I suspect all of us can remember witnessing schoolyard incidents back in our day, a generation or more ago, that involved someone picking on a "fat" kid -- or back then, perhaps, when childhood obesity was more exception than norm, "the" fat kid. Some of us can doubtless recall participating in such exchanges, to our credit if we attempted to interrupt them, to our shame if we were complicit in them. Generally the abusive banter, when that's all it was, served as what passed for wit: reminding a fat person they were fat. As if they might have forgotten.
But however we look back, and however the recollections might induce a wince, we must acknowledge that the situation is far worse now -- because childhood obesity is far worse now. It affects far more kids, of course -- but also is apt to affect them far more severely. In fact, we learned over recent months that while the overall prevalence of childhood obesity may have stabilized, and perhaps even declined a bit in some locations, the prevalence of severe obesity has risen steeply.
So make no mistake: The time-honored and dishonorable practice of literally adding insult to the injuries of childhood and adolescent obesity not only persists, but now afflicts more of our kids than ever. Children trying to overcome the burdens of obesity on their health and self-image are routinely obligated to weather a daily storm of bullying, abuse, and derision. They are denied the solace of friendship -- and often turn to food for comfort. And then, of course, eating the wrong things in the wrong amounts for the wrong reasons worsens the obesity -- and a downward spiral exerts its perilous pull.
At the bottom of it is not just dyslipidemia or Type 2 diabetes or joint pain. At the bottom is genuine despair.
For the most part, much as our society talks about "health care," we have no such system. We have a "disease care" system, and the response to these kids is a product of it. Public schools do not, and perhaps cannot possibly, have the resources to meet their needs. So their problems progress to the point of bona fide medical calamity -- and only then, we intervene. Insurers will pay for trips to the endocrinologist. They will pay for insulin injections. They will pay for in-patient psychiatric care in the aftermath of a suicide attempt. They will pay for bariatric surgery.
But as of yet, they won't pay for what is not only a kinder, gentler, less medicalized and more proactive form of salvation -- but one of far greater lifelong significance.
We do not, as a society, offer our children -- caught in this toxic and potentially even lethal impasse -- a way out before they reach the point of calamity. We don't offer them a way to escape the daily dose of abuse, and find their way back to health and self-respect in an environment of support, and the kind of community on which we all depend.
Or, rather, we generally don't.
Exactly that was done for a group of just such kids from the Independence, Mo. school district. They attended the Mindstream Academy in Bluffton, S.C. for the semester. Mindstream, in which I am privileged to play a supporting role as Senior Medical Advisor, is a fully accredited high school that also offers on-campus chef, dietitians, personal trainers, psychotherapy, and more. Perhaps most importantly, it offers kids a community of other kids who have been through much the same. It offers solidarity.
The results, currently capturing media attention nationwide, are nothing short of astounding. A dozen kids lost over 750 pounds. One member of this semester's group lost a truly stunning 93 pounds in just those few months, putting the effects of this school well within the rarefied weight-loss space dominated by bariatric surgery. But learning and a supportive community did for this boy what a scalpel never could; it put him in charge of his own transformation. And so he didn't just lose weight -- he found friendship, and meaning, and self-respect, and his sense of humor.
And something else. When weight loss is the product of skill power -- when it occurs because you learn things, rather than have things done to you -- it positions you to pay it forward. The benefits of bariatric surgery are bounded by a patient's skin. But the benefits of knowing how to cook, being able to identify and enjoy healthy foods, being able to fit exercise into a daily routine and derive pleasure from doing so -- these can be shared. These can be reasons why whole families benefit -- and they can be the reason why some other kid never develops quite so acute a need in the first place.
This is exactly what's being seen with the Mindstream experience. For about the cost of a surgical procedure our society is willing to pay for as a matter of routine, we can spare our young people the need to have their gastrointestinal tracts rerouted -- and instead empower them to re-route their lives for the better. Better health. Better self-esteem. Better skills. Better attitude. Better academics.
It's just better. A semester at the right kind of school can take kids from a fat chance at getting out of their desperate plight, to a new chance at the life they deserve.
Mindstream Academy exists, right now. It's got capacity for kids in great need, right now. It is the world as it could and should be for these kids, right now -- instead of waitin' on the world to change as more young lives are roughed up, and maybe ruined, by an at best inadequate, and at worst abusive status quo.
The Mindstream model should be covered by insurers as an alternative to bariatric surgery. The process of our medical system embracing a lifestyle alternative can take years, however, and there are kids we all know who can't wait. So between now and then, Mindstream needs support -- because the families that most need its services are often those who can least afford to pay for them. To learn more about the program, please visit Mindstream's website.
The New Year looms. We have the means at our disposal to give kids in need nothing less than a new lease on life. So let's not just keep on waitin' on the world to change. Let's change this one, for the better we already know how, and have the means, to do.
Thank you, and happy holidays--
David L. Katz, MD, MPH, FACPM, FACP
Director, Yale University Prevention Research Center
Senior Medical Advisor
Mindstream Academy: http://www.mindstreamacademy.com/
Childhood Obesity: http://www.liebertpub.com/overview/childhood-obesity/384/
American College of Lifestyle Medicine
President & Founder, Turn the Tide Foundation, Inc.
For more by David Katz, M.D., click here.
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