Childhood Obesity: Our Growing Problem

Excerpted from
Slim& Fit Kids; Raising Healthy Children in a Fast-Food World
By Judy Mazel, John E. Monaco, M.D.

I am a pediatric critical-care physician. This means that I spend my days, and often nights, in a pediatric intensive care unit. Here I take care of children who are severely ill, whose simple cold has advanced to pneumonia, or whose diarrhea has advanced to dehydration and sometimes shock. In the course of dealing with these problems each day, I see more and more children whose weight is out of control and out of sight. If the fat kids I see are not physically ill because of their obesity, then they are in emotional pain because of it. In many cases, both are true.

The epidemic of childhood obesity is not a recent revelation to me. This problem has frustrated me for years. I have tried to talk to parents, but many are in denial, afraid people will think it's their "fault" that their kids are overweight. So they simply accept it or try to rationalize the problem away. ... "I was a fat kid, too" or "Our whole family is big" are statements I often hear from parents who have decided to accept a situation they feel powerless over. . . . sometimes without even trying to fight it.

My colleagues in general pediatrics feel equally helpless in dealing with childhood obesity. "Kids are just getting fatter," they say. They blame junk food and TV and lack of physical education in schools. It is a complicated problem that they have not been trained to solve. In resignation, many say that it is only a cosmetic problem, whose medical effects will only be felt in adulthood.

Anyone who feels this way is missing the point. Any doctor, or parent, who refers to childhood obesity as simply a "cosmetic" problem needs to walk in my shoes for a few days. If they saw the situation from my perspective, they would see that fat can truly be life threatening. Day after day I see grossly overweight, asthmatic kids struggling to breathe . . . newly diagnosed diabetics, some with the adult form of the disease. I see young boys and girls so shy and lacking in self-esteem that after years of obesity they've shut themselves off from the joys of life.

Then there are the other children. Children whose lives may not be threatened, but their health and sense of self-worth are in peril because of their weight. Girls with bulging middles and wide backsides. Boys with double chins and breast development. When other children-and even parents and teachers-joke about their size, the kids themselves sometimes laugh along with them, in self-defense. But I know this is not sincere laughter. I know that inside their hearts are breaking.

They don't want to be fat, and they don't know why they are fat. They just know that one day they looked at themselves in the mirror and realized they were not like the other kids. They wonder why little Erica has a flat belly and slim legs, while they are all jiggly. They wonder what they could have done better, or what they did wrong. They want help, but no one seems to care. Well, I want you to know that I care, and now I have a solution, and with your help we are going to solve this problem and give these children their lives back!

Why do I care? Primarily, it's because children are my life and treating their pain and misery is my profession. But equally important . . . I've been there. I was a fat kid, too.

The Fat Kid: Facing Up to My Past

Fat oaf. That's what my family called me. Some still do. It was my identity. Like the overweight kids I work with, being fat was who I was. My weight dictated everything I did, or wasn't successful at doing. I was a scholastic "nerd" because I couldn't play athletics, date girls, wear cool clothes or hang out with the popular kids. Unless you've been there, you will never understand. Even now that I am no longer physically fat, I still think of myself as fat.

Even my mother still doesn't miss an opportunity to recount my transformation from a kid who was skinny as a rail until age nine-when my tonsils were taken out-to a fatty, forever relegated to shopping in the "husky" section for clothes. She doesn't mean anything by recounting these stories. To her they are endearing. But then, she was never a fat kid.

As far as the physical effects of being an overweight kid, I required knee surgery when I was fourteen, supposedly as the result of a football injury. Given how much I sat on the bench, this "injury" probably had more to do with my fatness than with my prowess as an athlete. My elevated blood pressure was first detected when I tried to donate blood in high school. The very first time my cholesterol was checked as a young man, it was elevated. Despite my strong family history of early cardiovascular death, I denied these symptoms . . . because to acknowledge them would require acknowledging the underlying problem. I was fat. Until I finally faced up to and combated my own weight problem, I avoided blood pressure cuffs and bathroom scales like the plague.

Still, these physical effects were nothing compared to the psychological trauma of being a fat kid and then a fat adult, and that trauma is still with me today, although the scales say otherwise. My battles against self-consciousness, insecurity and inferiority began in childhood. They were probably at their worst in junior high school, when everything is changing. At this age, kids are labeled by their peers, even their parents. There's the smart kid, the jock and the popular kid. My role, of course, was the fat kid. Deep inside, I still carry that label today.

Fat kids were the minority when I was growing up, but today more children than ever before are living with this stigma. The problem of childhood obesity has never been worse ... at least one-third of all young people are now overweight. Yet, despite this growing problem, no meaningful solutions have been offered. Now that I have discovered a solution, I hope to change that. I have made it my mission to separate those two words-fat and kids-forever.

My Path: How I Discovered the Solution

Not long ago, I had resigned to being forever fat. I had tried everything. I'd read all the books on nutrition, heart disease, obesity and exercise. I'd jog every day, starve myself, lose a few pounds, get really excited . . . and then gain it all back, and then some! When I felt really desperate, I even considered those canned liquid diet supplements. I knew they were useless, and in some cases even dangerous, but I was desperate. Still nothing worked.

I had to make a choice. One possibility was a life of monastic deprivation, denying myself all the culinary joys that I had ever experienced combined with five miles a day on the treadmill. Or I could accept being fat-forever-and continue partaking of the things in life that gave me joy. Realizing that my wife and I were raising two children, with trips to Disney World, birthday parties, fast food and all the rest, the life of a monk simply was not going to happen. And since one of the few rewards we give ourselves is an occasional night out at a nice restaurant, there was not much we could renounce without eliminating the joy of life altogether.

So I threw in the towel. Getting thin was beyond me. There was a force behind this problem that was beyond my comprehension or my control. If I couldn't help myself, how could I possibly help the kids in my practice who suffered from obesity?

Then one day my being fat became more than a cosmetic concern. The blood pressure and cholesterol problems I had always ignored finally caught up with me. On a routine insurance physical shortly after my forty-second birthday, my cholesterol was 300 and my blood pressure was 150/90. Although I am only five-feet nine-inches tall, my weight had ballooned to two hundred pounds. I was forced to accept reality. Not only was I still fat, but I was also officially unhealthy. Now I had to do something-but what?