Wednesday, January 31, 2001
Rate of obesity in kids zooms
By ANNE GEGGIS | News-Journal Staff Writer
DAYTONA BEACH — With figures – and body frames – showing that the number of overweight children and adolescents has doubled in the last two decades, doctors straight up to the U.S. Surgeon General have declared obesity an epidemic.
New weapons are being fashioned to fight the fat on miniature troops. The Surgeon General this month announced a national plan to systematically attack America's expanding problem. The Centers for Disease Control, in an effort to identify weight problems before they become more obvious, last year published a new pediatric growth chart. It includes body mass index, a number that had previously evaluated only adults' weight in relation to height.
And, more controversial than those efforts, pharmaceutical companies have begun testing adolescents on weight control drugs, now approved only for adult use.
So far, though, enthusiasm for the proven cure – better eating and regular exercise – appears to be extremely limited. Halifax Medical Center's Shape Down program – which involved parents and siblings in the weight loss effort of a child or teen-ager – was shut down for lack of interest. In that, Dr. Steven Sahai sees the heart of the problem.
"The apple doesn't fall far from the tree – we have children couch potatoes," said the director of pediatrics at Memorial Hospital in Ormond Beach, whose patients include a 7-year-old weighing 196 pounds. "When you look at the parents, they usually have a lethargic attitude about it. So, if you put a kid on a diet and dad's eating Doritos while the kid is eating a carrot, that's going to last about four days."
Andrea Aberman, a Spruce Creek High School junior, blames "eating all the time," and genetics for the realities she copes with – weighing 250 pounds at 5 feet, 8 inches tall.
Weightlifting, ballet and modern dancing helped her lose 30 pounds that she's kept off for the past year. But she said she's decided to ignore the societal prejudice against bigger people and the jibes that became particularly cutting in middle school.
"I really hated myself until a year and a half ago, when I realized that no one's going to love me until I love myself," Aberman said.
The long-term results of extra weight are serious, however. Obesity carries with it an increased risk of arthritis, high cholesterol, cancer and high blood pressure.
Even more alarming to health professionals, childhood obesity has also been linked to a disease previously limited to people over 50 – Type 2 Diabetes, which can ultimately lead to blindness and death. This kind of diabetes – considered avoidable in many cases – has been reported in teen-agers.
"A large number of overweight children go on to become obese adults and therefore develop all the terrible co-morbidities that go along with obesity," said Dr. Raul Zimmerman, medical director of the weight management program at Halifax Medical Center.
Why Americans have unprecedented weight problems at a time when science has never known more about food has many layers, according to Zimmerman and others. First, the human body was designed to store fat to ensure survival through food shortages until the next harvest or successful hunt.
"For the first time in human history we have a large number of people who have access to quantities of high-fat food all through the year," Zimmerman said.
Colliding with that reality, hectic modern lifestyles don't do much to encourage exercise and home-cooked, low-fat meals, the experts say. Convenience foods and snack foods have become much more alluring and accessible to kids hanging out at home alone while both parents are working.
Added to that, stranger fears have kept kids off the playground and pushed them indoors in front of the video game play station or television. And, finally, school cutbacks have reduced daily physical education class to a weekly occurrence.
"Kids are consuming more calories and exercising less," said Kim Koevenig, a registered, licensed dietitian as well as a certified diabetes educator. She was part of the Shape Down team at Halifax that included a dietitian, an exercise physiologist and two behavior therapists.
"My gut feeling is that we should find ways for kids to increase their activity and teach families to prepare quick, low-fat foods and make wise choices when they go out to a restaurant."
Too many, she says, "get sucked into supersizing everything just because it's a better deal money-wise."
Concerned about the damage to her grand-daughter's self-image, Jeanne Bunch of Holly Hill brought 8-year-old Emily to a nutritionist as soon as she heard the girl had suffered insults about her weight from other children at school.
"Because of her genes, she could tend to overeat," Bunch said. "She was starting to get a little chunky."
The probability of overweight children becoming obese adults – with the attendant medical problems – has led to testing the nation's two weight-loss prescription drugs Xenical and Meridia on adolescents. It represents a break in the long-held taboo that children shouldn't take such drugs.
"We're seeing an increase in the number of obese children to the point that it's frightening," said Dr. Ken Fujioka, director of Nutrition and Metabolic Research Center at Scripps Clinic in San Diego, Calif., which is conducting a trial of Xenical. "We need to look at other methods besides diet and exercise."
Xenical works by reducing the absorption of about one-third of dietary fat – and some vitamins. Meridia works on the brain's neurotransmitters, affecting the chemicals in the brain that regulate appetite. It's unlikely that they will be widely available to adolescents before 2003.
Carol Elliot, a licensed and registered dietitian in Ormond Beach, is adamant, however, that if ever there's a time to change habits – instead of relying on a pill – it's during an individual's youth.
"These are kids," she said. "They still have the rest of their lives ahead of them. They need to learn how to do the right thing."
Halifax's Zimmerman, however, said he's open to the possibility that medication might be a last resort. For the nation to overcome its obesity problem, he said he believes some kind of a cultural revolution is necessary.
"We reward our children with a Furby for ordering a high-fat Happy Meal, instead of rewarding them for eating broccoli," he said. "We can't give lip service to wanting to take care of this while putting soda machines in the schools and having the fast-food companies spend billions of dollars on advertising fast food for kids.
He said the solution to America's gaining problem among children lies in the same kind of pivotal changes that have decreased smoking rates.
"It's not that our treatments have become that much better -- the culture has made smokers feel less welcome in society."
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