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.