Desperate measures

Have you seen the anti-childhood obesity ads from Georgia?

With 40% of the kids in Georgia overweight or obese (only Mississippi is worse), health advocates decided that it was time for “a wake-up call.”  So the Strong4Life campaign and Children’s Healthcare of Atlanta have released print and TV ads with obese kids and slogans like “It’s hard to be a little girl when you’re not.”

Ouch. I mean, really. Imagine being on a playground and having some kid point at you and say, “You look like the fat girl on TV!”  What were they thinking?

Actually, I get what they were thinking. It’s a desperate-times-call-for-desperate-measures thing.

We do need a wake-up call. It’s not like Georgia is the only place with a childhood obesity problem. Nationwide, a third of US kids are overweight or obese, and studies show that overweight kids tend to grow up into overweight adults. Being overweight brings with it a higher risk of health, emotional, and even financial problems. That’s not what we want for our children—of course it’s not.

So we just tell people to eat less and exercise more, right? After all, weight gain or loss is an energy equation. If you take in more calories than you burn off you gain weight—take in fewer calories or burn off more of them, you lose weight. Simple stuff, no problem, right?

Wrong. Big problem.

I’ve been doing primary care pediatrics for twenty years now. I have helped all sorts of kids with all sorts of problems get better.  But obesity is one problem I can’t seem to make better. I’ve been feeling pretty desperate myself.

I’ve tried everything. We talk in detail about foods they should and shouldn’t eat and drink. I give them recipes and shopping lists. We make specific diet plans. We make specific plans for exercise, thinking together about what’s easiest and most fun. I try to make all the plans with them instead of for them, setting small goals, so that everything I ask them to do is realistic. We talk a lot about why it’s important to be at a healthy weight, and why being overweight is bad for them. I connect them to nutritionists, weight loss programs, community resources, exercise programs, psychologists and anyone else who might help. I see them regularly to check on their progress and try out new ideas.

And for the most part, I get nowhere. Really. It’s amazingly discouraging. I feel like a failure as a doctor—and I feel desperate about the future of my patients.

Part of the problem (by no means the whole problem!) is that many families don’t take things seriously enough, no matter what I say. They think it’s baby fat that the kids will grow out of. Or they don’t even think the kids are overweight, often because the entire family is overweight; it seems normal to them. I guess it’s this stuff that the folks in Georgia were trying to tackle with the ad campaign, and I applaud them for trying to do something.

But no solution should involve shaming children.  That’s taking desperation too far.

People say it’s like the gross pictures on the cigarette labels, meant to shake people up and make them rethink their habits. But the ones who really need to rethink things are the parents. Maybe pictures of obese adults, with captions like: “this is your kid in 10 years if you don’t start making changes now,” would be better. Same message, no shaming of children.

These really are desperate times, and we really do need desperate measures. We desperately need more safe outdoor and indoor spaces for exercise.  We desperately need affordable healthy foods. We desperately need more afterschool programs and other supports for families who are working so hard to make ends meet that they truly don’t have time to take their kids to the park or make healthy home-cooked meals. We desperately need to get people to shut off TV’s and other screens. We desperately need fast food to be healthier (we can’t stop people from buying quick, cheap food). There is so much we desperately need.

We do not, however, desperately need to make children feel shamed.


For information on what Children’s Hospital Boston is doing to fight childhood obesity, visit the website of the Optimal Weight for Life (OWL) Program and read about the Fitness in the City program as well as about our advocacy efforts, such as working for better school nutrition.

7 thoughts on “Desperate measures

  1. This was very well said.  I especially like: this will be your child in 10 years.  I was not heavy until my 40’s, when I married in the 70’s I was ools, get organizations to sponsor them, they are fun and reduce all over.105 by  96 I was 150 by 2005 235 I am now 140 and can wear a size 10.  I give credit to Biggest Loser because they show us all it can be done and theclass that helped me the most was ZUMBA.  get these classes in the sch

  2. Obesity requires a change in society.  Hopefully in 10 years, feeding your child junk food will seem as alien as letting your child ride in the car without a seat belt does now.  I have a blog

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    nutrition to help parents teach their children to love the taste of healthy
    foods.  Here is the URL: .  

  3. Great post, Dr. Claire.  As a mother and healthcare professional, I think we need to treat the emotional wellbeing of every child in addition to his or her physical health.  Any discussion of healthy eating habits and weight should be done with extreme sensitivity.  What happens when a child becomes so focused on what he eats that it leads to an eating disorder?  This is delicate territory and the ad above, in my opinion, is brazen and disrespectful of the little girl featured.

  4. I am overweight, more like obese if I am going to be honest. I KNOW its not okay and I am doing everything I can to loose weight. My daughter is 10 months old and eating EVERYTHING now. It’s helping me a lot. I don’t want her to be like me when she’s older. I spend all my time researching healthy foods we can eat together. So far I’ve cut out all junk food and done simple things like switch to selzer water and all natural no sugar added peanut butter and cut out white bread because its just a spongy form of white sugar. We eat fresh fruits and lo fat soy yogurt for breakfast and lean grilled chicken breakfast and steamesd veggies for lunch. I hope to teach her that eating heathly an exercising is the only acceptable way of life and that junk food is an occasional treat. After all if you put crap in you get crap out.

    Claire, I hope this makes you feel better. Some of us out there are listening. If one person listens and they get one other person to and so on the world WILL change. It’s just going to take some time. =]


    1. It does make me feel better!  Good luck to you, Amanda.  You are doing all the right things.

  5.  “Knowledge is necessary, but not absolute for behavior change”. In my experience as a Health Education Specialist, many of the individuals struggling with obesity already possess the knowledge regarding what foods to eat, the importance of exercise and living a healthly lifestyle. The medical and health science professions have been phenomenal with research, education and supporting individuals. I have found, even with myself, that individual behavior change is one of the most difficult aspects of obesity to overcome. No one person can make a another person change. It comes from within. Assessing where the individual is regarding their readiness to make a change is extremely important. Behavior change theory can be helpful (personally, I like the Stages of Change theory or Transtheoretical Model). Planning long term goals with short term objectives, motivational interviewing, and health coaching can help. I think Julia’s post is very important as well. Specifically to our society, it enables not only obesity, but many other health related issues as well (smoking,video games,fast food restaurants to name a few).   

  6. It’s a great post, however I feel very strongly that poor choices are too easy to make.  When I went on my own weight loss journey, I had to say no not just every day to poor choices, but NUMEROUS times a day!  I had to say no to those commercials for fast food or decadent chocolate everything that were always in my face.  I had to re-teach my 5 year old that sugary cereal was a poor choice and chocolate milk every day 3x a day is bad for him.  I had to drive past the 12 fast food restaurants within a mile radius from my house and make the choice to keep driving no matter how stretched for time I was.  On top of making choices to say NO to poor food, I had to choose to say YES to what would fuel my body and to say YES to sweating, hurting, working, fighting to hold on to my own self worth and become a role model that my children could look up to.  These values are not seen anywhere in our society.  PERSEVERANCE is unheard of in our society of quick fixes and easy ways out.  People need a reality check.  It is the sad truth.  Now, that the bad habits are under control, I do spend more each week on groceries which is another huge problem for many people struggling to put even basic food on the table.  This is a problem that requires many small steps and will take many many years to reverse.  I commend every effort you are making and encourage you to continue to chip at this huge mountain stone by stone if necessary!

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