Weight Loss Options: The Greatest Fail Ever In The History Of Fat

What are some excellent weight loss options? I'm a true believer in diet and exercise. When you burn more calories than you consume on a daily basis, the laws of chemistry, physics, and all other natural sciences say that you will lose weight.

There's also the option for gastric bypass, which is really nothing more than a really expensive way to make you stop eating so much. If you don't exercise while you diet, or don't continue to exercise after you stop dieting, your body will eventually slow down its metabolism and weight loss will become harder and harder. You will gain your weight back. Some people Many people have literally eaten their way through a gastric bypass procedure and find themselves right back at square one.

Weight loss is never easy. You don't get fat overnight. It takes years of hard work to become a member of the small but growing group of Americans known as the super obese. Those folks who are so over weight that they literally cannot walk. These folks can't function. These folks can't do their activities of daily living. These folks have life threatening cardiac and respiratory complications of their eating disorder. These folks often require an intensive inpatient multidisciplinary team of doctors, nurses, nutritionists, and psychologists to save their life.

So it didn't surprise me when 32 year old Mrs Smith returned a year later and one hundred pounds heavier on the doorstep of death. Her 600 pounds was literally crushing her from the outside in. What was this weight loss option that failed her so? In the words of her surgeon:

I offered to refer her to a surgeon who specializes in gastric bypass. She declined. I offered to arrange for evaluation of her heart failure and breathing problems. She declined. So I gave her a copy of the book "Finding a Thin Person Hiding Inside of You".

It didn't work. Which makes this the greatest Fail of weight loss options ever.

Percentage of Overweight, Obese Americans Swells

Americans Are Eating Poorly, Exercising Less, and Getting Bigger, Survey Finds

By Bill Hendrick
WebMD Health News

Reviewed By Louise Chang, MD

Feb. 10, 2010 -- More Americans are becoming overweight or obese, exercising less, and eating unhealthy foods.

That's the finding of the latest Gallup-Healthways Well-Being Index, which shows that 63.1% of adults in the U.S. were either overweight or obese in 2009.

That was a small but measurable increase from 62.2% the previous year. The survey finds that 36.6% of Americans are overweight and 26.5% obese.

The Gallup-Healthways Well-Being Index findings are based on telephone interviews with 673,000 adults in January 2008 to December 2009. About 90,000 surveys were done each quarter, and the margin of error for the quarterly results is +/- 0.3 percentage points.

The survey finds that:

• 59.2% of obese Americans exercised at least one day per week, compared to 69.9% of overweight people, and 73.8% of normal-weight people.
• Obese people are less likely than people in every other weight category (overweight, normal weight, underweight) to have eaten five servings of fruits and vegetables on at least three days of the past seven.
• Obese Americans also are less likely to say they ate healthy "all day yesterday."

Here's a breakdown of groups that ate the recommended five servings of fruits and vegetables three to seven days per week:

• 71.6% of normal-weight people
• 69% of underweight people
• 68.9% of overweight people
• 67.2% of obese people

Body mass index (BMI) is a common measure of body fat based on height and weight.

(Calculate your body mass index at www.webmd.com/diet/calc-bmi-plus.)

A BMI of 30 or greater is considered obese, overweight if it's between 25-29.9, normal if it's 18.5-24.9, and underweight if it's less than 18.5.

People who are obese are far more likely to report being diagnosed with high blood pressure, high cholesterol, diabetes, or to have had a heart attack.

The survey found that:

• Of people with high blood pressure, 46.2% were obese, 31.1% were overweight, 19.3% were of normal weight, and 17.2% underweight.
• Of people with high cholesterol, 36.8% were obese, 30.1% overweight, 19.2% normal weight, and 14.1% underweight.
• Of people with diabetes, 21.1% were obese, 9.8% overweight, 5% normal weight, and 4.2% underweight.
• Of people reporting heart attacks, 6.3% were obese, 4.8% overweight, 3.3% normal weight, and 4.4% underweight.
• Of depressed people, 23.3% were obese, 15.3% overweight, 15% normal weight, and 20% underweight.

The survey says that African-Americans in 2009 were among the most likely to be obese, at 36.2%, compared to the national average of 26.5%. The obesity rate among Hispanics, at 28.3%, is also higher than the national average. Asians are far less likely to be obese, with only 9.6% falling into that category.

The survey also reports that:

• 18.3% of young Americans are obese, compared to 27.6% between ages 30-44 and 30.6% among 45- to 64-year-olds. Of people 65 and over, 24.2% are obese.
• Men are more likely than women to be obese, 27.8% compared to 25.2%.

The report concludes that obesity is still on the rise and that reversing this trend may require the involvement of communities, businesses, and governments.

SOURCES: Gallup-Healthways Well-Being Index.

Bad news for Wii Fit curing childhood obesity.

Scott Owens, a researcher out in Mississippi decided to see what Wii Fit would do to family fitness so he loaned out 8 Wii Fits to 8 different families and was looking to see if it would help those families get more fit.

The study had two parts. 3 months where he studied the families' fitness levels before the introduction of the Wii Fit and 3 months post introduction. In so doing he used accelerometers, body composition analyses, aerobic capacity, and balance

What did he find?

In kids, while aerobic fitness did increase during the 3 months of Wii Fit, there were no changes to any other parameter.

More importantly, while initially a big hit in the homes, by the end of the 3 months the average family was only spending 4 minutes a day on the Wii Fit.

4 minutes a day sure ain't going to do much.

My advice? Buy a Wii for fun, go outside for fitness.

[Via ScienceDaily.com as the study has yet to be published]

Obesity Does Not Protect From Loss of Lean Tissue During Weight Loss

One of the biggest challenges during weight loss is the maintenance of lean body mass. In this regard, I have previously blogged about the importance of maintaining adequate protein intake even when restricting overall caloric intake. (Another important measure in this regard is resistance training).

A common misconception appears to be that obese people have enough stored energy to live off so that one can confidently reduce their caloric intake to help them lose weight - the fewer calories the better.

Nothing else can be further from the truth - as it turns out, obese individuals are just as, if not more, prone to losing lean tissue (mainly skeletal muscle) as are lean individuals.

This is nicely demonstrated in a study by Gregory Henderson and colleagues from the Mayo Clinic, just published in the journal Obesity.

In this study, whole body protein metabolism was studied in twelve obese women over a wide range of BMIs using leucine-tracer techniques following five days of a weight-maintaining diet and then after 30 days of a 1,400 kcal deficit with maintained protein intake.

Before weight loss, when expressed as total rates, per body weight (BW) or per fat-free mass (FFM), leucine rate of appearance (Ra), and nonoxidative leucine disposal (NOLD) were significantly higher in the heavier individuals indicating higher protein turnover.

Nevertheless, caloric restriction reduced protein turnover and oxidation to the same extent in obese and non-obese individuals showing that higher fat mass does not favorably alter the response of protein metabolism and clearly does not mitigate the loss of lean body mass with caloric restriction.

As any loss of lean body mass, a key determinant of resting metabolic rate, would be counterproductive both by limiting weight loss and by facilitating weight regain, it is indeed essential to maintain or perhaps even increase protein intake when reducing overall caloric intake.

The notion that obese people have enough stored calories and can therefore easily go without adequate protein intake (or perhaps no food at all) for a few days is plain wrong.

Happy to hear of any experiences with excessive lean body mass during weight reduction and prescribed measures to limit this loss.

AMS
Hamburg, Germany

Traditional Family Routines Reduce Childhood Obesity?

So, as Michelle Obama yesterday announced her childhood obesity initiative, another piece of news on childhood obesity crowded the news wires.

This was a study by Sarah Anderson (Ohio State) and Robert Whitaker (Temple) published as an early release in Pediatrics.

The researchers performed a cross-sectional analysis of a nationally representative sample of 8550 four-year-old US children who were assessed in 2005 in the Early Childhood Longitudinal Study.

The study focussed on the relationship between obesity and three household routines: regularly eating the evening meal as a family (>5 nights per week); obtaining adequate nighttime sleep on weekdays (10.5 hours per night); and having limited screen-viewing (television, video, digital video disk) time on weekdays (2 hours/day).

Analyses were adjusted for the child’s race/ethnicity, maternal obesity, maternal education, household income, and living in a single-parent household.

While the prevalence of obesity was 14.3% among children exposed to all 3 routines (14.5% of the sample), it was 24.5% among those exposed to none of the routines (12.4%).

The odds of obesity associated with exposure to all 3, any 2, or only 1 routine (compared with none) were 0.63, 0.64, and 0.84, respectively.

So if you do have kids ask yourself:

1) Do we regularly sit down for supper as a family?
2) Do my kids regularly get at least 10.5 hrs of sleep?
3) Do my kids have less than 2 hrs of screen time on weekdays?

A “no” to all of the above, probably puts your kids in the high-risk category, a “yes” to all of the above, and your kids are probably doing fine.

Now comes the tough part, i.e. wether or not, if you are not doing all of the above, simply doing these three things will actually change your kids risk for obesity. Or in other words, if you did nothing else, except sit down for dinner, have the kids in bed by 8.30, and limit their screen time, would your kids actually have healthy weights?

I am guessing that it will take far more than that. In fact I would not at all be surprised if the families that do any of the above were probably quite different from the families that don’t. I would indeed expect that these families are different in so many ways that really, these three factors are probably just “markers” rather than the actual explanation for the lower obesity risk.

Indeed, if you did have the time and parenting skills to ensure that your whole family sits down for supper, your kids don’t watch too much TV, and are off to bed at bedtime, then you are probably also doing a lot of other things right.

On the other hand, if your family meals are chaotic, you have no control over your kids’ screen time, and they are still running around at midnight, there are probably other issues that need to be addressed.

So while the findings are interesting (and by no means surprising), I am not exactly sure how they will help us address the childhood epidemic.

Perhaps a well-designed intervention study will show wether or not simply adopting these three “routines” will actually make a difference.

I certainly appreciate any comments or opinions on whether or not any of my readers think this will work.

AMS
Hamburg, Germany

President Of American Academy Of Pediatrics Joins First Lady Michelle Obama In Commitment To Reduce Childhood Obesity

Judith S. Palfrey, MD, FAAP, President of the American Academy of Pediatrics (AAP), joined First Lady of the United States Michelle Obama at an event today to unveil the White House's "Let's Move!" campaign to address childhood obesity.

The AAP, which represents 60,000 pediatricians, is committed to eliminating the epidemic of childhood obesity in the United States, and commends First Lady Michelle Obama for drawing national attention to this staggering health burden on our nation's youth. The four pillars of the First Lady's "Let's Move!" campaign- expanding efforts to make schools healthy environments for all children, increasing children's physical activity, improving the affordability and accessibility of foods, and empowering consumers to make healthier choices- support proven early interventions that the AAP recommends to help keep children healthy.

"We face a medical and moral imperative to rescue our children's health," Dr. Palfrey said during today's event. "Over the past twenty years, our nation has seen an alarming rise in the number of our children who are overweight and obese. It will take a concerted effort and thoughtful collaboration to help create healthier communities for children."

The AAP believes that the life success of every child should be the nation's highest priority, and as such, is proud to announce today a new commitment in partnership with the First Lady's "Let's Move!" campaign. First, the AAP will call on every pediatrician to calculate body mass index, or BMI, for every child over the age of two at every well-child visit. The AAP is also making available to all of its members official "prescriptions" for healthy, active living-including good nutrition and physical activity-to give out at every well-child visit.

Additional ongoing interventions recommended by the AAP to reduce the prevalence of childhood obesity include: encouraging mothers to breastfeed, childcare providers and schools to serve healthy foods, and families to eat nutritious, well-balanced meals together. Along with good nutrition, the AAP recommends that every child has opportunities to be active for at least 60 minutes every day, and that parents limit the time children spend in front of the television.

"This is a long-term commitment to our children's health, and we cannot expect a solution overnight," Dr. Palfrey said. "But we must take on this challenge. The health of our children-and the future of this country-is in our hands. Together, we can reverse the numbers and improve the health of our children."

For information on the AAP's commitments to the "Let's Move!" initiative and additional resources for pediatricians and families, visit here.

Source
American Academy of Pediatrics

Obese Children Twice as Likely to Die Young?

By Kathleen Doheny

Reviewed by Louise Chang, MD

Feb. 10, 2010 -- Childhood obesity more than doubles the risk of dying before age 55, according to a new long-term study that followed nearly 5,000 children.

''The bottom line is, obesity in kids is a serious problem that needs to be taken seriously," study co-author William C. Knowler, MD, DrPH, tells WebMD. Although experts have known that for years, he says, the new research is definite confirmation.

"What this particular study shows is, obesity is going to cause excess premature death," says Knowler, chief of the Diabetes Epidemiology and Clinical Research Section of the National Institute of Diabetes and Digestive and Kidney Diseases.

Although recent data suggest a leveling off of obesity in the U.S., one in six teens is obese.

The study is in the New England Journal of Medicine.

Obesity in Childhood, Early Death Linked

Knowler and his colleagues evaluated 4,857 American Indian children who were born between 1945 and 1984, then followed them long-term. Most participants were at least half Pima or Tohono O'odham Indian. They lived in the area of the Gila River Indian Community in Arizona.

The researchers gathered data about the children's body mass index (BMI), glucose tolerance, blood pressure, and cholesterol levels. None of the children had diabetes at the beginning of the study, although 559 developed it during the study.

During a median follow-up period of nearly 24 years (half followed longer, half less), there were 166 deaths from natural causes before age 55. There were 393 deaths from external causes, such as accidents or homicide, before 55.

The researchers divided the participants into four groups, or quartiles, depending on their BMI. In all, 28.7% of the children were obese, according to their BMI.

Higher BMI, Higher Premature Death Risk

The researchers compared the risk of early death for those in the four BMI quartiles. "Those in the top quartile had over twice the rate of death from natural causes before age 55 as those in the lowest quartile of BMI," Knowler says.

Among these natural causes of death were alcoholic liver disease, cardiovascular disease, infections, cancer, diabetes, acute alcohol poisoning, and drug overdose.

''Obesity was not related to external causes of death, such as auto accidents," Knowler says.

Other Risk Factors and Premature Death

Knowler's team also evaluated whether glucose levels, cholesterol levels, or blood pressure during childhood boosted risk of premature death.

Death rates from natural causes among children in the highest group of glucose intolerance (a risk factor for developing diabetes) were 73% higher than among the children in the lowest group of glucose intolerance, the researchers found.

No substantial links were found between cholesterol levels and premature deaths. They did find that high blood pressure in childhood raised the risk of premature death from natural causes by about 1.5 times.

"Obesity was a stronger predictor of premature death than either abnormal glucose, cholesterol, or blood pressure," Knowler tells WebMD.

Obese Kids at Risk for Early Death

By Kristina Fiore, Staff Writer, MedPage Today
Published: February 10, 2010
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston. Earn CME/CE credit
for reading medical news
Action Points

* Explain that children with obesity, glucose intolerance, or high blood pressure may be at risk of premature death, but those with hypercholesterolemia were not at increased risk.

Children with obesity, glucose intolerance, or high blood pressure may be at risk of premature death, according to a longitudinal study of Native Americans.

Youngsters from two Arizona tribes who had the highest body mass index (BMI) were more than twice as likely as those with the lowest BMI to die prematurely from endogenous causes, and those with the worst glucose intolerance had a 73% higher risk of death than those with the best control, Paul W. Franks, PhD, now of Umeå Universitet in Umeå, Sweden, and colleagues reported in the Feb. 11 issue of the New England Journal of Medicine.

Youths with high cholesterol weren't at increased risk for premature death, but the researchers said that may be because Native Americans have lower cholesterol levels than most other ethnic groups.

"The pattern of relationships between the risk factors and observed mortality supports the view that childhood obesity is an early metabolic derangement, whereas most of the other risk factors evolve later," they wrote.

While the study may not be applicable to the general population, it may "be applicable to those vulnerable populations -- the poor, African Americans, Hispanics -- who today have a comparably high prevalence of childhood obesity," said Barbara J. Moore, PhD, president of Shape Up America!, an organization that raises obesity awareness.

But Nicolas Stettler, MD, of the Children's Hospital of Philadelphia, said the study offers the opportunity to see what happened to a group of children who had a high rate of obesity 20 to 30 years ago -- a rate similar to the general population today.

Because of this, Stettler says he worries that a similar high rate of early death could be in the general population's near future.

For their study, the researchers assessed 4,857 children from the Gila River Indian Community in Arizona, most of whom were Pima or Tohono O'odham Indians. All were born between 1945 and 1984, and none had diabetes.

All of the children were assessed with glucose tolerance tests.

During a median follow-up of about 24 years, 559 patients died before they reached age 55, with 166 of those deaths due to endogenous, or internal, causes.

The researchers found that BMI was positively associated with the risk of premature death from endogenous causes, including alcoholic liver disease, cardiovascular disease, infections, cancer, diabetes or diabetic nephropathy, and acute alcohol or drug overdose (RR 1.40, 95% CI 1.20 to 1.63).

Rates of death from endogenous causes more than doubled among children with the highest BMI, compared with those with the lowest (RR 2.30, 95% CI 1.46 to 3.62).

The association between BMI and premature death was attenuated after adjusting for baseline glucose levels, cholesterol levels, and blood pressure -- but it remained significant (RR 1.41, 95% CI 1.19 to 1.67).

Rates of premature death from endogenous causes among youngsters with the worst glucose intolerance were 73% higher than those in the lowest quartile (RR 1.73, 95% CI 1.09 to 2.74).

"The presence of impaired glucose tolerance in a child is sinister because it silently undermines health," Moore said. "The child feels poorly and does not know why, and may even think that the way he or she feels is perfectly normal."

There were no significant associations between overall premature death and childhood cholesterol levels or hypertension. But the latter was significantly associated with premature death from endogenous causes (RR 1.57, 95% CI 1.10 to 2.24).

The lack of an association between premature death and cholesterol levels may be due partly to the low proportion of deaths due to cardiovascular disease in the cohort, the researchers explained.

Also, they noted, cholesterol levels are lower in American Indians than "in most ethnic groups."

In an accompanying editorial, the CDC's Edward W. Gregg, PhD, cautioned that Pima Indians aren't always considered representative of the U.S. population because they have an especially high risk of diabetes.

However, he wrote, "the prevalence of impaired glucose tolerance among persons in the current study (4%) is similar to the current prevalence in the general population of U.S. adolescents (3%) and is far less than the prevalence among obese adolescents in the U.S. (9.5%)."

"Since the trends with respect to obesity and diabetes among the Pima Indians have been a reliable harbinger for trends in the rest of the U.S. population during recent decades," he continued, "the present study should intensify the debate about whether interventions that are initiated during childhood and young adulthood can affect our broader diabetes epidemic."

He added that it will be "important to convert these results into effective prevention policies."

Moore said addressing childhood obesity rather than high cholesterol is the "first order of business."

"There is evidence from the diabetes prevention program that weight loss will improve and in many instances reverse the impaired glucose tolerance and avert the development of diabetes altogether," she said. "The same is true for high cholesterol."

The study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, and by grants from the Swedish Diabetes Association, the Swedish Heart Lung Foundation, the Swedish Research Council, Umea University, and the Vasterbotten regional health authority.

Neither the researchers nor the editorialists reported conflicts of interest.

This article was developed in collaboration with ABC News.

Primary source: New England Journal of Medicine
Source reference:
Franks PW, et al "Childhood obesity, other cardiovascular risk factors, and premature death" N Engl J Med 2010; 362: 485-93.

Additional source: New England Journal of Medicine
Source reference:
Gregg EW, et al "Are children the future of type 2 diabetes prevention" N Engl J Med 2010; 362: 548-50.

Laparoscopic Adjustable Gastric Banding in Severely Obese Adolescents

A Randomized Trial

Paul E. O’Brien, MD, FRACS; Susan M. Sawyer, MBBS, MD, FRACP; Cheryl Laurie, RN, BHSc; Wendy A. Brown, MBBS, PhD, FRACS; Stewart Skinner, MBBS, PhD, FRACS; Friederike Veit, MBBS, MD, FRACP; Eldho Paul, MSc; Paul R. Burton, MBBS, FRACS; Melanie McGrice, BSc, M Nutr Diet; Margaret Anderson, BHIM, Grad Dip HA; John B. Dixon, MBBS, PhD, FRACGP

JAMA. 2010;303(6):519-526.

Context Adolescent obesity is a common and serious health problem affecting more than 5 million young people in the United States alone. Bariatric surgery is being evaluated as a possible treatment option. Laparoscopic adjustable gastric banding (gastric banding) has the potential to provide a safe and effective treatment.

Objective To compare the outcomes of gastric banding with an optimal lifestyle program on adolescent obesity.

Design, Setting, and Patients A prospective, randomized controlled trial of 50 adolescents between 14 and 18 years with a body mass index (BMI) higher than 35, recruited from the Melbourne, Australia, community, assigned either to a supervised lifestyle intervention or to undergo gastric banding, and followed up for 2 years. The study was performed between May 2005 and September 2008.

Main Outcome Measures Weight loss. Secondary outcomes included change in metabolic syndrome, insulin resistance, quality of life, and adverse outcomes.

Results Twenty-four of 25 patients in the gastric banding group and 18 of 25 in lifestyle group completed the study. Twenty-one (84%) in the gastric banding and 3 (12%) in the lifestyle groups lost more than 50% of excess weight, corrected for age. Overall, the mean changes in the gastric banding group were a weight loss of 34.6 kg (95% CI, 30.2-39.0), representing an excess weight loss of 78.8% (95% CI, 66.6%-91.0%), 12.7 BMI units (95% CI, 11.3-14.2), and a BMI z score change from 2.39 (95% CI, 2.05-2.73) to 1.32 (95% CI, 0.98-1.66). The mean losses in the lifestyle group were 3.0 kg (95% CI, 2.1-8.1), representing excess weight loss of 13.2% (95% CI, 2.6%-21.0%), 1.3 BMI units (95% CI, 0.4-2.9), and a BMI z score change from 2.41 (95% CI, 2.21-2.66) to 2.26 (95% CI, 1.91-2.43). At entry, 9 participants (36%) in the gastric banding group and 10 (40%) in the lifestyle group had the metabolic syndrome. At 24 months, none of the gastric banding group had the metabolic syndrome (P = .008; McNemar ²) compared with 4 of the 18 completers (22%) in the lifestyle group (P = .13). The gastric banding group experienced improved quality of life with no perioperative adverse events. However, 8 operations (33%) were required in 7 patients for revisional procedures either for proximal pouch dilatation or tubing injury during follow-up.

Conclusions Among obese adolescent participants, use of gastric banding compared with lifestyle intervention resulted in a greater percentage achieving a loss of 50% of excess weight, corrected for age. There were associated benefits to health and quality of life.

Trial Registration ANZCTR Identifier: 12605000160639

Author Affiliations: Centre for Obesity Research and Education (Drs O’Brien, Brown, Skinner, Burton, and Dixon and Mss Laurie, McGrice, and Anderson); Obesity Research Unit, Department of General Practice (Dr Dixon); and Department of Epidemiology and Preventive Medicine, Monash University (Mr Paul); Centre for Adolescent Health, Royal Children's Hospital (Drs Sawyer and Veit); Department of Paediatrics, University of Melbourne, and Murdoch Children's Research Institute (Dr Sawyer), Melbourne, Australia.

Is Banding or Bypass Surgery Best for Obese Teens?

By Anna Wilde Mathews

scalesA new study in JAMA reports that teens who got bariatric surgery lost a substantial amount of weight. But the clinical trial only looked at one type of surgery — gastric banding, which involves wrapping a silicone band around the upper stomach to restrict food intake.

There’s another bariatric procedure, gastric bypass surgery, which typically involves creating a small stomach pouch and a passage so food bypasses the rest of the stomach and parts of the small intestine. The authors argued in their paper that gastric banding is more appropriate for young patients because it is safer than gastric bypass as well as being “adjustable and reversible.”

Paul O’Brien, the lead author, said in an interview that “the band is safe, whereas the bypass is not yet safe enough.” For teenagers, the option to remove the band later in life is important, partly because new treatment options may emerge, according to O’Brien. “The band I can back away from, the bypass I can’t back away from,” he said.

But that argument is likely to spark some debate, reflecting the back-and-forth that’s already common among surgeons over which procedure is best for adults. Another prominent researcher, Thomas Inge of Cincinnati Children’s Hospital, who is leading a major NIH-funded study of bariatric surgery in young people, said “the jury is out for the teens on which is going to be more effective.” He said bypass operations are “generally more effective for weight loss,” and that the safety question is “subject to interpretation.”

Inge and others note that in the past, the Australian group that led the new study has seen better results from banding than are typical in the U.S., partly because of the fractured U.S. health system and payment policies that can limit follow-up care.

Image: iStockphoto

Commercials Are the Culprit in TV-Obesity Link

By TARA PARKER-POPE

Too much time in front of the television has long been linked to childhood obesity. Now, new research suggests it’s not the TV but the commercials that are making kids fat.

In a study of more than 2,000 children, researchers from the University of California, Los Angeles, compared the time the kids spent viewing television and video. They asked caregivers to track children’s media use during one weekday and one weekend day during 1997, then again in 2002.

The findings showed that the amount of television a child watched wasn’t a predictor of obesity risk. Instead, risk for being overweight increased the more television commercials a child was exposed to. There was no association with television viewing and obesity for those who watched videos or commercial-free programming.

Although the effect was seen among all children studied, it was strongest for children younger than 7, according to the report in The American Journal of Public Health.

Because people with more education and better eating habits might also insist their children watch videos or PBS rather than commercial television, the study authors controlled for a number of other factors that might influence the findings. They looked at such variables as the mother’s weight and education level, the child’s starting weight and overall physical activity, time spent eating in front of the television and even the amount of sleep children were getting. Even after controlling for these factors, the link between commercials and weight gain remained.

Fred Zimmerman, the study’s lead author and chairman of U.C.L.A.’s Department of Health Services, said television commercials for sweetened cereals, junk food and fast food chains probably had an insidious influence over a child’s food preferences. The more television commercials a child is exposed to, the more likely he or she will be to try those foods and want to continue eating them, which then increases risk for weight gain.

Although it’s long been speculated that television viewing is associated with a lack of physical activity, that’s often not the case. Young children often stand, jump and wiggle while watching television, and children who play sports also may be watching more sports programming.

“There’s been a fair amount of work showing TV viewing is associated with obesity,’’ Dr. Zimmerman said. “What’s new about this research is that it suggests there’s no evidence of a couch potato effect. It’s highly suggestive that it’s the effect of watching TV commercials.’’

The study wasn’t able to document how much food advertising children were exposed to. But research shows that young children are exposed to about 30 hours of food-related advertising annually. During Saturday cartoons, children see an average of one food ad every five minutes, most of which are for junk food, the researchers noted.

“Advertisers have been clever about building brand loyalty, making these foods seem attractive,’’ Dr. Zimmerman said. “I was talking with one of my graduate students who was saying, ‘When I was a kid, it was just a dorky rabbit talking about Trix.’ Now it’s about being cool, and what’s fun and exciting. It really grabs your emotions much more powerfully than it used to.’’

For more information on obesity, see the Times Topics Obesity Page.