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Once obese, always obese: Can we prevent it in the first place?

At the turn of the year, we love to make resolutions.  Many might like to make resolutions of the health variety: I resolve to eat better, I resolve to exercise more, I resolve to lose weight.  A few weeks might go by, and our resolutions might slip.  In fact, over a third of resolutions are broken by the end of January.

Then, there is a twist.  On January 1st, the NYT ran an article discussing new studies in the realm of obesity: once obese, are we always obese?  Some studies show that we can get stuck in a fat trap, once fat.  Obese individuals who successfully lose weight will only regain all that weight (and more, possibly) in due time.

Depressing?  Yes.

What can we do about it?  Well.  There is much focus now on "upstream public health", tackling the root of the cause, preventing the fatness before we even enter (and get stuck) in the "fat trap".  This got us thinking about programs that affect our children, making sure that programs are designed to keep them active, to make sure they have access to healthy food, to help them be safe when active.

We live in a busy, complex world.  Our lives can be overwhelming.  How can make living a healthy lifestyle easy for people of all socioeconomic backgrounds, races, etc in our modern world?  Our lives are complex, and the environments that shape our health behaviors are too.  Work, school, urban or rural infrastructure all of these these can attract us to or deter us from eating more fruits and vegetables and moderate exercise.  How can we make this utopia of walkable/bikable cities with access to affordable fresh produce for all a reality for all?  What do we, as parents, see to be barriers to that reality?  What do the experts think we can do to change?  What are your top priorities for change?  What do you do in your day-to-day life as small steps toward keeping the family healthful?

* Keep the conversation going at a screening & panel discussion of "Fat, Sick & Nearly Dead", next Monday, January 23, 6-9pm at Living Room Theaters.  100% of proceeds of the $35 ticket go towards EcoTrust's Farm to School program.

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"Once obese, always obese" seems to also reflect the mind set of a person: Once you start having problems with your self image and food, it's as hard to make the change in your mind as it is in your diet.
Your own mind can be more vicious than the DB in the bar or your best frenemy.
Making mental peace or getting into a good place is as important as shedding the pounds if you want to keep them off!
(Still working on that!)

Martina, I agree. Love the skin you are in and then try to slowly make better choices for yourself. Self-love and self esteem is key.

Here is an interesting, open and honest perspective relating to the issue:

http://wweek.com/portland/article-18663-confessions_of_a_chu.html

That WW author was a total jack wagon if you ask me. Being obese might be a factor of choices for some (like it was for him), but it's far for more complex than that for many. In my case, it's a brain issue that simple willpower can not conquer. I know exactly what I need to eat and how much I need to exercise. I know that eating more calories than I burn will cause me to gain weight. I know that my high cholesterol is putting me at risk for heart disease. I know that if I want to be around to meet my grandchildren, I must drop weight. An obsession with food and compulsion to eat when I am not even hungry are the reasons I am obese. I suspect there are a myriad of other factors for others.

Typical that it was written by a man! It's so much easier for men to drop massive weight than women! Income level, your education, etc. also greatly plays a role in weight. Ask a single parent with no car who lives in a food desert how easy it is to drop weight. For certain populations of people weight loss (and not gaining in the first place) is much easier--i.e. the more money you have, the less likely you are to be obese. America needs to start looking at obesity as a class issue and an issue around privilege and not just about lazy people who choose to eat too much.

JC...hear hear.

Calories in=Calories out, pretty simple. However, I do think that once someone is obese it is harder to manage that equation or to permanently adjust attitudes about food which may lead to the once obese, always obese comment. I don't discount that it is more difficult for some to stop eating and that there are differences in metabolism, but that is why we need to make sure children recognize the importance of exercise and healthy eating and being good examples. As parents it is our job to teach our children that food is fuel and not a reward. Parents that allow their children to overindulge to the point of obesity are setting their children up for physical and psychological challenges that are absolutely unnecessary and frankly make me sad for those children.

We moved to Oregon from the Midwest and lived in an inner city neighborhood for a year in northwest Indiana (Chicago suburb). It was amazing to me how many of these lower income single moms did not know how to cook for their children and lacked nutritional knowledge. Many of them had Mc Donalds every single day and ate from the work vending machine 2-3 times a day. It makes sense because it's quick, easy and so accessible. I know obesity is a problem here (and is everywhere) but I am encouraged by all the community gardens, cooking classes, and recreation events for kids (like kid's running races). We did not have that back in the Midwest.

"It was amazing to me how many of these lower income single moms did not know how to cook for their children and lacked nutritional knowledge."

I'm sorry...what?

Amazing? Probably not the right word. Frustrating...baffling..concerning? At any rate, I had the idea of setting up free cooking classes on my lunch hour...but the idea unfortunately never surfaced.

I think parents, no matter the neighborhood, can most likely cook for their children. The combination of low pay/long work hours, transportation issues, the high price of healthy food, a lack of stores being willing to locate in some neighborhoods, and more, may conspire to prevent families from being able to create the ideal menu. Unfortunately, those problems are a more challenging to solve than a offering a cooking class, as generously offered as it may be.

i don't think a cooking class is a bad idea at all. no single answer solves all problems, but gathering together and supporting parents in sharing information about meal planning, shopping, and cooking is such a practical concept.

we can't assume people DO know how to cook any more than we can assume they do not know how. previous generations had home ec classes, but those are long gone, and current generations have much less exposure to passing along cooking techniques than previous ones did. going through the drive through at mcdonalds SEEMS easier than cooking at home, because experience makes it appear easier. buying a whole chicken and throwing it in a pot one night and then eating from it for several days in a row (if you are a meat eater) is cheaper, easier, and healthier. if someone felt like they knew what to do with a raw, whole chicken, i think they would be more inclined to choose that option, with some support and a few simple ideas to make it all more appealing.

I simply wouldn't assume that mothers in a poor neighborhood would be unable to cook any more so than any women in any other neighborhood.

kt your posts are really spot on. Thank you.

I think a good way to address this for kids (and for adults) is to focus on fitness instead of weight. Don't comment on your kids' weight one way or the other unless it is a serious health concern you've discussed with a pediatrician. Do structure your family to encourage activity. It does not have to be organized sports or even Parks and Rec classes. Wrestle with the kids, send them outside to run around if they're moping inside, go out for a walk after dinner instead of settling onto the couch with the TV or books, if possible hang out on the playground after school, encourage games inside that are running and jumping and dance oriented for toddlers (you don't need much space for a toddler to run around compared to a 12-year-old). Help kids be active, don't keep junk food in your house . . . you'll be setting your kids up for success even though they'll still have to confront food marketing and screen-related temptations to be sedentary.

For adults, the worry that once we're obese we're stuck hits close to home, but I think that again, focusing on fitness is a reasonable approach. I am overweight. I don't know if I will ever be able to lose weight (and keep it off) to bring myself down to what most would consider an appropriate weight. But I can be overweight and not fit, or overweight and strong/fit. I'm betting that the second option is healthier. So while I weight more now than I did in college, I am also much stronger. I would encourage overweight adults to set goals that are not related to numbers on a scale. How much can you bench press? How far is it comfortable to walk? How long do you want to stay on the dance floor at a wedding? If you're active and fit and strong and that focus causes you to lose weight, that's a bonus. But I would hate for people who are overweight to get the message that the situation is hopeless and there's nothing they can do to improve their health simply because they're already overweight.

That WW article was so smug and condescending. And I am saying this as a woman who, when I gave birth to my 3rd child, weighed 298lbs. (Yes, that is a "2".)

Through a combination of babywearing (I walked an average of 120 blocks/week while wearing the child) and just eating less, I ended up losing about 135lbs. It took about a year to lose the weight, but it has been almost 4 years and the weight is still off. People I first met while I was heavy often don't recognize me now.

I basically lost weight the same way the WW guy suggested, but his tone was just so off-putting.

Yes, fitness is a huge part of the picture and one that I feel our society is really trying to focus on in new ways. It doesn't mean you have to run a marathon, but YES, be active and encourage your kids to be active!! I don't really feel this is as simple as cooking classes, but that (combined with fitness awareness and necessity) could be a grassroots start and it seems the poster who suggested them had the best intentions. The WW article was honest and raw, especially given the author and his past (I don't see why it makes a difference whether the author is female/male--it's still an interesting perspective). I appreciated it and listening to this view of these issues. The part that compared things to the previous view of smoking cigarettes many years ago and how much that as changed over the past few decades was extremely promising. If food/over-eating truly is an "addiction" for some, then it should/could be treated that way and accepted as something that people are working on and striving to "quit" in a healthy way, if they are willing to do so.

From the WW article: "That can’t change overnight. It will, eventually, I’m confident. Just like it did with smoking, still the country’s leading cause of preventable death but half as common as it was in the 1960s. Foods will get lighter, perhaps aided by new technology—look at the miracle of Popchips. Urban planners will build cities that get people on their feet. Portland is getting there quickly."

More from the WW article from the author's perspective: "Responsible people can’t sit idly waiting for macro change, though. For the fat, that starts by admitting your weight is a byproduct of your choices. Then it’s a matter of recognizing those choices are unsustainable. I realized if I didn’t change my life, I was going to die—but not before burdening the people I loved and our hospitals, and not before missing out on the life I could have been living."

In yesterday's magazine, the NY Times ran a letter from a group of doctors in response to the January 1 article. For those interested in more on the debate, the full letter is available here:

http://www.ipetitions.com/petition/response-to-nytimes-the-fat-trap

I would like to recommend the free NAAFA Child Advocacy ToolkitSM (CATK) and other written guidelines/resources to assist you looking at programs.

A Yale Rudd Center report reviewed existing research on weight stigma in children and adolescents, with attention to the nature and extent of weight bias toward obese youths and to the primary sources of stigma in their lives, including peers, educators, and parents. As a result of weight bias and discrimination, obese children suffer psychological, social, and health-related consequences. http://www.yaleruddcenter.org/resources/upload/docs/what/bias/StigmaObesityChildrensHealth.pdf

Rebecca Puhl of the Rudd Center further brings to light the stigmatization of large children in the following article.
http://www.obesityaction.org/magazine/oacnews7/Childhood%20Obesity%20and%20Stigma.pdf

The NAAFA Child Advocacy Toolkit shows how Health At Every Size® takes the focus off weight and directs it to healthful eating and enjoyable movement. It addresses the bullying, building positive self-image and eliminating stigmatization of large children. The CATK lists resources available to parents, educators or caregivers for educational materials, curriculum and programming that is beneficial for all children. It can be found at:
http://issuu.com/naafa/docs/naafa_childadvocacy2011combined_v04?viewMode=magazine&mode=embed

I don't think so. People make their own whether to be or stay obese or do something about it. It's up to us to make the change in our lives.

For me personally I strongly disagree on that saying "once obsese always obese" since everybody can change. Even if it's genetic we say, a person can still do something about it and start living healthy and making the right choices when it comes to what they eat. Being obese or healthy is a personal choice.

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