same as a candy.
05:32 AM on 10/29/2011
Parent's are only responsible for what food the parents bring into the house. So supper, lunch if the kid always brings lunch from home, some snacks, and maybe breakfast - if they eat breakfast at home and not at school. The parents do not decide what foods the child gets at school or any snacks the kid buys with their own money (allowance still exists). Also, if the kid gets home from school before the parents get home from work, there is no one there to stop the kid from reaching for the 'sometimes' snack of cookies instead of an apple. Therefore not all blame lies solely on the parents.
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HUFFPOST SUPER USER
attydallas3
03:04 AM on 10/27/2011
What an unhelpful article .. Like we didn't already know about all this?
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HUFFPOST BLOGGER
Nelson Montana
Artist, Author, Composer
09:58 PM on 10/26/2011
How about this one -- don't eat so much crap. Done.
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TheMysteriousStranger
01:04 AM on 11/01/2011
No, how about this one: you are perpetuating the problem the article's very title is describing.
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HUFFPOST BLOGGER
Nelson Montana
Artist, Author, Composer
02:08 AM on 11/01/2011
So by simply stating the solution, I'm insulting fat kids. You're serious?
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mhagerinteriors
08:03 PM on 10/26/2011
As an adult with diabetes I say teach your kids now to eat good food. Lay off white flour, white rice, high carb foods. Really, it does make such an impact on your life to get diabetes.
06:47 PM on 10/26/2011
Thank you for mentioning MOVEMENT and recess, as well as body awareness. Kids with sensory processing issues, that's 1 in 20 kids, can really struggle with these. Too often, physical education focuses on "battling your body" to get it to obey your will instead of self-awareness, self-regulation, and gently pushing your body to increase your stamina and coordination. They also overemphasize competing with others instead of being sensitive to kids who know they'll always be picked last. We need options for ALL our kids to get physical exercise without being pressured into competitive team sports and "no pain no gain." For kids who have an uncomfortable relationship with their body due to sensory processing issues, it's ultra important to provide movement options throughout the school day that will motivate and not demoralize them!

http://www.sensorysmartparent.com
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05:51 PM on 10/26/2011
The problem is the parents. The vast majority of parents make terrible life choices and pass this "wisdom" to their kids. As a society, we keep up the ludicrous idea that squirting out a baby grants the parents with magic knowledge of how to raise that human being properly. Mommy and Daddy only know best when they are rigorously educated on how to be an effective parent.
unique
Animal lover forever
05:27 PM on 10/26/2011
Less sweets, less junk food, more activity.
I would even say have the children spend
extra time at school for another gym period.
06:49 PM on 10/26/2011
Assuming they have a gym period! In my son's middle school, 2 out of 4 quarters, there is NO physical education! More movement is absolutely necessary, as is healthier foods and snacks at home and at school.

http://www.sensorysmartparent.com
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creddell6
05:04 PM on 10/26/2011
Very simple. Don't have a bunch of junky food in the house and allow the kids access to it whenever they please. We were given a small snack when home from school, then outside to play until dinner. A healthy dinner. No snacks before dinner, period. Maybe a little dessert after dishes are done. No one was fat. We were healthy and active. Allowing kids to stuff their faces all the time makes fat kids.
06:49 PM on 10/26/2011
Remember when it was a big deal when Mom gave you a sugary drink in a Dixie kitchen cup not a Dixie bathroom cup that was slightly larger than a shotglass? Boy, have portion sizes changed!
I-US
Beware the monsters lurking in word swamps.
06:09 PM on 10/28/2011
You are absolutely right about portion sizes. There are so many articles where perplexed authors wonder why our waist sizes have increased in the last forty years. It seems more than a little coincidental that our plate sizes have increased in the last forty years, too!
04:50 PM on 10/26/2011
the problem is not our food, the problem is the TV, computer, video games, and cell phones that provide all of the above. Unplug the kids and the family and see what happens to the overall health of the household....!
06:01 PM on 10/26/2011
The food is also a problem in a lot of households...no fruit or fresh veggies, all high-fat processed foods. That stuff DOES make a difference
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Nosybear
Liar, damn liar, statistician and brewer
04:17 PM on 10/26/2011
No paradox! We're flooded with information, sure, but we're also flooded with cheap, empty calories. One is very easy to consume, the other takes some effort. Nutrition on the other hand isn't cheap and not particularly easy - something that looks healthy might not be due to sodium or fat. Given a choice, we tend to the path of least resistance, that being cheap, empty calories. So we have an obesity epidemic. No paradox at all!
04:11 PM on 10/26/2011
I would agree that parents have to accept a large portion of the blame for the unhealthiness of our children.

That said, it was a lot easier back when I was growing up. Back then, kids were outside playing with their friends (the neighborhood was full of school age kids) from after-school (they all walked home from the local school together) til supper time, and again after supper til bed-time. Now, rightly or wrongly, kids must be supervised every minute that they spend outside. Driven to and from school. Organized play-dates. No wonder kids spend so much time in the house watching TV - it's something they can do while their parents are busy (cleaning the house, making supper, grocery-shopping... All the things that can't get done any other time because both parents work now).
04:54 PM on 10/26/2011
perhaps the problem of children not becoming independent as adults has something to do with the micromanaging parents.......shut the electronics off and send the kids outside with a few simple rules, dont go anywhere with strangers, stick together, stay out of the street, stay out of trouble and come home when the lights come on....that used to be all that was required. Are our younger generations really so fragile or ignorant that this is no longer enough?
05:51 PM on 10/26/2011
no, but the generation before them is and will harm and hurt our children and have no respect or care if they live or die. Please see repubs regarding people without health insurance. No one cares anymore unless it affects them. Its sad.
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04:07 PM on 10/26/2011
Working families have many challenges w/ latchkey kids, and food is most obvious.
Suggest global conversation focus on working parents and health for direct answers.