Myths & Misconceptions about Obesity
By Philip R. Nader MD
Professor Emeritus, University of California San Diego

When CATCH was first developed, we were not as aware then as we are today of the gradually increasing rates of child obesity sweeping America. The behaviors that CATCH targets (activity and eating) were known to be very important in preventing childhood precursors of adult cardiovascular disease. This is still true today. However, the rates of child obesity continued to increase, tripling from 10% in the1970s to a nearly a third at present.

Some of the stark consequences of being overweight in childhood:          • Children become isolated from their peers, learn that they            cannot be active in sports, and develop low self-esteem.          • Children develop physical ailments once reserved for adults            such as sleeping problems, bone and joint problems, high            blood pressure, liver disease and diabetes.          • Overweight children are likely to become overweight and            obese adults.          • Unless changes happen, children today will have shorter            life-expectancies than their parents.

This GREAT DENIAL is at the root of why we all hang on to myths and misconceptions that perpetuate the cause of overweight and obesity: more calories taken in to the body than are burned up in growing and maintaining what we do, and being active.

Let's explore some of the common Myths and Misconceptions that perpetuate the causes of overweight, and that keep us from changing our own behaviors and not fighting trends in the environment and society that keep us from eating healthfully and being active.

MYTH: OBESITY IS ALL DUE TO GENETICS
Ever heard this?
         • "Being overweight runs in our family; there's nothing to be done"
         • "It's a problem with my metabolism"
         • "I can gain weight on water"

REALITY CHECK:
Less than 5% of overweight and obese children have a diagnosable "metabolic" or "glandular" cause for being overweight. About 25-40% of the tendency to become overweight is "heritable" (that means due to the genes). If your parents are obese, you have a greater chance of becoming obese, but 60-75% of the cause of your own overweight comes back to the imbalance in the energy equation- i.e. taking in more calories than you burn.

It is the interaction today of the genetic predisposition of an individual (that hasn't changed) with the environment (that has changed dramatically) which is largely responsible for the modern obesity epidemic. There is easy availability of fast foods and empty calories, exposures to advertising, and lack of physical activity. It used to be the case that 80% of kids walked to school, now 80% are driven to school in a car or bus. Bike sales have decreased, and active PE and recess is disappearing from schools.
Parents need to become activity and nutrition detectives to take charge of the environment that is impacting any genetic risk that is present in their family.

MISCONCEPTION: AT THREE, NOTHING CAN BE DONE TO PREVENT OBESITY
Ever heard this?
         • "My child demands candy and chips"
         • "My grandmother always had a sweet for me"
         • "If you clean up your plate you can have some candy"

REALITY CHECK:
We did a study of over 1000 children in 10 locations around the United States. If a preschool child's weight went over the 85thpercentile only one time, they had a five times greater risk of being overweight by age 12 years. What was even more surprising was that the level that made a 3-year old girl of average height "overweight"(at or above the 85th percentile) was only four pounds! This means today that that the old MYTH of BEING ABLE TO LOSE YOUR BABY FAT as you grow up is not happening! Does this mean that we should put young children on a diet?

NO, but it does mean that parents and doctors could be more active in detecting this early minimal risk, and act to make sure:
         • There is a good variety of healthy foods and snacks available
         • Excessive sweets and fats are limited
         • Portion size is appropriate to a preschooler
         • There is outside activity at least an hour a day
         • TV time is limited to 1-2 hours a day

MYTH: THEY WILL GET LOTS OF ACTIVITY AND HEALTHY FOOD AT SCHOOL AND AFTER SCHOOL PROGRAMS
Ever heard this?
         • "We used to have recess and PE every day, don't you?"
         • "We couldn't buy soda pop at school when I was a kid"

REALITY CHECK:
There is no doubt that across the country, both the amount and quality of school PE has decreased in recent years, perhaps because of an increased emphasis on better academics. Some data suggest that schools that have better quality PE programs also have better scores on academics. We did a study on the amount and quality of structured PE classes for over 1000 third grade children across the US. Fewer than 6% had daily PE. Generally, they had two classes per week of about 33 minutes each. Of this time only 25 minutes per lesson was spent in moderate to vigorous physical activity - far short of national recommendations. In addition, many schools no longer have recess periods, and those that do lack the environment (e.g. no balls to play with) or the support (no aides on the playground to encourage physical activity).

CATCH was originally a research program, supported by your tax dollars through the National Institutes of Health. The Coordinated Approach To Child Health was tested to see if it was effective in altering activity and eating behaviors of the children exposed to the intervention. The intervention, for the first time on a large scale, tested a multi-component model including the classroom, PE, school food services, and home environments. The program and its subsequent dissemination have proven to be effective in changing these behaviors, and was shown to limit the rate of weight gain among elementary school children in El Paso, Texas. The key to success of the program is continued teacher training, and school wellness policies that promote a healthy school environment.

The only way to know what is going on in your child's school is to visit and inquire about it. By looking at the PE programs you can tell if the kids are active most of the time or spend a lot of time lining up, waiting their turn. Observe the lunch lines, and what kids are choosing to eat. What are the choices for foods outside of the regular lunch program? Are there healthy choices and water in vending machines, if they are present? What do clubs do to raise money and how are celebrations and rewards handled in the school?

Your child spends more time at school than almost anywhere else. Hopefully you can make sure that time is not spent in an environment of poor nutrition and lack of physical activity.

MISCONCEPTION: SEXUALITY AND OBESITY HAVE NOTHING IN COMMON
Ever heard this?
         • "You're much too young (early school age) to ask about that!"

REALITY CHECK:
It used to be thought that, because young school children were always busy and engaged in doing and learning, sexuality and sex-roles "disappeared" or became "latent". This could not be further from the truth. Both sexes talk about the other with intense interest. When questions are brought to adults such as "where do babies come from", adults tend to brush these questions off because they think the kids are too young. What children learn from this is that certain topics are "taboo". Just how taboo depends upon their family and cultural environment and may set up barriers to future communication between parent and child on many other issues.

What do sexuality education and promoting healthy lifestyles have to do with each other? There are connections between being overweight and sexual development. For one thing overweight leads to earlier puberty. Since overweight may also be associated with poor self-image and lack of peer relationships, this could result in placing overweight youth at increased risk for early unprotected intercourse and teen pregnancy.

Healthy developmental foundations are nature's way of immunizing kids against too early detrimental effects of risky behaviors, depression, and eating disorders. Parents who are prepared to answer kids early sex questions with the appropriate facts are setting up an open path of communication that will help in future discussions of more important issues, and the ability to share their knowledge and values with their growing children.

Remember to always be sure you know what question the child is asking. "Where did I come from?" Recall the story of the five year old whom after getting a complete birds and bees talk from his father, said: "Oh I just wondered, Johnny said he was from Chicago!"

Dr Nader was one of the Principal Investigators and developers of the CATCH Program and has recently written a book called, "You Can Lose Your Baby Fat, New Rules to Protect Kids From Obesity", and can be purchased at www.youcanloseyourbabyfat.org

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