Right. My hesitation in throwing in sucrose (and glucose!) under the label of addictive substance is that glucose is obviously essential to normal function. I hesitate to label something like that as an addictive substance. In practice my cravings don’t notice the difference between fructose, glucose, and sucrose.
ETA. And in my personal experience, non-caloric sweeteners most definitely don’t hit the same, or even at all. I go so far as to derisively label things like Stevia and monkfruit sweetener as naturally occurring fake sugar .
Case closed. Most of us already have an available “cure”, and that is to use at least as many calories as we consume. It’s implementing the “cure” that can be difficult because we are surrounded by a plethora of culinary riches, we have to make a special effort to exercise and burn more calories, and we have to deal with emotional issues that might cause one to be an “emotional eater”.
This is the opposite of what was found in the approval studies, where side effects declined over time. Do you have a citation for this?
Well, if you mean abundant food availability, that is indeed a necessary predecessor for obesity.
Is everyone aware of the many studies showing that starvation leads to later obesity when food becomes easily available? Happened to POW’s after the U.S. Civil War. Happened to starved people after World War II, including holocaust victims and survivors of the Dutch hunger winter. Happened to survivors of the 1959 - 1961 famine in China. I’m not putting in bunches of links but they are easy to Google.
In recent decades we have a situation where many people are going into a calorie restriction mode not once, but repeatedly, due to dieting, and, now, drug-induced calorie reduction. Effect on obesity is predictable — short term less, long term more.
The first happens whenever people can afford to buy all the food desired. I’m strongly against giving that up.
As for physical exertion, there is evidence that male subsistence farmers in China avoided the obesity effects of the 1960 famine. So you are correct about lifestyle there, but how many of us will take a job that requires physical exertion all day long?
The lesson for Wegovy and similar drugs is that if patients are unwilling to stay on for life, they will backfire.
P.S. There are some people who have successful lifelong weight loss from voluntary calorie restriction. I am of writing about averages, not atypical cases. I like the word disease because it implies treatments will be based on what works best for the greatest number of patients, in the long-term.
No, it is not complicated. It is simple, but as we all know simple has absolutely nothing to do with easy. With all her wealth she still “struggles”? Oh dear.
This article implies Americans (and so likely Canadians) are getting more obese. Not that surprising. But it also implies people are getting shorter. I didn’t know this, if it is true, but neither did most people.
I think it is worth returning to the concern of the OP:
The OP’s granddaughter, her family, cannot rely on these medications as some kind of miracle.
Dieting during childhood is strongly associated with increased future risk of both obesity and eating disorders. Getting bullied does not motivate change in childhood or adulthood - it makes things worse.
Neither she or her family can alter to food environment outside the household, or change her genetic predisposition to become obese in the face of our modern obesigenic environment.
What they can do is -
De-emphasize attention to weight and increase emphasis on lifestyle habits.
Control the food environment in the home at least and for the complete household.
Most emphasis on healthy options. Lowest hanging fruit is virtually no sweet beverages. Not soda, sweet tea, sports drinks, juice, or even diet drinks. Water and milk. Special occasions maybe.
Dessert is a treat.
The same healthy patterns of eating offered as adults: lots of vegetables, fruits, legumes, etc.
As grandparent do not show your love with treats. But teaching her to cook healthy foods together for the benefit of the whole family, predisposed to obesity or not, is wonderful.
Model and encourage mindful eating. Slow it down. Small portions and eat more if after assessing it there is still hunger. Not just because it is there. But she needs to be the one in control of that.
Exercise preferably together. For fun and health. Not with the goal of her becoming thin.
Do those things and as she grows maybe she’ll grow more in height than weight and stretch out. But if not she will be healthy and that is what matters.
Preventing serious obesity and avoiding unhealthy lifestyle habits will result.
The decrease in height remains to some degree after controlling for immigration, race, aging … but is strongly associated with lower education (and presumptively SES). As is obesity and less ideal nutrition. Junk food is more available and cheaper. Obesity correlates with earlier puberty and height growth stopping sooner.
I don’t know how often you get to see her, but the good news is that she has someone on her side – you.
A niece of mine was in this situation, with her weight a frequent subject at family gatherings. I would say I am ashamed I could not significantly shut it down, except that I don’t see how I could have. Now she is a married mother with a husband who I have the greatest admiration for. This of course is far more important than anything in the thread.
Re what DSeid wrote, it sounds like excellent advice by itself, the question being how it will be received on top of all the messaging your granddaughter is already receiving.
I don’t know. A little googling shows that, just like with other variations on cosmetic surgery, there are successes and failures. I would never push it!
It makes sense, but some of the conclusions drawn were new to me. It is a very good article. I also think I am getting shorter and heavier, but perhaps gravity is especially fierce in these parts.
Hopefully our OP has a good relationship with and is respected by the parents and can support that approach in the household. Prevention (in this case of serious adult obesity with morbidities and poor self image) is always more effective and less difficult than cure.
Real world honestly the grandmother (and yeah not as often the grandfather) is not infrequently more a problem than a help. The price of their helping with daycare is their spoiling their darling grandkid with food, and parents are often powerless against that. There have been multiple times that I’ve seen childhood obesity improve dramatically when other care has been found. Grandparents’ messaging is also often of power, both to the parents and the child. It can be helpful with unconditional love. Or it can reinforce over attention to body image and the scale.
Thanks to everyone for the responses. I don’t spend much time with the kids these days, but I admit I really struggle to feed her and her siblings when they are with me. The middle kid is the absolute pickiest eater I’ve ever run into. I think they have some pretty bad eating habits already, unfortunately.
I do wish kids weren’t such little shits sometimes.
FWIW re picky eaters: what are you worried about? They won’t starve themselves into malnutrition. (Short a very few kids with specific eating disorders.) Offer reasonable and healthy meals and snacks. Period. If they don’t eat it oh well. Their choice. Whether it’s with parent or visiting grandparent the authority trying to cater, convince, coerce, or otherwise control are not effective tactics.
You risk turning into the cartoon: oh darling you are getting fat and why don’t you eat!
Enjoy kids being little shits! Soon enough they will join us adults and old farts as big shits …
I love kids. I enjoy them very much. I don’t like hurtful name calling, whether from the little shits or the big ones. It’s wrong to want to punch a 12 year old when you’re 67 though.
I will just say that the way they eat is a bit dysfunctional to me and so I worry. The oldest is going to be overweight and the middle one is skinny as a rail.
I think I worry about self esteem issues as much as anything.
Very seriously here, be diligent to self monitor your comments to each of them.
I don’t know you but I do know others who do have their own history with body image and food being used as a power item by their caregivers who project that onto their kids and grandkids. That may not be you but you are saying the sorts of things those people say.
Above all else do not encourage them to change their body shapes in service of their self esteem.
I do want to revisit the conceptualization of obesity as a disease.
Clearly it is a condition resultant of genetic predisposition, even trans generational epigenetic change, coupled with life in an environment that these predispositions are not built for.
Is the condition necessarily pathological? It certainly is strongly correlated with pathologies. But to very large degree those pathologies are correlated with the behaviors whether obese or “ideal” BMI.
The concept that obesity itself is a disease per se that should cured?
I think obesity will cease to be a public health crisis when the world changes. When global agricapitalism ceases to funnel people into eating food that is terrible for one’s health – enormous amounts of sugar, trans fats, far too much meat, over-processed everything, and instead people start eating in a far healthier manner, plant-based and minimally processed.
I also think obesity will cease to be a public health crisis when humans have to move to stay alive: physical work is again the norm, walking and bicycling the normal forms of transport. Entertainments would normally consist of sports you yourself participate in, dancing and singing in community, and little to no time spent staring at a flickering box.
That is to say, our way of life almost of necessity leads to obesity. Obesity is just one of the symptoms of a sick culture. You can call it a disease, or whatever you want. The culture will have to change before obesity changes.
I don’t do that. I give them unconditional love. But I see the hurt in her eyes when her classmate calls her fatty and I know how much that can shape a persons self esteem. I want a lovely happy life for her.
So I hope science can someday help with this very difficult issue.
It’s the normal response of the body, developed over many million years of evolution, to intermittent periods of caloric deprivation alternated with caloric plenty: store the excess calories in fat, so you’ll have them available when you need them. Long predates the ability to store them by learned food preservation techniques. It’s not a disease process, it’s a health process.
But it goes wrong in our current circumstances for a combination of reasons: for one, for very many people in the modern world the excess calories are almost always available. For two, people are strongly encouraged to go on calorie restriction diets, thereby triggering the mechanism. For three, much of the food many people eat is carefully jiggered to hit as many as possible of the instincts that say ‘eat more of this!’ – which reactions developed when the sugars and salt that bring them on were hard to come by. And then on top of all of that people get convinced that they mustn’t eat satiety-producing fats –
One reason that we’ve got a lot more fat people than we used to is that we changed the definitions.
And another is that we’ve had a whole lot more people going on those diets. Partly because of that change in definitions; and partly due to a lot of advertising. There’s lots of money in the weight-loss business; and as long as they can convince people that its failures are due entirely to the customers, they can keep right on making it.
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