Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, February 17, 1991 TAG: 9102150470
SECTION: EXTRA PAGE: E-1 EDITION: METRO
SOURCE: JANE SEE WHITE STAFF WRITER
DATELINE: LENGTH: Long
The number of children between the ages of 6 and 11 who are obese has increased 54 percent since the '60s, according to a study of 22,000 children done by Harvard University researchers. The number between the ages of 12 and 17 who are obese rose 39 percent.
Nearly one in every four kids under 18 now is classified as obese, weighing at least 20 percent above their ideal weights.
This translates into possible health problems for these children - an increased risk of high blood pressure, respiratory problems, glucose problems, high cholesterol.
It also translates into a world of pain.
"Kids are prejudiced against overweight kids, and adults tend to be prejudiced against overweight people. Parents are ashamed of overweight kids because they feel like they've failed," says Joseph McVoy, director of the eating disorders program at St. Albans Psychiatric Hospital in Radford.
"Childhood obesity shapes how you see yourself," McVoy adds. "Look at how society sees fat kids . . . weak and lazy. Think about the movies - the fat kid's always the clumsy one, the scaredy cat, always bingeing, always an object of ridicule."
One of McVoy's adult patients still remembers with pain being excluded from grade-school games. "There was a stand of pine trees near the playground and the children had gathered under it and made a whole pretend community. But when I tried to join them, they said, `Fat people aren't allowed in Pinetown.' "
Rites of passage may be laced with pain, as well. This woman, who asked not to be named, remembers trying on high-heeled shoes in a store when she was about 13. "Two women who were in the store started laughing together about how funny this chubby girl looked in heels."
Her family tried to help her, she says. But everything they did to encourage her to lose weight only hurt her more.
"The thing I didn't receive from my family was acceptance of me. I always was told if I could lose 5 pounds, 10 pounds, 30 pounds, I would be pretty. If I lost some weight, they'd say, `Lose 5 more pounds and you'll be great.'
"You later come to understand that your parents did the best they could. But I've spent my whole life wanting to be accepted as a person, not because I was thin or fat."
Why do kids get fat - and why are more children getting fat now than 30 years ago? Does fatness in childhood or adolescence predict obesity in adulthood? And how should parents proceed when they become concerned about a child's weight?
Genes are destiny
Obesity has many origins, but the key building block is this one: genetics.
Your genes carry information that determines your gender, your eye color, your height, and, yes, your weight. The experts call this last bit of information the set point, actually a weight range that your body is programmed to carry.
Some of us are programmed to be heavier than others. Some seem to put on weight if they merely gaze at a chocolate sundae. Others eat all day and never gain an ounce.
If both parents are obese, their child has an 80 percent risk of being an obese adult; if one parent is obese, the child's risk drops to 40 percent; if neither parent is obese, the child's risk is just 10 percent.
But when you combine other factors with a genetic inclination to be heavy, you get an explosion in the number of fat children:
> Couch potatoes tend to be round. According to a 1988 A.C. Nielsen report, the average child spends four hours a day watching television. That's four hours not getting exercise and, in many cases, it's four hours of constant snacking.
One study found that obese girls ate 300 to 400 fewer calories a day than thin girls, but were "dramatically" less active.
Fat foods build fat bodies. Harried working parents sometimes rely too heavily on calorie-laden, high-fat fast foods rather than planning nutritious meals and snacks, and they may leave older kids to their own devices.
Charlotte Kidd, who runs an after-school program for overweight teens co-sponsored by the Roanoke City Extension Service and the city schools, says many young people in the program have working parents. These kids generally prepared their own meals - "or they had Hardee's for breakfast and Hardee's for dinner."
And here's the surprise: Dieting makes people fatter.
One key reason for the growth of obesity in the United State may well be our national obsession with slenderness and our growing reliance on dieting in pursuit of that ideal.
"Most people assume that fat children are the product of overfeeding," writes nutritionist Ellyn Satter in her book, "How To Get Your Kid to Eat . . . But Not Too Much." "That does happen, but not always. At the other extreme, underfeeding can make a child preoccupied with food and prone to overeat when he gets a chance."
McVoy agrees. "Underlying childhood obesity in almost all cases initially is genetics . . . But it's the solution, the diet, that creates the problem."
Lyn Day, a Roanoke psychologist whose doctoral thesis examined obesity in children, puts it this way: "We do not recommend putting children on diets. Dramatic intervention is the problem. . . . If you make a big issue of a child's weight, you're going to see eating disorders develop."
Such disorders can turn a pleasingly plump teen-ager into an obese grownup eating compulsively, eating to comfort the battered ego, bingeing in response to the hunger suffered on a diet.
And, as Satter notes, "for some people (probably the ones with a genetic predisposition to obesity), once gained, excess weight is extremely difficult to get off and keep off."
But the national obsession with slenderness and dieting continues, and children and teens are no more immune than their elders.
The current issue of the University of California at Berkeley's Wellness Letter reports on a study of 850 girls and women ranging in age from 12 to 23. Two-thirds of the subjects were unhappy with their weight, and "most who wanted to lose weight were not even overweight by any standard measures."
There's irony in the case of McVoy's patient, the woman with so many painful memories associated with being fat:
Like many children who are teased and ostracized because they're heavy, whose parents nag them, take them to doctors, put them on diets or withhold food that the rest of the family is allowed to eat, she was not an obese child.
"I'm surprised when I look back at the pictures because I wasn't very fat. In elementary school, I was probably 10 pounds overweight. In high school, maybe 15 pounds - I wore a size 14 when my friends were wearing 10s."
What not to do
Remember that many children go through fat phases.
"I could tell you lots of stories about children I have known who were fat when they were little and slimmed down as they got older, all by themselves with no particular efforts," Satter writes. "The research bears me out. Children often go through times when they are fat, and they lose that fatness."
Young people who become grossly overweight do run a higher risk of being obese adults, the experts agree.
"But it is not true that moderately overweight kids will be fat adults," McVoy says. "Most people think their kids are obese, but typically they're only slightly chubby."
So consult a physician to assure yourself that your child's weight hasn't shot off the charts. Also see a doctor if the weight gain was sudden and dramatic - say, a gain of 20 pounds over a few months.
But whatever you do, do not put your child on a weight-loss diet, the experts agree. "Only 5 percent of adults are successful on diets, so asking a kid to control his eating is crazy," McVoy says.
"In my program I see kids who weigh 250 pounds who probably should be around 160 - they're not programmed to be skinny, but dieting pushed them over the top," he adds.
Here's why: Children on diets are very likely to feel hungry. As a result, "kids on diets develop obsessions with food," says Chiglinsky. "And, of course, they develop negative self-images."
One way or another, the child on a diet is likely to find a way to eat what he wants - and probably more of it than he normally would, because he's hungry and because he can't be sure when he'll get it again.
"Then, by the time I see such patients as adults, a good portion of their weight is not genetic. It's caused by dieting," McVoy says.
Satter agrees, citing a study by Duke University psychologists that showed that "the more parents had controlled and restricted the children's food intake, the fatter they were."
Dieting made Joanne Chiglinsky fat, she says. It started when she was 17 and decided she was a bit too plump.
"I went on a 1,000-calorie-a-day diet and lost 5 pounds in a week," she recalls. "I thought `Great!' and I went off the diet. But within a few weeks, I'd gained back the 5 and 5 more."
The diet-it-off, gain-back-more spiral continued. By the time she reached her early 20s, Chiglinsky was nearly 30 pounds overweight.
"By dieting, I'd depressed my metabolism, so when I'd finish a diet and go back to normal eating, I'd gain weight," she says.
Today Chiglinsky is slender again. How did she do it?
"I stopped dieting. I will never diet again," she says. "I listened to my body. I ate when I was hungry. I stopped when I wasn't. I didn't deny myself junk food if I wanted some, because if I do that I'm going to end up eating more of it later."
Over the next two or three years, Chiglinsky's extra weight gradually melted off.
How to help
The bad news is that the experts agree there's very little parents can do to prevent their children from being heavy.
If you can establish a healthy eating routine in your home and if you can find ways to encourage your child to exercise, Satter writes, "there is a chance he will grow up to be of normal weight. Or he may be thinner than he would have been otherwise."
"You can get to the lower range of your set point, but unless you're willing to starve yourself that's about all you can do," Chiglinsky says.
McVoy is more blunt: "Be very, very careful not to give false hope. Parents can help a child accept his destiny by not putting him on the diet cycle that will make him extra heavy."
So what you can do is establish healthy eating habits. You can also help prevent your child from getting onto a lifelong roller-coaster of weight-loss dieting.
Finally, you can do a powerful lot to raise an emotionally healthy adult who feels good about herself and understands that size alone does not define how valuable she is and what she can accomplish.
McVoy's patient, who still is struggling in her sixth decade with weight issues, has a message that she wishes her own parents had heard: "Love your kids and accept them, regardless of what size they are."
Here's what the experts advise you do:
Establish regular meal and snack times in your home. Keep to them.
In her book, Satter cites a 14-year study of almost 200 children in which researchers found "only one dietary factor that distinguished fat from thin children: The thinner children had more structure in their meals and snacks."
> Buy healthful foods and snacks, and plan balanced meals. But don't deny your child junk food altogether - it'll only make him want it more, and eat more of it when he gets it. Buy limited amounts of these treats.
If your child wants seconds and even thirds, allow him to have them.
Satter is so emphatic about this that she uses italics: " Even the fat child is entitled to regulate the amount of food he eats."
Don't give the chubby child different menus and snacks from those you give the rest of the family. If you're going to limit the amount of potato chips he's allowed, the entire family needs to observe the same limit rather than stigmatize him and make him feel deprived.
Don't allow anyone in the family to eat while reading a book or watching television.
"You want to pay attention to savoring food and to be listening to your body's messages," says Lyn Day.
Satter notes that if food is consumed only at certain times and only at the table, children will have to choose between eating a snack or watching television. Perhaps they'll pass up the snack.
Set a good example. Don't eat standing up. Don't nibble all day long. Don't eat in front of the television or while reading. Get regular exercise.
Don't use food as a reward.
McVoy's patient remembers being frightened before a visit with one diet doctor as a child. To make her feel better, her mother bought her a chocolate soda on the way there. "She wanted me to be thin, but she also wanted me to be, well, happy."
by CNB