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They Said It, We Believed It — Teens and Food Addiction

December 3, 2010

The Awakening's Giant Hand

One of the features of the Weigh2Rock website is the Comfort Eating Board, which is typical of the several different discussion groups that are available so kids can talk about and seek help for their obesity problems. It even has a search function. Just for grins, we plugged the word “addict” into the search box, and guess what? These teenagers have poured their hearts out, in an astonishing display of honesty.

The complete entries are on the page, with the age and weight of all these different young people. But just for the sheer intense impact of it, we’ve isolated the parts where they self-identify as food addicts, and make the connection between this addiction and their obesity. When these excerpts are all strung together, they read like one huge, doleful lament.

The kids say:

I’m addicted to food.
It’s like I’m addicted, and I really don’t want to be.
I’m so addicted to food, I don’t know what to do.
It feels like I’m addicted to food. I have to eat until I’m full. And then I eat again, perhaps an hour later.
I feel like I have an addiction to over eating I pick up something and I’ll want it again again.
I just feel so bad I’m addicted to food!
I’m so frustrated with my weight. I’m addicted to food, seriously.
I am addicted to food.
I am like addicted to food, I eat it because it’s there, not because I’m hungry.
I want to be thin and cute again, but I seem to be addicted to food.
Once I start eating I just want more and more! Food is a total addiction to me, how do I stop it???
I try to lose weight but it’s just impossible, I’m addicted to food.
I am addicted to junk food and eat it all the time.
I am addicted to food, when I get home from school I always eat tons of stuff and then later I eat a normal supper.
My emotional addiction to food makes me go off my diet pretty quickly, which in turn blows my whole exercise program.
I am sick of being overweight and I don’t know how to handle being overweight and how to handle my emotions and also my addiction to food.
I need to lose like 150 lbs. I have a food addiction, I’m a binge compulsive eater.
I have no friends, because people don’t want to know anyone who is fat. People laugh and stare at me when I go out. I am addicted to food.
The problem is I have a huge addiction to food!
I’m 70 pounds over weight… it’s like I’m addicted to food.
I’ve tried like just eating a little bit of something but for me food is addictive so I just keep eating more of it.
I love to eat and I have an emotion addiction to food.
I’m the fattest girl in my class, maybe the ugliest, loneliest and the most miserable one… I think I’m addicted to food.
I’m so addicted to food.

And, of course, there are longer anecdotes of individual misery. A teen girl says,

My mum is such a b*tch!!!! I asked her, ‘Can you please stop buying junk food, I really think it would make us healthier and we might lose a little weight.’ You know what she said?? ‘No, I need it.’ I said she sounded like a drug addict and she agreed!!!!

Some people say, “Oh well, you know teenagers, they always talk crazy and magnify everything. They don’t really mean they are addicted, it’s just a figure of speech.”

How patronizing! How condescending! And how rude, too, and anti-therapeutic. Imagine a meeting of Alcoholics Anonymous. A member stands up and says, “I’m Trudy, and I’m an alcoholic.” Some heckler jumps up and scolds, “Oh, don’t be such a drama queen.”

Wouldn’t that be just about unthinkable? When somebody is courageous enough to admit to their addiction, you just don’t treat them like that. Is it any wonder that Dr. Pretlow writes, in his article titled “Food Addiction in Children” (PDF),

This compelling evidence points to an actual addictive dependence on highly pleasurable foods as a substantial component of the childhood (and adult) obesity epidemic, shockingly similar to tobacco, alcohol, and even drug dependence… Acknowledging highly pleasurable food as an addictive substance for a segment of the pediatric population is emerging as an important factor for control of the childhood obesity epidemic.

Dr. Pretlow quotes one of the communications sent to Weigh2Rock by a 16-year-old girl:

A teen who does drugs or smokes would get in trouble if their parents found out. But no one’s going to ground you for eating, which can be equally as damaging, and is equally as difficult to stop.

Your responses and feedback are welcome!

Source: “Food Addiction in Children” (PDF), Robert A. Pretlow, M.D.
Source: “Comfort Eating Board,” Blubberbuster.com
Image by WorldIslandInfo.com, used under its Creative Commons license.

The Childhood Obesity Perfect Storm, Part 5

December 2, 2010

Storm in Brisbane

The childhood obesity perfect storm continues — the combination of circumstances that have accumulated to bury children in layers of fat, and not only our own home-grown American children, but children all over the world. Something very ominous is happening, and it’s almost like a corny old science fiction story from a pulp magazine. What has made so many people fat?

Yesterday we talked about the cupcake controversy in grade schools, and the nutritional value of lunches brought from home versus the lunches bought in the cafeteria by middle-school students. In both cases, the right answers might help reduce childhood obesity.

And what about the schools’ responsibility for monitoring children’s health in this particular way, to try and prevent obesity? Schools are supposed to have rules about immunization records being up to date. This is a public health issue. Schools are supposed to report signs of child abuse to the proper authorities. Few people would argue with that, though misinterpretation or malice can bring a world of trouble to parents who don’t deserve it.

Schools should be very conscientious about the food served in their cafeterias, and everyone agrees about that, though they don’t agree on the definition of “healthful,” or on how better menus might be financed, or on what to do if the kids just won’t eat the nutritious stuff. And many people, including Dr. Pretlow, would prefer the complete disappearance of processed hedonic foods and sugary drinks from vending machines in schools everywhere.

But should we insist that public schools take it upon themselves to be the Fat Police? In Arizona, Deborah Delabruere says no. The mother of an 11-year-old girl was interviewed by Emily Valdez, a Fox network TV journalist, about the family’s experience. The daughter’s school sent her home with a letter telling her parents she is obese, and did it in such a way that the content was obvious to her peers. Delabruere describes her child as “humiliated and dejected,” and is especially upset because she actively works with her daughter on self-esteem issues, and feels that her good work has been undone.

Dr. Christine Carter-Kent, a Cleveland specialist in pediatric gastroneurology, was also interviewed. She believes that schools should monitor a child’s BMI (body mass index) and warn the parents when it is out of balance. But Carter-Kent also thinks this should be done in a more tactful way, privately, and face-to-face. She told the reporter,

Privacy is an issue. It should be something that is guaranteed that it won’t be revealed to other kids and their families, because in this time when we are seeing a lot of bullying and that sort of thing, we need to make sure this information is confidential.

In Massachusetts, another mother of a grade-school student made news by going public about her dissatisfaction with the way the local school district handles their job of notifying parents about the danger of obesity. Reporter Ashley Studley says,

Under a recent state regulation aimed at combating obesity, school nurses must measure the body mass index of students in first, fourth, seventh and 10th grades. Parents are notified of the results, but the state doesn’t have set guidelines about how parents are informed.

Lori-Ann Sumner, whose daughter brought home a piece of paper documenting the school’s BMI measurement, believes there is little sensitivity involved. She is especially worried that a child could misunderstand the meaning of the numbers, or even the fact that measurements are being done. A child could then slide into dysfunctional habits and possibly develop an eating disorder. Her own daughter is an active gymnast with a muscular body, and Sumner sees no problem with that.

Your responses and feedback are welcome!

Source: “School Letter: Dear Parent, Your Child is Obese,” KTLA.com, 11/16/10
Source: “Mixed views on tracking students’ BMI,” Metrowest Daily News, 07/05/10
Image by Burning Image (Nam Nguyen), used under its Creative Commons license.

The Childhood Obesity Perfect Storm, Part 4

December 1, 2010

The best thing one can do

We have talked before about the “perfect storm” that Dr. Pretlow identifies as the cause of the childhood obesity epidemic. It’s a witch’s brew of at least five elements: the high-tech production of hedonic foods; their availability to kids; the increased stress kids are dealing with; the ubiquitous marketing of comfort foods; and the decreased tendency of kids to do anything that involves physical exertion.

None of these conditions alone could have done so much damage, and even some combination of two or three of them would not have been able to raise such havoc. But when they all pile up together — Voila! It’s the perfect storm. For a succinct overview of the problem, see Slides 42-49 in “Why Are Children Overweight?” (the presentation Dr. Pretlow took on the road to London).

Today, we’re looking at the availability angle. Hyperpalatable foods can be addictive, so they are as dangerous to the health of children as other addictive substances, like tobacco or alcohol. Dr. Pretlow feels that the main difference is the limitless availability of unhealthy pseudo-foods. Sad to say, schools are very much to blame for making hedonic foods readily available. We wouldn’t serve up cigarettes or booze in the school cafeteria or from vending machines on the school grounds. How does junk food get a free pass?

But, say, we all vote for strict regulations in every state, banning soda pop and sugary treats from every school in the nation, and strictly curtailing the amount of fat, sugar, and starches in school lunches. How far are we willing to go? Are we willing to hire lunch police, to check the brown bags that kids bring from home, to make sure they’re not smuggling in contraband foods?

Actually, lunch from home is healthier. That conclusion was arrived at by a study of middle school students conducted by the University of Michigan earlier this year, and described by Dr. Elizabeth Jackson to reporter Charlene Laino of WebMD Health News.

Kids who eat school lunches are more likely to be overweight or obese, partly because of their tendency to eat more servings per day of fatty meats like fried chicken or hot dogs. They are also more likely to have higher levels of “bad” cholesterol. At the same time, the school-lunch eaters are less likely to eat fruit and vegetables. And, by strange coincidence, Laino says,

The school-lunch kids also were less likely to participate in active sports like basketball, moderate exercise like walking, or team sports than their home-fed counterparts. And they spent more time watching TV, playing video games, and using computers outside of school.

Then, there is the cupcake controversy, typical of the kind of problem that regulatory attempts always run up against. Over the past few months, reports have come in from various school districts where the banning of birthday cupcakes from grade schools has been considered.

Tammy Mayrend, who writes about parenting for AnnArbor.com, is a mother who has always enjoyed making cupcakes from scratch, for her children to share with their classmates. She questions the overall impact on the child obesity epidemic that could be achieved by such a ban. This is how Mayrend feels about it:

My opinion is that children only get to be kids for a short window of time. Since the focus on birthdays lessens as the years pass, why not let them have their cake and eat it while they are young and solve the issue with more time outdoors, exercising and parents teaching their children to make better choices overall, with less processed foods and lots of healthy fresh fruits and vegetables!

Your responses and feedback are welcome!

Source: “School Lunches Linked to Kid’s Obesity,” WebMD.com, 03/15/10
Source: “Will banning cupcakes in schools for birthday celebrations solve childhood obesity?,” AnnArbor.com, 11/19/10
Image by Krikit, used under its Creative Commons license.

Prediction for 2011: Food Addiction Will Still Exist

November 30, 2010

Dinosaur Exhibition in Beijing

Dr. Mark Hyman does not speak in polite euphemisms, but titles an essay in the bluntest terms, “Food Addiction: Could It Explain Why 70 Percent of Americans Are Fat?” Yes, it could! This is what Dr. Pretlow has been saying all along. There really is such a thing as food addiction, and the sooner we catch on to that fact and act accordingly, the better.

Borrowing a phrase from Michael Pollan, Dr. Hyman endorses the idea that food “made in a plant rather than grown on a plant” can be biologically addictive. In agreement with Dr. David Kessler and Dr. Pretlow, he believes that certain kinds of ersatz food are intentionally and clandestinely engineered to be as addictive as possible. Dr. Hyman says,

In his book The End of Overeating, David Kessler, M.D., the former head of the Food and Drug Administration, describes the science of how food is made into drugs by the creation of hyperpalatable foods that lead to neuro-chemical addiction.

Dr. Hyman is also certain that nobody sets out wanting to be an addict of any variety, whether the substance is alcohol, heroin, or pseudo-food made of fat, sugar, salt, and chemicals. He dismisses as humbug the notion that all food is created equal. Likewise, the “Just say no” approach is refuted.

Also, the “personal responsibility” jive that the food industry tries to lay on us is perceived as the same rationalization given by the most predatory of crack dealers: “Nobody forces them to buy the stuff.” Dr. Hyman asks us to perform a thought experiment:

Imagine a foot-high pile of broccoli, or a giant bowl of apple slices. Do you know anyone who would binge on broccoli or apples? On other hand, imagine a mountain of potato chips or a whole bag of cookies, or a pint of ice cream. Those are easy to imagining vanishing in an unconscious, reptilian brain eating frenzy. Broccoli is not addictive, but cookies, chips, or soda absolutely can become addictive drugs.

Exactly as Dr. Pretlow did in Overweight: What Kids Say, Dr. Hyman points out an interesting fact related to the childhood obesity epidemic. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, familiarly known as the DSM-IV, enumerates the criteria for addiction. If a patient has a certain number of these traits, the patient is diagnosed as addicted. We can’t help but notice how closely the characteristics of food addiction conform to those accepted signs of addiction, the ones that apply when the substance is something other than food.

When kids write in to the Weigh2Rock website and talk about their unhealthy relationships with food and eating, the feelings and behaviors they describe are the same that would be ascribed to addiction, if they were talking about some other substance. In fact, the kids come right out and say the A-word, frequently. This means it would be helpful to look at childhood obesity through the Psychological Food Dependence-Addiction Lens.

Dr. Hyman’s article is like a pocket guide to the territory of food addiction. He offers some of the questions from the quiz developed by the Rudd Center for Food Policy and Obesity at Yale University. Find out if you are an industrial food addict! Most of us are, the author says. Then, he gives us a roundup of the important studies that all point to the same conclusion: Food can be addictive.

The sociological and environmental considerations are also examined: food deserts, nutritional wastelands, school vending machines that dispense junk food, and numerous other elements that surround us. Also, advertising — the relentless merchandising of stuff that makes us fat and sick.

Here’s an interesting digression: a piece by Lea Rittenhouse about technology addiction among college students. Rittenhouse draws heavily on the ideas of Dr. Hilarie Cash, who is executive director of reSTART Internet Addiction Recovery Center. Located in Fall City, Washington, conveniently close to Microsoft HQ in Redmond, reSTART treats a variety of Internet-related addictions including video-gaming. The therapists are of course prepared to address the underlying problems that contribute to the development of addiction. These are startlingly reminiscent of the difficulties that lead to food addiction: “family problems, divorce, childhood trauma, depression, anxiety…”

For all addicts, there is hope. As Dr. Hyman says,

We can alter the default conditions in the environment that foster and promote addictive behavior. It’s simply a matter of public and political will. If we don’t, we will face an ongoing epidemic of obesity and illness across the nation.

Your responses and feedback are welcome!

Source: “Food Addiction: Could It Explain Why 70 Percent of Americans Are Fat?,” The Huffington Post, 10/16/10
Source: “Addiction in Student Life,” PatriotTalon.com, 11/22/10
Source: “Our Mission,” reSTART Internet Addiction Recovery Program website
Image by Ivan Walsh, used under its Creative Commons license.

Fiction and Nonfiction for Tween Girls

November 29, 2010

015-365-so little

One of the obvious drawbacks of childhood obesity is that it hangs around and becomes adolescent obesity and, eventually, adult obesity. Sure, many people have overcome their propensity to be overweight, and they are heroes. Ruby Gettinger and others have documented their own histories, including the recognition that food addiction was controlling their lives, and what they had done about it.

And how much better it is if the problem never develops in the first place! This is why the Archive page of Dr. Susan Bartell’s Girls-Only Weight Loss website is such a treasure. We’ll just pick one at random — “Don’t Model Yourself After Models.” Back in 2006, a major world-class fashion show, the Pasarela Cibeles, made its famous decision to reject skeletal runway models. Dr. Susan says,

The Spanish government realizes that while it is important for girls not to be overweight, the opposite — being super skinny, like runway models usually are, is dangerously unhealthy. And when girls watch those models show off clothes, it sets a bad example and also makes girls frustrated. Some girls even try to get that skinny and develop eating disorders like anorexia and bulimia.

Dr. Susan is a psychologist, consultant, and an award-winning writer. Her collection of insightful and helpful articles is a splendid resource for young women struggling with weight issues. She points out to kids the things they might not have thought about, like, for instance, product placement in the media. It’s a good idea for anybody, not just a young person, to stop and consider, “Am I buying this thing just because my favorite actor had one of these in a movie?”

Once a person starts thinking about stuff like, “Why, really, do I buy Coke instead of Pepsi?” or, “Why, really, do I buy Pepsi instead of Coke,” you never know what could happen. He or she might move on to think something like, “Why don’t I just drink some nice water instead?”

Here is Dr. Pretlow’s comment about the book, Dr. Susan’s Girls-Only Weight Loss Guide:

Dr. Bartell’s book is the first I’ve seen that deals with the connection between feelings, overeating, and overweight in childhood. She is right on point. Her book contains excellent tips for improving self-love and for coping with emotions without resorting to food.

Tweens are not-quite teenagers, roughly ages 10 to 14, and they have their own set of problems. These are addressed in a fiction book for tweens, Don’t Call Me Cookie, by Vanessa Pasiadis. The author earned a Master’s degree from the School of Public Health at the University of Pittsburgh. She puts her accumulated knowledge to work as a teacher and health care consultant, and by placing good advice in a framework kids will enjoy, a story.

Twelve-year-old Cookie Lemon wants to be an actress, but meanwhile she’s dealing with obesity. With help from a savvy pediatrician called Dr. Max and a wonderful teacher, Ms. Martiss, Cookie not only sets out on a better path, but brings along her best friend and even her parents. The book has been endorsed by Children’s Hospital of Cleveland and other worthy institutions.

In a print magazine called The Hermenaut we have found a terrific article called “Fatty Fiction.” The author, Lynn Peril, re-examined half a dozen books that she had read as an overweight young girl. They were published between 1955 and 1982, and the main characters were always girls who were unhappy and/or unpopular because of their excessive weight. Even worse, Peril says the girls in the young-adult novels were passive and unwilling to fight back when bullied. Generalizing about this sub-genre of fiction tailored for teens and tweens, Peril says,

The plot hinges on her struggles to lose weight, and the denouement is reached when the young girl achieves her goal. Along the way, her emotional and social problems are resolved, the result (overtly or not) of her weight loss. Often there is a moralistic bent to the story, urging the presumably porcine young readers to diet.

Peril says that fatty fiction went out of style when anorexia nervosa became a bigger problem than obesity. Now that the polarity has reversed again, what is fiction for young girls saying today?

Your responses and feedback are welcome!

Source: “Archive,” Girls Only Weight Loss
Source: “Don’t Model Yourself After Models,” Girls Only Weight Loss, 09/18/06
Source: “Book Aimed at Young Readers Takes on the Important Topic of Childhood Obesity,” PRLog.Org, 11/17/10
Source: “Fatty Fiction,” Hermenaut Number 14
Image by stars alive (Keirsten Balukas), used under its Creative Commons license.

The National Initiative for Children’s Healthcare Quality

November 26, 2010

Balinese children watch ceremony

Be Our Voice is an organization of healthcare professionals. The group was created by the National Initiative for Children’s Healthcare Quality (NICHQ), and its object is to persuade healthcare professionals to put on their “community leader” hats to pursue the goal of ending the childhood obesity epidemic. Working with and treating individual children is a basic job, and through Be Our Voice, healthcare professionals voluntarily take on another layer of accountability by accepting leadership roles in the community.

The regulations that affect children’s health are made by legislators, and since they are not born omniscient, legislators need to turn to someone for information and advice. But an organization such as the Robert Wood Johnson Foundation is not allowed to use its resources to attempt to influence legislation related to childhood obesity. So, how can minds be changed?

Such organizations can provide policy briefs and research reports, and can provide technical assistance at the written invitation of a governmental body or committee. Through Be Our Voice, healthcare professionals can speak for the children as their advocates. This is the place with the resources, with the advocacy training tools to help you learn the skills and find the needed technical assistance.

It is really important to understand the difference between lobbying (prohibited) and advocacy (permitted). The publication that helps to do this, the main tool, is a 45-page PDF file titled “Lobbying & Advocacy: Foundation-funded Policy Change,” and it is full of great information.

The manual explains the difference between private foundations and public charities, and outlines the areas in which grant funds can be used to communicate ideas, including broad issues of social policy. It explains how to best communicate through letters to editors, press conferences, newsletters, websites, and even paid advertising under certain conditions.

What else is NICHQ up to? Well, there is the Prevention Center for Healthy Weight and the Healthy Weight Collaborative (HWC). Here is some information about the planned Prevention Center:

There will be two core activities of the Center. The first is to create a resource hub for information and activities designed to meet the healthy weight challenge — a place for practice sharing, quality improvement training and general exchange of information. The second core activity for the Center is to organize and manage a nationwide Healthy Weight Collaborative (HWC), in which fifty trans-sectoral teams from around the country will identify, test and implement program and policy changes in their communities to achieve local healthy weight objectives.

Speaking of mental influence, author Michael Pollan collected more than 2,500 personal eating rules from real people. He aimed to glean nutritionally valid examples of folk wisdom for inclusion in a book, and ended up with much more than he bargained for:

[… A] banquet of food policies that even when they made little, if any, nutritional sense (and therefore didn’t belong in the book) nevertheless opened a window on our current thinking about food: the stories we tell ourselves, the games we play and the taboos we invoke to organize our eating lives.

Some are funny, some are wise, and Pollan has published a large assortment of them with his remarkable essay titled “Rules to Eat By,” which originally has appeared in the New York Times magazine. Here are three excellent examples:

”It’s better to pay the grocer than the doctor’ was the saying that my Italian grandmother would frequently use to remind us of the love and attention to detail that went into her cooking.’ (John Forti)

From my Romanian grandmother: ‘Breakfast, you should eat alone. Lunch, you should share with a friend. Dinner, give to your enemy.’ (Irina A. Dumitrescu)

Eat foods in inverse proportion to how much its lobby spends to push it. (Kirk Westphal)

Your responses and feedback are welcome!

Source: “About Be Our Voice,” National Institute for Children’s Healthcare Quality
Source: “Prevention Center for Healthy Weight,” NICHQ
Source: “Rules to Eat By,” MichaelPollan.com, 10/11/09
Image by ^riza^ (Riza Nugraha), used under its Creative Commons license.

Happy Thanksgiving!

November 25, 2010

Autumn falls

Image by paul(dex), used under its Creative Commons license.