• The IOM report on childhood obesity strategies

    This comic strip* basically sums up exactly how I feel about obesity in America. I give out Milo’s advice (complete with sarcasm) to my friends all the time. In fact, my success with Weight Watchers’ Points system years ago is likely because it just forced me to, well, eat less and exercise more.

    It sound so simple, and yet it’s so complicated. We keep trying to come up with fancy solutions to what is, in the end, just simple math.

    I was pleased today to see the IOM’s release of its Early Childhood Obesity Prevention Policies:

    The IOM reviewed factors related to overweight and obesity from birth to age five, with a focus on nutrition, physical activity, and sedentary behavior. In this report, the IOM recommends actions that healthcare professionals, caregivers, and policymakers can take to prevent obesity in children five and younger. Pediatricians and other healthcare professionals have an important opportunity to make parents aware of their child’s excess weight early on, and the IOM recommends that healthcare professionals measure weight and height or length in a standardized way, as well as pay attention to obesity risk factors, such as rate of weight gain and parental weight, at routine pediatric visits. In addition, the IOM recommends that parents and child care providers keep children active throughout the day and provide them with diets rich in fruits, vegetables, and whole grains, and low in energy-dense, nutrient-poor foods. Caregivers also should limit young children’s screen time and ensure that children sleep an adequate amount each day. What happens to children during the first years of life is important to their current and future health and well-being.

    What pleases me about this is that, once you wade through all the complicated language, it comes down to a few solid principles: Catch kids before it’s too late. Encourage them to eat better. Get them to be more active.

    In essence: “Eat less, and exercise.” Let’s figure out how to get that done.

    *If you don’t recognize this as Bloom County, then I pity you. You are unaware of one of the best comic strips of all time, and I suggest you go rectify that immediately.

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    • Ok, let’s figure out how to get people eat less…..
      Hmm, one easy way is to make them eat with chopsticks!

    • Unfortunately this answer is not useful as answering the ‘why’ question; we understand the ‘how’ question.

      Why do 1/3 of the population over-eat? Why are human populations susceptible to over-eating vs. other animals?

      The better question is why do obese people over-eat, plateau and maintain an overweight body vs. the rest of the population. If we know that answer then we might be able to formulate a better answer.

      Mind you, I’ve stolen all of this from Gary Taube’s article:

    • It makes sense to me, but the apparent simplicity of this principle seems to be at odds with the Gary Taubes view, cited in Austin’s post Why we get fat? No, really, why?

    • I don’t have the reference, but I remember reading a study that pointed out that ethnic Japanese, while not obese in Japan, become just as obese as the rest of us (I’m a WASP from New England currently living in Tokyo) when they move to the US. So I think that the Taubes/Frackt idea that it’s our genes is quite wrong. It’s our lifestyle. That said, it’s hard to _change one’s lifestyle permanently_ to a lower-calorie one. But as a 6’2″ caucasian, I’m happier at 170 lbs (current weight) than 180, and expect to be even happier at 165. But it really is hard. Still, my father was over 220 lbs and it killed him and a friend from high school is around 240 lbs and his knees are trashed and he finds walking painful. It’s pretty obvious that it’s very much worth the effort to keep one’s weight down.

      • I have not read Tabues yet beyond that one post. (Have his book, haven’t gotten to it.) At the moment, my interpretation of what he said in that post is simply that there are factors that influence why some have a caloric imbalance. Saying merely that one is fat because one eats more than one burns does not itself provide very much guidance as to why and what to do about it. We know from many, many, many studies that diets don’t work. That is, attacking the energy balance directly and considering nothing else (other lifestyle factors as well as genetic ones, perhaps), is doomed to failure.

        See also http://theincidentaleconomist.com/wordpress/the-many-spellings-of-frakt/ 🙂

        • “Saying merely that one is fat because one eats more than one burns does not itself provide very much guidance ”

          Hmm. It seems to me that it provides a lot of guidance: it tells you that you have to figure out how to reduce calorie consumption and maintain that reduced level of consumption.

          It may be really hard to reduce calorie consumption in the social context one is living in, but, again, making a permanent lifestyle change will change one’s weight. Same genes, even the same individual, living in Japan and living in the US result in very different obesity outcomes. So those other “factors that influence why some have a caloric imbalance” are all secondary (except for, perhaps, a small number of people who really do have medical issues). Since we know that the incidence of obesity is culturally determined, the vast majority of obese individuals are folks who wouldn’t be obese in another cultural context.

      • Food cost more in Japan (http://www.econtalk.org/archives/2006/09/the_economics_o_5.html). Also they are more urban and walk more in Japan.

    • It is simple, but the cultural deck is stacked against a healthy lifestyle. Walkable communities, reasonable portion sizes, even time for exercise and cooking are all things we’ve basically given up as a culture, and they all contribute to overweight.

    • I had a brother-in-law who weighed over 200 kilos (sometimes way over), and could see first hand how complicated this situation can be. He was in anguish over his weight his entire life, and was desperate to find a solution. His only successful (temporarily) strategy was near total fasting. If he didn’t eat ANYTHING for a few weeks, he lost a few pounds. Really.

      “Increasing exercise” was not a helpful prescription. He could barely walk, his feet and legs just not up to holding his weight. Swimming was out, there was no way for him to get out of the pool afterwards.

      Frank finally died, due to side effects from the Fen-Phen that he took in desperation. Very sad. But I get very upset when people blame the obese for lack of willpower, or just not “trying” to lose weight.

      Also sad is that this was clearly a genetic condition. Frank’s parents, his sibling, and sadly his children all show the same problem.