The Opposite of Childhood Obesity is not Anorexia

10.8.14

There’s an article over at the Frisky that sounds the alarms about weight loss apps for kids. For the record I 100% agree that giving an 8 year old instructions to count calories is a bad idea. However, the app in question is not just any weight loss app. It’s an app that’s designed to teach children ages 8 to 18 how to make better choices about their food and exercise.

This is where I lose most people. I’ve heard the responses on Facebook already and they’re telling. Our responses to children’s health issues are part of the reason we have rampant obesity.

  • BMI is bullshit! What about weightlifters?
    If your 8 year old is bench pressing their own body weight you probably won’t want this app.
  • My mom made me diet and gave me special food.
    This app helps kids make slow changes and the whole family is involved making changes too.
  • Apps don’t work, you need to learn how food works
    Valid point, they do have counselors available and it’s meant to be an educational tool
  • I don’t want to tell my kid they’re fat.
    They know they’re fat. It’s your responsibility to tell them they aren’t second class, weak or dumb because they are overweight.
  • It’s just baby fat.
    Well, when the baby fat is squeezing their lungs and they can’t play like other kids is that the time to start? 
  • This app doesn’t help poor kids, they can’t afford good food.
    That’s true, it’s not a panacea for the world but that doesn’t mean helping some people doesn’t have value. 
  • You can’t get an app to parent for you.
    Since when it seeking out expertise to share with your children bad parenting? Riddle me that.

Here’s what I’ve found out about Kurbo Health.

kurbo health

 

Kurbo Health is an app that requires parental involvement and doesn’t count calories. If you mention calorie counting to Joanna Strober on the phone you’ll be the recipient of an audible gasp. Kurbo slowly weans kids off of white bread, sugar and highly processed foods in a realistic manner.

Kurbo is actually a licensee of the Stanford Pediatric Weight Control Program. It’s a $3500 program that’s great for kids who live near the University and can get there each week. For the rest of the us there’s Kurbo.

Kids can have an app where they can track their food and exercise and they get feedback from the app. If desired they can have a trained coach Skype with them each week. The parents are involved in the first session and moving forward the kids are on the sessions alone but counselors are in contact with the parents too.

Weight loss isn’t the goal of the Kurbo app. It’s a reduction of BMI. Again, we all know that BMI isn’t perfect. According to blog comments and fat acceptance groups everywhere 99% of the world is an outlier. If your child is a weightlifter, amputee or plans to leave behind an extraordinarily thick skeleton we already know this isn’t for them. If you can look realistically at your child or if you’re willing to hear your pediatrician when they have the very uncomfortable talk with you about your child’s size then you might want to look at Kurbo.

According to Kurbo 88% of kids who met with Kurbo Coaches for 10 weeks:

  • Reduced BMI (body mass index)
  • Lost an average of 5-10 pounds
  • Exercised more frequently
  • Felt healthier and happier
  • Gained confidence

According to Stanford, “Since 1999, more than 80% of participating children and adolescents have achieved age-appropriate weight reduction.”

Kurbo is basically Stanford lite. For many children weight loss isn’t a goal. Simply maintaining their same weight while they grow taller is the goal.

I don’t know what will work for your kid. I know what it is to be a mother and see something in your child that the world will pinpoint as a weakness. We get them braces and contact lenses and the right clothes because we want to ease their way through social situations. We help our daughters learn to wear makeup and our sons get great hair cuts.

What we don’t want to do is apply weight to all of this. We don’t want our kids to feel ugly or unattractive if they aren’t thin so we pretend like they’re just a little overweight when the reality is that they’re unhealthy. No one is suggesting that skinny jeans are for everyone but to dismiss a Stanford University proven weight control program because we’re afraid that kids will be anorexic? Well that’s just ridiculous.

Until recently there was no such thing as Type 1 and Type 2 diabetes. There was juvenile and adult onset diabetes. Juvenile diabetes was part of an autoimmune disorder and adult onset was almost exclusively lifestyle related. With obesity reaching epidemic proportions young children are now getting adult onset diabetes and the nomenclature needed to change.

Do not tell me that you have to diet to have an eating disorder. The obesity we’re seeing is a result of disordered eating. Let’s not try to pretend that it’s somehow less dangerous or important to fix than starving one’s self.

Kurbo might be a solution for your child and your family. Don’t be afraid to help your kid, they know there’s a problem and Haagen Daaz won’t fix it.

 

 

This is the Obesity Message We All Need to Hear

01.24.13

obesity

No, you are not healthy at every size. Yes, fat acceptance is dangerous.

Daniel Callahan writes about the obese in The Hastings Center Report. When reading Obesity: Chasing an Elusive Epidemic you’ll find:

 Only a carefully calibrated effort of public social pressure is likely to awaken them to the reality of their condition. They have been lulled into oblivious-ness about their problem because they look no different from many others around them. They need to be leaned upon, nudged, and—when politically feasible—helped by regulations to understand that they are potentially in trouble. They should not want to be that way, nor should others.

Before folks get all screechy with me, nowhere does it say that the obese person is a bad person. It simply points out that as everyone is getting fatter people aren’t noticing it because if you look left or right you’re surrounded by people who have gotten fat with you. Sort of like putting a frog in water and slowly turning the heat up.

About Stigmatization he writes:

Misled by the public health community’s acceptance—and even enthusiastic embrace—of supply and demand measures against and outright stigmatization of smoking, I naively assumed that community would do the same against obesity. I had not realized that smoking was the exception—that the public health community generally opposes anything that looks like blaming the victim. This fact was surely evident in the struggle against HIV, as well as in other campaigns over the decades against the stigmatization of people with many other diseases. It has not been hard to fnd examples of stigmatization turning into outright discrimination, even (notoriously) in health care.

Why is obesity said to be different from smoking? Three reasons are common: it is wrong to stigmatize people because of their health conditions; wrong to think it will work well, or at all, with obesity; and counterproductive with the obese because of evidence that it worsens rather than improves their condition. Ethically speaking, the social pressures on smokers focused on their behavior, not on them as persons. Stigmatizing the obese, by contrast, goes after their character and selfhood, it is said, not just their behavior. Stigmatization in their case also leads demonstrably to outright discrimination, in health care, education, and the job market more generally. The obese are said to be lazy, self-indulgent, lacking in discipline, awkward, unattractive, weak-willed and sloppy, insecure and shapeless, to mention only a few of the negative judgments among doctors and nurses.

Clearly there’s a difference between stigmatization (which is subconsciously happening whether you choose to believe it is or not) and having the very real, very frank discussion that obesity is an unhealthy condition and that there’s quality of life to be gained by being a healthy size. Callahan wraps up with:

What I am suggesting—empow-ering the victims, not blaming them, and that individual responsibility is necessary—has its risks. But if the individual and public health impact of being overweight and obese is dangerous, then it is hard to imagine any kind of strong and effective efforts that will not meet resistance. The failure of efforts to date to make much difference suggest that a change of strategy is necessary.

Things you’ll find when you read the full text:

  •  Most of the 67 percent who are overweight or obese will remain so for the rest of their lives, guaranteeing serious health problems as they get older.
  •  Meanwhile, the food industry fights back, debunking scientifc evidence, minimizing the harm, and spending considerable money lobbying legislators.
  • Whether or not they [the public] recognize their own role in it, they need to understand that obesity is a national health problem, one that causes lethal diseases, shortens lives, and contributes substantially to rising health care costs
  • It is hard to know whether to laugh or cry when the most important studies of obesity count a 5 to 10 percent weight loss a “success,” adding that even that much loss has a health benefit, not to be dismissed.

This is not a condemnation of you if you have weight to lose. I absolutely condemn the folks who keep shusshing me when I say that it’s not healthy to be fat. You cannot be obese and have the same quality of life as a typical sized person. It’s a simple impossibility. It’s okay to tell your kids that it’s better for your body to be normal sized than to be fat. It won’t give them an eating disorder… of course overeating IS an eating disorder that Americans love to pass on to their children.

Please. Read this study and rethink the wisdom of fat acceptance.

 

UPDATE: This is a great article too: Gap widens between actual weight and people’s imagined weight

 

 

Does it Matter What the Addiction is?

11.14.12

When people smoke they smell bad. First they smell like smoke and then they get a weird cough while their skin dries out. Their hair stops shining and their teeth turn yellow. We used to treat smoking as glamourous and finally we acknowledged that smoking is really unattractive, taxed the hell out of it and hardly anyone I know smokes. The smokers are dying off and not being replaced.

When people drink too much they might be fun before they’re unruly but after a time they turn doughy, red in the face and mean. They’re unreliable with big bellies and stick legs. When people drink too much we stay away from them. Many folks are able to give it up, many aren’t and their lives plummet. Some folks die from drink.

When people eat too much of the wrong things and combine it with a sedentary lifestyle they gain weight. When children are fed processed foods and sugar first they get fat and then they get obese. Along the way many of them get diabetes, fatty liver and high blood pressure. Eating sugary processed foods releases hormones in the brain. The pleasure center if you will. This is a wonderful feeling and we are made to seek pleasure. They brain and body crave more of these foods and the combination of flour, salt and sugar creates glycogen spikes and then crashes. It’s impossible to feed someone fast food and expect brain or body to be in good condition.  When we are obese it’s the same as carrying a heavy weight around all day long; fatigue and defeat are natural.

None of this is a condemnation. Good people give their children horrible food every day. People are resistant to change and they don’t want the information. People want to pretend that you can be healthy at any weight, people want to pretend that giving children Gatorade isn’t just like punching them in the kidneys.

If this video upsets you I’m happy. Maybe you’ll rethink how you treat your precious children’s bodies.

#Unashamed and Strong for Life

02.17.12

I’ve thought long and hard about how to write a post about the #ashamed hashtag you’ve seen a lot of in the last week or two. In the event that you haven’t seen the discussion surrounding ashamed, let me bring you up to speed.

Earlier this year a Children’s Hospital in Georgia started a campaign revolving around childhood obesity. I’ve posted some of their videos here and here. In addition to incredibly powerful videos there are billboards that accompany them. The billboards and videos feature real life overweight children talking about the real life issues that obesity causes. The issues are social (loneliness) and physical (heart disease, diabetes and more). The videos (watch them) are presented with neither judgment nor over dramatization. The fact that these children are in physical and emotional pain is dramatic enough, nothing more is needed.

strong4life ashamed

There is a campaign to have the Children’s Hospital take down these billboards, the belief is that these billboards bring shame to children who are fat. Many top bloggers are bothered by these ads. Leading the charge is Leah Segedie.

Leah Segedie, who is the brains behind Mamavation, finds these ads to be riddled with shame. Leah is undoubtedly an authority in the weight loss arena as she battled depression along with her weight and has had a wonderful lifestyle change. She lost a hundred pounds and found her voice. Leah would be the FIRST person I would talk to if I needed a lifestyle overhaul. Leah is also an incredibly compassionate and passionate woman, she is bright and articulate, she is educated and she is charismatic. You get the picture? Leah is a woman I respect, enjoy and look up to. As a rule I do not call her judgment into question.

The women behind the #ashamed movement have it wrong. I don’t believe for a single solitary second that an ad campaign will make these children feel ashamed for being overweight. I believe with all my heart that the fat that’s covering these children’s bodies might make them ashamed. It should be noted that the fat covering their bodies also makes them ill and it’s much easier to die of diabetes or heart disease than of shame. Further, these ads are empowering. In the state of Georgia 40% of the children are overweight. Georgia is at the heart of the obesity epidemic and it’s imperative that they become forerunners in the fight against obesity.

By talking about fat, rather than whispering, some of the stigma has to leave. It’s not like no one can see. I’ve gained 15 pounds in the last two years, everyone can see it. If I only talk about it while whispering in private it’s not like people won’t notice. One of the many goals of this campaign is to have parents actually acknowledge that their children are overweight. It’s not baby fat, it’s just fat.

Having too much fat on your body is a medical issue. Yes, it can become a social one, and yes, it can be emotionally crippling. Not talking about the fact that children are overweight won’t stop them from hurting. Not discussing the fact that adults are robbing children of their health when they don’t provide proper nutrition and exercise won’t make anyone thinner or healthier.

When I was a teen everyone was worried about self esteem. There was this ridiculous notion that every child should feel good about themselves. Ted Bundy had incredibly high self esteem. What was missing was giving children the opportunity to feel good about themselves by presenting them with tools to reach the goals they wanted to achieve. The whole give a man fish or teach him to fish thing. If you don’t want children to feel ashamed let’s give them a reason to feel proud, give them a goal they can reach like walking a mile or riding their bike to school for a week. Teach kids to put together a healthy lunch or how to stop eating before you’re full and then to wait twenty minutes before eating again. If you want children to feel good give them some tools, forget advocating against healthcare workers who are trying to save lives.

Some feelings will be hurt. I assure you those feelings were hurt long ago, and if it takes an ad campaign in a region where children are gifted disease by their diets then so be it. I say let’s have hurt feelings, because the folks who are going to look at these commercials and feel like they’ve been sucker punched are going to be the parents. The kids already knew how they felt, it’s not a mystery to them.

I support Strong4Life and I’m sad that we’ve reached this place. I hope that Georgia can be the canary in the coal mine for all of us and that we can all love our children enough to make changes that will keep everyone living happier, fuller lives. Every part of me believes the women behind #ashamed have their hearts in the right place. I think they just missed the point.

Saving Obese Children Surgically?

01.9.12

obese-youngsters-children-body fat

This Sunday’s New York Times has an article that took my breath away. It follows the journey of a teenage girl who opts for the lap band in order to cure her of morbid obesity. The story is heart wrenching in every way, from the sad fact that a teenage girl would weigh close to 300 pounds to the ultimate failure of the device and our medical system.

Currently Allergan is trying to get the FDA to to allow it to market the Lap-Band to patients as young as 14. This is a phenomenal disaster in so many ways I’m not quite sure where to begin.

The Lap-Band restricts the size of the patient’s stomach so that they feel full. It’s not a surgery without risk but of course the folks who are getting the Lap-Band are already at risk for a host of terribly debilitating and life threatening diseases. The Lap-Band isn’t about getting cute, it’s a medical Hail Mary.

In restricting the size of a patient’s stomach, the Lap-Band also restricts a patient’s ability to get nutrition. Lap-Band recipients are told to take vitamins, but because of the size of their stomachs the vitamins are very uncomfortable to swallow. I have a hard time swallowing vitamins and I assure you I have the palate of a billy goat and a rather average sized stomach.

There are countless stories about Lap-Band patients and their misery post operatively. Common sense dictates that when someone needs to lose half their body weight it’s a medical issue, a behavioral issue and a psychological issue. A 45 minute surgery is more of an introduction to the solution than it is an ending.

It is alarming that Allergen would seek to make Lap-Bands available to 14 year olds. It is not alarming that Allergen wants to do business with teens. Allergen is a business and it operates to please it’s shareholders. What is alarming that there is a growing market for Lap-Bands with teens both literally and figuratively.

As I mentioned before Lap-Bands are the Hail Mary of medicine. When a patient gets a Lap-Band that means that diets, therapy, exercise, and behavior modification have failed. The tremendous risk of surgery is overshadowed by the risk of diseases such as diabetes and heart failure.

Every parent, educator and ally of children should be wondering how we can affect change so that 14 year olds never need to lose half their body weight. Every lawmaker who thinks they can cut physical education out of the school day needs to know that it’s going to cost our country hundreds of thousands of dollars to treat those children who are unable to work and who will require medical care that healthy sized folks don’t require. Every school board that serves crap lunches should know that they’ve effectively slapped every child in the face, hard, when they serve them dubious food.

Every time high fructose corn syrup (or Corn Sugar) is added to a food it should have a surgeon general’s warning on it much like a pack of cigarettes. This will attack your liver and send your pancreas into a tailspin. Your body doesn’t know what to do with this much sucrose.

And every time we tell ourselves that a ten year old has “baby fat” and then we reward him with a Snickers Bar we should be ashamed. Because it hurts our kids. It’s Munchausen’s by Twinkie.

It’s entirely possible that your breakfast cereal has more sugar in it than your homemade cake or cookies.

It’s probably not good medicine to give Lap-Bands to teenagers, but Allergan isn’t their parent. Let’s please look at articles like this and be shocked into doing something good for our kids, all of our kids.

If these kids feel ashamed for being fat we should all feel shame for making them that way.