The fewer teeth you have the higher your risk of obesity.

Missing Teeth Can Lead to Obesity

THE FEWER TEETH YOU HAVE THE HIGHER YOUR RISK OF OBESITY

This blog was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated in July 2013, but you can read the original post here.

There has always been a link between missing teeth and poor nutrition. After all, chewing is the first step in the digestive process. It breaks down food into smaller pieces and mixes it with saliva. Our ability to chew also determines the variety of foods we eat, which is important to getting a well-balanced diet.

Now there’s evidence that body weight is related to how good our chewing apparatus is.

Studies from Egypt and Canada suggest poor dentition may lead to obesity. In one study researchers reported that those with only 21 out of their original 32 teeth were 3 times more likely to become overweight. They concluded that part of the weight gain can be attributed to the inability to chew whole fruits, vegetables and other fiber-rich foods that are typically lower in calories.

Another way to look at it is that chewing takes time and slows down the rate at which we can consume calories. Softer foods are easy to eat and go down quickly.

The good news for the baby boomer generation is that we are the first to have benefited from water fluoridation and fluoride toothpastes since childhood, according to the Centers for Disease Control. This means the majority of us can look forward to having our pearly whites for our entire lives.

Getting Ready for a Life Time of Eating

There really are no short cuts to the timeless advice to brush after meals and floss daily. Practicing good oral hygiene and getting regular dental exams is the best way to preserve your oral health.

Dentures and replacements are not the answer. They’re expensive, have their own maintenance problems, and may never provide the same chewing ability as your own choppers. Research has also shown that use of dentures is associated with declining nutritional status, loss of taste and digestive problems.

As a quick reminder of what you can do to enjoy a lifetime of healthy eating, here’s a review from the American Dental Association (ADA).

Best dental care products and practices from the ADA:

Manual Toothbrush – They come in a wide range of prices and styles, but the most important feature is the ADA label of approval. Most dentists recommend a soft bristle and replacement every three months.

Powered Toothbrush – This is a good option for those who have difficulty maneuvering a manual toothbrush properly. A rotary head motion that is passed over each tooth is better than cruising across the surface.

Tooth paste – It’s an abrasive, so can damage soft tissues if you brush too hard. Those with added fluoride help strengthen and repair small cracks in teeth where cavities develop.

Floss – It should glide easily between each tooth and not be used as a saw.

Mouth Wash – Those containing antimicrobial agents and fluoride can reduce bacterial count and tooth decay. Avoid those with alcohol since it can dry the mouth making it more susceptible to bacteria.

Care packages from home can contribute to college weight gain

Tips to Prevent College Weight Gain

This post was originally written during my 2 1/2 year tenure as a blogger for Family Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

CARE PACKAGES FROM HOME CAN CONTRIBUTE TO COLLEGE WEIGHT GAIN

Now that everything has been purchased and packed to send your recent high school graduate off to college, what’s left to do? For many parents and grandparents, it’s time to start worrying about the notorious freshman 15.

College weight gain is a bigger concern today than ever before because so many more young people are arriving on campus overweight. Packing on five or ten pounds between now and winter break and another five or more by the time they move back home in the spring can saddle them with excess weight they may never lose.

The health risks of starting adulthood overweight should not be ignored. As anyone who has tried to lose 15 pounds – and keep it off – knows, it’s not easy. Taking steps to prevent gaining those unwanted pounds in the first place is far easier.

As the author of Fighting the Freshman Fifteen, I can show you how you can help your college student do just that.

What Causes College Weight Gain?

Life on campus is filled with opportunities to eat, drink, and party too much. The rest of the time is often spent sleeping, sitting in classes (sometimes both at the same time) and studying. That combination of overconsumption and under activity is all it takes for some kids to gain a pound a week, which happens to add up to 15 pounds at the end of the first semester.

Yes, the school has a state-of-the-art fitness center, a campus that stretches over several acres or city blocks, and round-the-clock recreational activities. But somehow all of that opportunity to burn calories is underutilized. It’s sort of like all the home exercise equipment and gym memberships that go unused.

Another source of unneeded calories are those care packages that come in the mail filled with all their favorite foods. Bags of Twizzlers, boxes of Cheez-Its, and tins of homemade chocolate chip cookies arrive one day and are gone the next.

Repackaging those care packages from home can eliminate the temptation, and extra pounds that go with them. Try some of these instead.

Care Packages That Prevent College Weight Gain

Hair Care

  • Shampoo
  • Conditioner
  • Gel or Mouse
  • Spray or Spritz

Dental Care

  • Toothbrush
  • Toothpaste
  • Dental floss
  • Mouthwash

Laundry Care

  • Detergent
  • Bleach
  • Dryer sheets
  • Stain remover

Body Care

  • Bar soap
  • Shower gel
  • Bath powder
  • Deodorant
  • Body lotion

Appliance Care

  • Printer cartridges
  • Computer paper
  • Batteries
  • Gift cards for apps

And whatever you do, don’t keep reminding them of what it was like when you were in college!

Physician in white lab coat speaking to middle aged obese woman

Pro or Con: Is Obesity a Disease?

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. This site was deactivated on July 1, 2013.

CLASSIFYING OBESITY AS A DISEASE IMPACTS WHETHER WE SHOULD FOCUS ON PREVENTING IT OR PAYING FOR THE TREATMENT OF OBESITY

Members of the House of Delegates of the American Medical Association (AMA) passed a resolution at their annual meeting this week that could be as significant as anything being considered by the US House of Representatives. The AMA Delegates voted in favor of classifying obesity as a disease, moving it up from its former designations as either a behavioral problem, chronic condition, health concern or complex disorder.

This vote was in direct opposition to the recommendations of their own Council on Science and Public Health.

The Council studied the issue and concluded obesity should not be considered a disease because there’s no good way to measure it. Body Mass Index is the measurement now used, but is considered too simplistic, especially since it cannot distinguish between excess weight from fat versus muscle.

As it turns out, obesity isn’t the only thing the AMA has a hard time defining. There is no universally agreed upon definition of what constitutes a disease, either.

This action by the world’s largest physician’s group is largely symbolic since the AMA has no legal authority over the insurance industry, which gets to decide which claims to pay. The resolution was, however, supported by other health groups including the American Association of Clinical Endocrinologists, American College of Cardiology, and American College of Surgeons.

After reviewing the widespread coverage of this decision, it was immediately evident that not everyone in the public health and policy arena agrees with the decision. To put it into perspective I’ve rounded up some of the Pros and Cons to help you decide whether this new designation will help or hurt our national problem with energy imbalance.

PROS: If obesity is a disease the benefits are it may

Reduce the stigma that it’s caused by poor personal habits

Result in expanded coverage by health insurance

Force physicians to raise the issue with their patients (more than half of obese patients have never been told by their doctor that they need to lose weight)

Encourage more obesity prevention programs in schools and the workplace

Support efforts to restrict the sale of certain foods and beverages to those receiving food assistance

Increase research to find a cure or more effective treatment for obesity

Qualify expensive treatments for IRS tax deductions

CONS: If obesity is a disease the disadvantages are it may

Increase stigma towards those who don’t seek treatment

Raise health insurance premiums paid by individuals and employers

Run up the cost of care for the 1/3 of Amercians who are obese and seek treatment

Increase the sales of ineffective and untested products

Support taxes and restrictions on certain foods and beverages

Undermine personal responsibility to change one’s eating habits and activity level

Shift attention towards expensive drugs and surgery and away from programs aimed at preventing obesity

If you’d like to read more about this evergreen issue, here are some past posts worth revisiting:

  • Prejudice Against the Overweight and Obese
  • Obesity and What We Buy at the Supermarket
  • 3 Anti-Obesity Drugs Now Available in U.S.
  • Reflections on Obesity and Weight of the Nation
  • Metabolic Syndrome is Worse than Obesity
  • Research on Mindless Eating Offers New Insight into Obesity
  • Update on Dieting and Weight Loss News
overweight woman measuring waistline with tape measure

Prejudice Against Overweight and Obesity

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

STUDIES SHOW GROWING ANTI-FAT BIASES FOR OVERWEIGHT CHILDREN AND ADULTS

Two-thirds of Americans are overweight or obese. We reached the point where the majority of us were exceeding our healthy weight in the 1990s. We also have very high rates of fat prejudice in this country. So the question that begs to be answered is, if the majority of Americans have been bigger than average for the past 20 years or so, who is perpetuating the anti-fat bias?

Anyone who has ever circulated a fat joke via email or liked one on Facebook can raise a hand.

Two studies published this month made me think it’s time to turn the mirror on ourselves.

It Takes A Village

Long before children have the math skills to calculate their body mass index (weight/height2 x 703) they show an aversion towards overweight children as playmates. (Body mass index, or BMI, is a measurement used to determine one’s weight classification. A BMI below 20 is considered underweight, between 20-25 normal weight, 26-29 overweight and above 30 is obese.)

Researchers at the University of Leeds in England found children aged 4 and 7 would select a normal weight child or one in a wheelchair before choosing an overweight child as a friend. The scientists discovered this through the use of illustrated storybooks. They created three versions of a story, each with a central character named Alfie. He was either normal weight, overweight or in a wheelchair in the different versions. After hearing and seeing the stories the children in each group were asked if they would befriend Alfie. They were far more likely to choose normal weight or disabled Alfie, with just one out of 43 children saying they would like overweight Alfie as their friend.

The same experiment was done with a female character named Alfina and produced similar results. In both cases older children expressed more negative views towards the overweight child, including seeing him or her as less likely to win a race, do good school work or get invited to parties.

These findings suggest children pick up on the social stigma against overweight people from adults and the media at a very young age as. The authors of the study concluded, “We have a real habit of equating fatness with bad and children are reflecting that back to us.”

Physicians Against Fatness

The second study on fat prejudice that came across my desk this week was done on medical students. It didn’t involve story books.

Researchers at the Wake Forest School of Medicine in Winston-Salem, North Carolina had over 300 third year medical students complete the Weight Implicit Association Test (IAT). This test is a validated measure of implicit preferences for “fat” or “thin” individuals.

The value in measuring implicit biases is that they occur at an unconscious level. They reflect our first reaction or initial emotional response to someone before our conscious thought emerge.

The students also completed another test to identify their explicit preferences, which are the ones we are consciously aware of.

The results showed that the majority of students had implicit weight-related biases, with more than twice as many showing anti-fat bias compared to anti-thin. The majority also reported they preferred thin people to fat people in the explicit test, with males twice as likely to report explicit anti-fat bias. Among students with a significant weight-related bias, only 23% were aware of it. More than two-thirds of them thought they were neutral.

The authors suggest these findings may be due, in part, to the fact medical students are learning about the dangers of obesity and may feel they should prefer thin people over fat. Or they may believe body weight is under an individual’s control so they may hold a negative view of someone who doesn’t do something about it.

Unfortunately, these results are very similar to those obtained when non-medical students take the tests, and they reflect the attitudes of the general public. Even those of kids in kindergarten.

Lead author Dr. David Miller said these biases can affect the doctor-patient relationship and must be overcome to improve care for the millions of Americans who are overweight or obese.

A good place to start may be by looking in the mirror.

Calculations of A Body Shape Index can help predict those at risk of dying

A Body Shape Index: The Newest Risk Factor

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

CALCULATIONS OF A BODY SHAPE INDEX CAN HELP PREDICT THOSE AT RISK OF DYING

You don’t need a calculator to tell if you are fat. Standing naked in front of a full length mirror will do. But you do need a calculator to figure out if your body size and shape put you at risk of premature death. The new measurement, called A Body Shape Index (ABSI), requires a square root, a cube-root and some long division to predict who has a “hazardous body shape.”

And you thought stepping on the bathroom scale was scary!

This new index was developed by researchers at The City College of New York. They wanted to overcome weaknesses in the other measurements now used by health professionals to determine who, among the rapidly growing overweight and obese population, is most likely to suffer complications from their fatness. This latest tool will allow them to identify those most likely to die from their excess weight.

What Measurements Have We Used?

The widely used calculation of Body Mass Index(BMI) is based solely on height and weight. It cannot account for fat distribution or muscle mass, which can be quite different between any two people of the same height, especially a man and woman who are both 5′ 10″. It’s better at assessing obesity in populations, not individuals.

Waist circumference does a good job of identifying fat deposits around the visceral organs, but it cannot tell how tall or well-proportioned you are. A waist circumference of 32 inches may be fine for a very tall woman, but not a very short one.

What’s Different About A Body Shape Index?

ABSI is based on both BMI and waist circumference. When used to follow more than 14,000 Americans adults over five years it was better than BMI or waist circumference in predicting who would die of any cause during that time period among men, women, and blacks, but not Mexicans. It was also a reliable way to predict who was more likely to die when other factors that significantly increase your risk, such as cigarette smoking, high blood pressure and diabetes status, were considered.

Losing weight by any means will lower your BMI, and shrinking or redistributing fat deposits will give you a smaller waist circumference. Those steps will also decrease your risk of developing diabetes, heart disease, and certain cancers. What we don’t know yet is what changes are needed in the ABSI to delay dying.

While waiting for further research on ABSI, you can always take a look in a full length mirror after your next shower. It’s another good way to see if you have any body shape issues to address.

For more updates on obesity research:

Two new anti-obesity drugs have been approved this summer giving consumers more help with weight loss

3 Anti-Obesity Drugs Now Available in U.S.

This post was written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, but you can read the original post here.

TWO NEW ANTI-OBESITY DRUGS HAVE BEEN APPROVED THIS SUMMER GIVING CONSUMERS MORE HELP WITH WEIGHT LOSS

After 13 years with only one Food and Drug Administration (FDA) approved pill for weight loss available in the U.S., the agency added two more anti-obesity drugs to the arsenal in the past 30 days. Qsymia is the latest.

I covered the Belviq when it was approved last month. Before that, Xenical was the only option. It received FDA approval in 1999, then became available in a lower dose as the over-the-counter drug Alli in 2007.

What does this recent flurry of activity in the world of anti-obesity drugs mean?

To the 68 percent of American adults who are either overweight or obese (that’s more than 23 million people) it means hope. Hope that one of these drugs will help them win the battle they fight every day with overeating. They still have to learn to make better food choices and be more physically active – no pill can replace that – but maybe, just maybe, one of these prescriptions will make it easier.

Obesity is a complex disease with multiple causes. No single treatment will work for everyone. Since each of these drugs functions in a different way, one could be better for you than another.

If you tried weight loss pills in the past and didn’t get the results you expected, you may want to try again. If you’ve been afraid to try them before, keep an open mind. It’s a hard battle to win alone.

FAQ About the Anti-Obesity Drugs

How do they work?

  • Some have a single mode of action, others have a combination of effects. They may:
  • Suppress appetite
  • Increase metabolism
  • Block absorption
  • Increase satiety
  • Stimulate alertness

How much weight can I lose?

FDA approval is based on studies that show weight loss is greater using the drug than can be achieved from just diet and exercise alone. Weight loss varies for each drug and with one’s ability to comply with the diet and exercise recommendations, but range from 5-10 percent.

How long must I take them?

Each of the available drugs must be taken daily to maintain results. They are not a cure, but a treatment that must be continued for the rest of one’s life.

Do they have side effects?

As with most drugs there are risks associated with their use, but when taken as recommended the benefits are expected to outweigh any risks for most people.

Can anyone take them?

Most are approved for adults only. Some are restricted if pregnant, when taking certain medications or if suffering from other conditions. These concerns must be discussed with your physician.

Some related blogs:

  • My post on last month’s anti-obesity drug: New Weight Loss Drug Wins FDA Approval
  • Some thoughts on what obesity is not: Reflections on Obesity and the Weight of the Nation
  • Why obesity isn’t our biggest problem: Metabolic Syndrome is Worse than Obesity

 

A new study on behaviors that aid weight loss found keeping a food journal is number one

Proof: Keeping a Food Journal Aids Weight Loss

This post was written during my 2 1/2 year tenure as a blogger for Family Goes Strong. The site was deactivated on July 1, 2013, but you can read the original post here.

A NEW STUDY ON BEHAVIORS THAT AID WEIGHT LOSS FOUND KEEPING A FOOD JOURNAL IS NUMBER ONE

When it comes to weight loss, any diet that results in caloric reduction will do the job. But if you’re looking for the best results, keeping a food journal can make the difference. That, along with not skipping meals or eating lunch at restaurants too often.

Those are some of the findings from new research done at the Fred Hutchinson Cancer Research Center and published in the Journal of the Academy of Nutrition and Dietetics. The aim of the study was to identify behaviors that support caloric reduction in a population of sedentary, obese and overweight postmenopausal women between the ages of 50 and 75.

The researchers monitored 123 women for one year who were randomly assigned to either the ‘diet only’ arm of the study or the ‘exercise plus diet’ option. They looked at the impact of a wide range of self-monitoring strategies, diet-related behaviors and meal patterns on weight change in the subjects.

At the end of the study participants in both groups lost an average of 10 percent of their starting weight. But those who kept food records lost the most — approximately 6 pounds more than women who did not keep records.

Skipping meals also affected results. Women who skipped the most meals lost about 8 pounds less than those who did not skip. Going out for lunch was another behavior that impacted weight loss. Those who ate lunch out in a restaurant at least once a week lost about 5 pounds less than those who went out for lunch less often. Eating out regularly for breakfast or supper were also linked to less weight loss, but lunch had the biggest difference on weight.

This research reinforces something I have seen work over and over again in my clinical practice. Throughout the 25 years I was seeing clients, those who keep the best food records lost the most weight and kept it off the longest – women and men, young and old alike. I’ve included this advice in my blogs, too.

Where you keep your record does not matter. It can be done in a simple blank note pad or detailed food journal template, in a computer tracking program or voice activated phone app. What matters is what you report.

Tips for Keeping a Food Journal

Honesty: Record everything you put into your mouth and swallow. Don’t leave out anything whether it was just a nibble or had no calories, like a diet drink. Make it your goal to record everything you eat and drink, period.

Accuracy: Get quantifiable information about the amount you are eating or drinking whenever you can by measuring or weighing the portion you take, counting the items, or reading the label to determine what is the serving size. The more you do this, the better you will be at estimating when you have to.

Thoroughness: Include descriptive information about how the food was prepared, what condiments were used, any sauces or gravy added, and any special features such as low fat, reduced sodium, sugar free, etc. Ask questions when eating out if you’re not sure how something was made or what it was made with.

Consistency: Continue your record-keeping when you are away from home so you can enter information as soon as you eat or drink something, even if you must use the back of a receipt until you can transfer it to your permanent record. Don’t rely on your memory.

I have been keeping a food journal every day since I was in college studying to become a dietitian and my weight has not changed other than when I was pregnant. Has anyone else been keeping a food journal that long?

Use these checklists to see if you are developing diabetes

Are You Developing Diabetes?

This post was written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, but you can read the original post here.

USE THESE CHECKLISTS TO SEE IF YOU ARE DEVELOPING DIABETES

One of the biggest threats of gaining 20 pounds is the increased risk of developing diabetes. Twenty pounds is all it takes to go from a healthy body mass index (BMI) of 21 to an unhealthy one of 25. That is the point on the BMI chart when you are considered overweight.

Being overweight is a risk factor for developing type 2 diabetes in both children and adults.

Why the Disconnect Between Overweight and Diabetes?

When I was in private practice, many of my new clients who had gained 20 pounds came in saying they didn’t like the way they looked or how their clothes fit — as if that was all that was at stake. When I was writing The Wedding Dress Diet, many of the brides-to-be I talked to admitted they would probably gain 20 pounds after they got married — as if it didn’t matter.

Obviously, the connection between being overweight and diabetes had not hit home because whenever I asked anyone how they felt about getting diabetes, they shuddered. Being a little pudgy was one thing, having diabetes was quite another.

Sadly, the message still has not sunk in. Nearly 26 million Americans now have diabetes and three times that many are pre-diabetic – people with elevated blood glucose levels that are not quite high enough to be diagnosed as diabetes. That’s 75 million people who almost have diabetes!

If you or someone you know is concerned about developing diabetes, use the checklists below recognize the risks and warning signs, then get the help you need to prevent or treat it.

Who is At Risk of Developing Diabetes?

  • Overweight or obese with a BMI of 25 or higher
  • Waist circumference greater than 35 inches in men and 32 inches in women
  • Woman who had gestational diabetes or gave birth to a baby weighting more than 9 pounds
  • Low HLD cholesterol of 35 mg/dL or less
  • High triglyceride level of 250 mg/dL or more
  • High blood pressure of 140/90 mmHg or greater
  • Family history of diabetes in parents or siblings
  • Low physical activity level of exercising less than 3 times a week

Early Warning Signs of Diabetes

  • Blurry, clouded vision – once blood sugar is lowered, vision returns to normal
  • Increased thirst and hunger – not satisfied after drinking or eating
  • Frequent urination – 20 or more times a day
  • Always tired, weak, fatigued – even after sleeping since cells can’t get the energy they need
  • Sudden, unexplained weight loss –the body is breaking down muscle and fat for energy

Tests Used to Diagnose Diabetes

  • Fasting blood glucose: 126 mg/dL or greater on 2 separate tests. Blood sample is taken after not eating or drinking anything for at least 8 hours, but not more than 16 hours
  • Casual blood glucose: 200 mg/dL or greater. Blood sample used is taken at any time regardless of last meal
  • Glucose tolerance test: 200 mg/dL at the 2-hour reading. Blood glucose is tested after fasting, then a sweet liquid containing a known amount of sugar is consumed and blood glucose is tested periodically for up to two hours.
  • Glycated hemoglobin (A1C): 6.5% or greater. Used to tell blood glucose control over the previous 2-3 months.

Goals for Treating Diabetes

  • Maintain blood glucose levels as close to normal as possible with changes in diet and exercise and, if needed, medication
  • Lose at least 10% of body weight to improve symptoms, maintain a BMI of 25 or less to eliminate diabetes

Dietary Objectives for Diabetes

  • Eat meals and snack at the same times every day
  • Distribute total calories evenly among meals, don’t skip meals or eat just one or two big meals
  • Increase soluble fiber content in meals from oatmeal, oat bran, beans, lentils, barley, flax seed, nuts, apples, pears, oranges celery, and carrots.
  • Control the type of carbohydrates eaten by choosing “whole grain” breads and cereals over refined grains, raw and cooked vegetables and whole fruits instead of juice.
  • Limit the amount of carbohydrate to 45-60 grams per meal, including carbohydrates from added sugars
  • Pay attention to all of the ingredients in “sugar free” foods and those made with sugar substitutes
  • Use healthier fats and oils, such as olive and canola oil, and limit saturated fat and trans fat to reduce heart disease risk

See these related stories on diabetes.

  • Fast Eaters Have Greater Risk of Diabetes Than Slow Eaters
  • A Secret Weapon to Help Control Diabetes: Barley
  • Tired All the Time? 11 Reasons Why (Besides Lack of Sleep)

Reflections on Obesity and the Weight of the Nation

This post was originally written during my 2 1/2 year tenure as a blogger for Health Goes Strong. The site was deactivated on July 1, 2013, so the post has been reproduced here.

A REGISTERED DIETITIAN’S VIEW OF OBESITY CONTRASTS WITH HBO’S WEIGHT OF THE NATION

While awaiting the heavily promoted premier of the HBO documentary, Weight of the Nation, I took the time to reflect on what I have learned about obesity in my 35 years of experience treating people who are overweight or obese. It just so happens my career spans the same trajectory as the epidemic, but I’m pretty sure I am not to blame!

Much has changed in this country since the mid-1970’s when obesity rates began to soar, and it all matters. But it is also true that no one thing is more important than any other in bringing about this unprecedented weight gain among Americans of every race, class and region.

I cannot offer all the mind-numbing statistics, frightening graphics, and challenging expert opinions of a high-tech television production, but I can tell you some things that need to be said.

What Obesity Is Not

All obesity is not same. Every person who reaches the benchmark to be classified as obese got there in his or her own way. It’s the result of a complex interplay of personal biology, environment, and lifestyle, where no two situations are exactly the same because no two people are exactly the same. This becomes even more apparent as the epidemic spreads around the world.

Obesity is not curable. There are many different factors that play a causal role in developing obesity and there no cure for it. Once you become obese, you must spend the rest of your life treating it or risk becoming even fatter or dying of the chronic diseases that accompany it.

 

Obesity is not easy to diagnose. Weighing a person and measuring their height is easy. Using those figures to calculate body mass index (BMI) is also easy. But deciding if someone is obese based on their BMI is not. More sophisticated measurements are needed to determine what the percentage of fat is in the body and where it is located to fully understand whether someone is at risk due to their body size and composition.

 

Obesity is not easy to prevent or treat. The best advice medical science has to offer as a means to prevent obesity is to maintain a state of “energy balance.” That advice is difficult to follow. It requires knowing precisely how many calories you consume every day (over a lifetime) and how much energy you expend every day to offset them. These are intangible values. Once you become obese, you are expected to create an energy imbalance by expending more calories than you take in. Only at this point, your body has a whole new way of dealing with energy that defies the mathematics of using calorie control to achieve weight control.

Obesity is not a plague. Obesity spread very quickly in the last three decades, but it is not a scourge that must be routed out by any means possible. Drastic measures have been proposed to “fix” the way we grow, distribute, and sell food in this country, while the obese have been scrutinized, marginalized, and penalized for their weight. In the panic to find a solution we have lost sight of the fact individuals become obese and it is individuals who need help dealing with it.

I hope I can look back 35 years from now and reflect on all that we learned about obesity to lift this weight from our nation.

 

Parents can play a major role in preventing childhood obesity

Childhood Obesity: 5 Things Every Parent Should Know

This post was written as a guest blog for Family Goes Strong. You can read the original post here.

PARENTS CAN PLAY A MAJOR ROLE IN PREVENTING CHILDHOOD OBESITY

Childhood obesity has more than tripled in the United States over the past 30 years. It affects children in every state and from every socioeconomic group. As of 2008, more than one-third of children and adolescents in the U.S. were overweight or obese.

When a problem becomes that prevalent there is a danger of not taking it as seriously as we should. But the risks of obesity are too great to ignore. Preventing excess weight gain in children may be the most important way we can protect their health and quality of life.

With more than 30 years of experience helping families deal with childhood obesity, I know there is no simple solution to this problem. But there are some things every parent should know as they consider their options.

5 Things You Need to Know About Childhood Obesity

1. Your child’s relationship with food is established in the first five years of life

When solid foods are first introduced to a child between the ages of 4 and 6 months, they begin their relationship with food. For the next year parents must learn to interpret the subtle signals their children use to express how hungry they are and what they like until they can tell you themselves. The goal is to allow the child’s internal sensation of hunger to govern how often and how much they eat. Their evolving taste preferences should allow them to accept and refuse different foods without threat of punishment or reward. If this is done consistently, in an eating environment where no bias or judgment is expressed about any food, children will grow to trust their feelings of hunger and appetite by the time they start school.

2. What is eaten at home is more important than what is served at school

Children spend far more time eating at home or out with their parents than they do in school. What children experience during meals with their family is far more important than the institutional feeding that goes on in schools. If parents don’t like the selections available on school menus, they can pack a lunch for their child to eat instead. But if a child is being exposed to new foods in the cafeteria that are not available at home, they have no choice but to eat what is served at home.

3. Weight loss in parents is the biggest predictor of children’s weight loss

A recent study looked at 80 parent-child sets with an overweight or obese 8-12 year old in each. The participants were assigned to one of three different programs to help their child lose weight. Features of the three programs included having the parents change the home food environment, limit what the child ate, and lose weight themselves. The researchers found parents’ weight loss was the only significant predictor of children’s weight loss. These results are consistent with other research showing how important the example set by parents is to successful weight loss in their children.

4. Genetics are a factor in obesity, but age of onset is more important

There is no test we can take at birth to tell us who will become overweight or obese as an adult. If one or both parents are obese, that does increase a child’s risk of also becoming obese, but it is not inevitable. Research from the Children’s Hospital and Medical Center of Cincinnati found that being obese during the teen years is a stronger indicator of who will be obese in adulthood than being obese in early childhood, regardless of whether the parents were obese. Preventing obesity in adolescents is one of the best ways to prevent obesity in adults.

5. Treat overweight and obesity in your child as a health concern, not an image problem

All children need to learn how the food they eat and their level of activity can affect their health. The conversation should be the same for an overweight child and one who is not, just like talking about the importance of wearing seatbelts and getting immunized. When the focus is on staying healthy, not appearance, your child is less likely to develop emotional issues about their weight.