My daughter was 3 years old the first time a doctor scolded me about her weight. I didn’t understand it then, and it’s still a bit of a mystery to me now.
“Little” was just 21 months old and 22 pounds when we adopted her from Yongning, China, in 2012. She had been left in a field with pneumonia as an infant, presumably to be discovered or die. There were IV marks on her arms, feet and even scalp, suggesting her birth family tried to get her treatment but had exhausted its resources.
Luckily, a farmer found her. She went to the local orphanage, got medical care, then spent a year with an indulgent foster family before she came to ours. Little had been with us only a few months when bronchitis sent us to the emergency room. The point here is, she endured multiple rounds of antibiotics by age 2, which has been associated with a higher risk of obesity in later childhood.
At least, that’s the best I can figure. We’ve never talked about weight but rather about health: It’s hard on the body to carry an extra 10, 20, 30, 40 pounds everywhere! We made great progress during the pandemic when we could manage everything she ate, and she was close to normal weight for her age by the time schools reopened in 2021.
Then the real trouble began.
California public schools were required to provide free breakfast and lunch to all kids, regardless of financial need. This kindness to struggling families turned into a curse for Little’s still-developing impulse control. She was in fourth grade. There was breakfast at home, and another at school! Lunch from home — and another at school! When we asked the school for help, officials said they could not deny food to a child who said they were hungry. Even if the child was clinically obese.
It has been a struggle ever since.
Putting on pounds
We’re apparently not alone here.
“There appears to be a slight increase in the newest data among youth in low-income homes and among all youth” who are heavier pre- and post-pandemic, the California Department of Public Health told us.
• Among adolescents aged 12-17 statewide, 18% were obese in 2022, compared to 14.6% in 2014, according to state data.
• Among fifth graders, obesity hovered around 15% through those years.
• But obesity is just part of the problem. Thirty-six percent of adolescents were overweight in 2022, according to data from the California Health Interview Survey at UCLA.
• On the local front, Orange County kids are less overweight than their counterparts in surrounding counties, but non-White kids were more likely to struggle everywhere.
There had been a statistically significant drop in overweight 2-11-year-olds in families earning less than 185% of the federal poverty level statewide between 2018 and 2021, CDPH said, but the new data suggests the rate increased almost one full percentage point.
“Obesity is a complex disease with many contributing factors,” a spokesperson said by email. “These shorter-term fluctuations in obesity rates could be due to a variety of social, economic, health care or other secular factors, making it difficult to pinpoint any one factor. Neighborhood design; access to healthy, affordable foods and beverages; and access to safe and convenient places for physical activity, among others, can all impact obesity.”
Racial and ethnic disparities play a role, too, the U.S. Centers for Disease Control and Prevention says, and underscore the need to address social determinants of health such as poverty, education and housing to remove barriers to health.
CDPH said it’s on the case, with its Nutrition and Physical Activity Branch working with local health departments, schools, afterschool and summer programs and other organizations to stress good eating and physical activity “to make the healthy choice the easy choice,” CDPH said.
Those choices aren’t always easy for fourth-graders, however.
‘Food noise’
Semaglutide, in its Ozempic incarnation.
Two years ago, the American Academy of Pediatrics said kids with obesity should be offered more intensive treatment sooner rather than later, including therapy and medication. We discussed side effects, risks and (obscene, uninsured) costs. But the light went on when the doctor said the most amazing thing about the drug may be how it silences “food noise” — the constant cravings for this or that, the obsessive thinking about what to eat next.
Little said she had food noise. She wanted to try.
So, a painful $714 later, we are in possession of a one-month supply of Ozempic. Little giggled as I tried to swab her belly with the alcohol wipe. She couldn’t stop laughing long enough for me to stick the tiny needle in. So, she did it herself.
I’ve told a few people about this, and the disapproval feels thick. Like having addiction issues, weight is often viewed through a lens of blame. Just don’t take those drugs. Just don’t eat that cookie. It’s a matter of will — and if you succumb, you’re weak.
I’m sure I’ll also hear from folks who’ll say I’ve failed at parenting by allowing this. But I’ve been reporting on addiction for eight years and the parallels are inescapable. Drug addiction is a physical phenomenon with acute health effects; so is obesity. An addict’s physical cravings for (some) drugs can be managed by medication; an obese person’s physical cravings for food can be managed by medication, too.
Think of it like diabetes. It’s a physical condition managed with medication. While diabetics may learn to better manage their condition and eventually lower their insulin dosage, we don’t expect them to conquer it entirely and quit the medication. Addiction doctors say we shouldn’t expect drug users to conquer and quit their meds either — if they need to take them forever to keep control of their lives, so be it.
Little’s doctor feels the same way about the weight drugs. While there’s still much to learn about them, she’s not sure quitting cold turkey — when a lot of folks have regained weight — is necessary. She envisions a future — maybe just six months from now — when the frequency shrinks from one shot a week to one a month, or maybe even less frequently.
The status quo is just not OK. Obesity in children increases the risk for high blood pressure and high cholesterol (which are risk factors for heart disease); breathing problems, such as asthma and sleep apnea; joint problems such as osteoarthritis and musculoskeletal discomfort; gallstones and gallbladder disease; and Type 2 diabetes, according to the CDC.
It’s also associated with psychological problems such as anxiety and depression; low self-esteem and lower self-reported quality of life; social problems such as bullying and stigma. We’ve been through a lot of that.
And, of course, it often translates into obesity as adults. That means higher risks for stroke, many types of cancer, premature death and mental illness such as clinical depression and anxiety. It’s also absurdly expensive: Annual obesity-related medical care costs in the U.S. were about $173 billion, and the “productivity costs” of obesity-related absenteeism have been estimated between $3.4 billion and $6.4 billion, the CDC said.
So. Here we go. I’ve gotten permission from Little to share her journey here, and we’ll keep you updated on our progress. If you’ve had a child go through this, we’d love to hear your wisdom and share it with our readers. Please wish us luck (and spare us the hate mail)!