Updated: Jan 8, 2021
I want to talk about why our children are gaining weight at an exponential rate. When I say our children, I'm mainly talking about American children, but the rates are going up all over the world. However, America is leading the obesity epidemic. So if you look at the stats in the literature from 2015 to 2016 and prior, you will find that the rates are continuing to go up. There are certain age groups where there's a minimal plateau, but overall our children are gaining weight at an exponential rate. So why is this happening? Well, I have a few ideas.
As you know, I have encountered many families who are dealing with weight issues and that's why they are referred to me. One common denominator that I see in many of the families that I counsel is that when they come out of their homes they’re inundated in unhealthy choices. So, as soon as they step out the door in the morning, what's there? Dunkin Donuts, McDonald's, Burger King; basically a quick breakfast right? This is one of the reasons why the obesity epidemic exists... and unfortunately, willpower doesn't really work.
There are many studies in psychology journals that prove that willpower doesn't work. In other words, you can try to not eat something for a while but at some point you will eat it. Some people will say “you should have willpower” or “you should just not eat it”or ”you should be healthy” or “there's something wrong with you”. There is nothing further from the truth. Some people might be able to avoid certain things for a longer time than others. But eventually, if you keep placing something right in front of a person, they'll eventually eat it or relapse. Okay, so the first issue is our environment. We are surrounded by unhealthy choices everywhere.
The next thing that I want to talk about is the family’s knowledge base. Many people do not know how to decipher what is (and isn’t) healthy. So when they discuss their food log with me, they state things like
”I ate fruits and vegetables” and they're telling me what I think they think I want to hear. They also say things like “all I drank was water”. But in reality, we know that's not what we're going to have all the time. My response to the patient usually is, “Other than fruits and vegetables, what else did you eat?” or “Are you going to just eat fruits and vegetables for the rest of your life?”
So how do you decipher what is or isn’t healthy when you have a plate in front of you or a menu in front of you? When doing your grocery shopping how do you decipher what's healthy? During my clinical encounters, I usually find that most people don't know how to read a food label. Most people aren't sure that something that they're picking up and putting in their shopping cart is even healthy. How can you make a healthy choice or a good decision when you're not informed? The fund of knowledge that you know about healthy choices, in this example, is called health literacy. In other words, how literate are you about making healthy choices?
This was something that I also had to learn. There is a vast body of knowledge about this but it wasn’t something that I learned in my residency program or medical school. I had to go to medical journals to figure this out on my own so that I was able to teach patients about not only eating healthy but also to learn about the comorbidities of obesity. Everyone has a different level of health literacy and honestly, most patients that I encounter think things are healthy that really aren’t. This is especially true for kid snacks. I don't want to call out any companies, but there's just one in particular that comes up often. The parent usually proudly discusses the healthy snacks that he or she has just purchased only to find out that it‘s just loaded with sugar sugar, sugar and more sugar. However, the packaging is tailored to make the parent think that it's healthy. It is just a lose-lose situation for many.
The next thing I want to talk about is genetics. One of the things I hear often from parents is the statement that “we're all big-boned in our family”. Yes, genetics does play a role but a small role. Your body type or body habitus, will have a genetic predisposition. For example, you may know some people that are just skinny no matter what they do. They eat all the time... they have 5 babies...and they're still skinny. But for the majority of people, genetics will play a small role. If you think genetic factors are playing a role in your child’s weight gain, there are things that you can do to counteract his or her genetics. Surely, you can start eliminating processed foods to counteract the genetics and surely you and your child can exercise more. Learn your child’s body and learn what types of exercise work for his or her body.
Indeed, there are a small number of genetic diseases that promote weight gain in kids. One is called Prader-Willi syndrome. In this genetic disorder, the newborn is found to be floppy and a poor feeder and as he or she grows, they become insatiable. They continue to eat large amounts and have rapid weight gain. Not many people have Prader-Willi syndrome nor other rare genetic disorders that can cause weight gain. So, of course, if everything's eliminated or if your child is fitting into the description of one of these genetic disorders, your doctor or specialist will probably order some tests. But to just come out the gate saying I think my kiddo has a genetic disorder and that's probably why they are gaining weight...it's probably not! Usually, when I review most patient’s food logs, they're indeed eating a lot. One’s interpretation of what's a lot of food can vary; especially if the parents eat a lot and the child is eating less than that, they think “well, it's less than mine.” However, since we are talking about growing kids here, it’s probably best to research how much your child should be eating for age and sex (boy/girl). Or, it may be wise to have someone outside of the family (like me) review their portion sizes. They certainly shouldn’t be eating adult portions until they are actually an adult (unless they are a professional athlete). That is why I love my Grade My Plate series. This is a chance for parents to ask questions about what they are feeding their child. So please feel free to send me some photos of what you are serving your child and yourself for that matter. I would be happy to do a live review.
Another issue that needs to be addressed is economics. Some families may not be able to purchase healthier options and so that's a barrier to healthy living. If you don't have the means to get the healthier option, what can you do? There are ways to try to find healthy, cheaper options, but when reality sets in and we have busy schedules it becomes difficult. When we're running to after school activities, what's available in our immediate environment? Yes, a cheap burger off of the dollar menu. So that is a big barrier. Also, parents may not have access to a healthcare provider because of this economic barrier. For example, a doctor's visit might be 15 miles away and they don't have money for gas. A lot of parents don’t see their child being “chubby” as a reason to go the extra mile and use money that can go toward food or something else. However, it is usually the child’s practitioner that tells the family that their child’s BMI is elevated. This encounter usually begins the education and tool building for success.
Another common barrier is an unsafe neighborhood and this is a legitimate complaint. I have families tell me that there are loose dogs in their neighborhood just roaming the streets. Nobody wants to walk around the neighborhood if there is a fear of getting bit by a dog. Or, some complain that they live in a bad neighborhood. There may be gun violence and drugs. No one wants their child taking a walk in an unsafe environment. So, what other resources are there? Maybe there's a park in an adjacent neighborhood that you can go to. There are places like the Y and other indoor gymnasiums, but they can be pricey. If one doesn’t have the money to get to the doctor how is one going to have the money to get to the Y? How are these families going to exercise with these types of barriers? You can buy some equipment for indoors. This may work since many are staying at home due to the Covid-19 pandemic. There are also some treadmills without a motor for younger children; it moves by the energy generated by the child. Older children can use a treadmill with supervision.
Other reported barriers to living a healthy lifestyle include the outdoor temperature. Many will say it's too cold outside in the winter time. So, their neighborhood may be safe, but now it's too cold outside. In the summer, they complain that it's too hot outside. Well, then, they'll never exercise if it's based on the environment! Sometimes those are excuses that the kids come up with to avoid exercise. You may have to do some encouraging here. You can firmly encourage your child to put on a jacket and a hat and take a 30 minute walk if it's not extremely cold outside. But sometimes, even if it's 50-60 degrees, there's a complaint about being too cold or too hot. At some point we have to take the extra step and state “it's a little cold, but we're going to bundle up and we're going to take a walk”. I encourage you to look at your own family dynamic and evaluate your current barriers to living a healthy lifestyle. Try to find a way to take a small step forward in a new direction. Try to make some outdoor activity fun and avoid using the word “exercise”.
Feel free to check out my YouTube channel for videos on these topics: https://youtube.com/c/LeticiaHardyMDStepUpWellnessCenter