Fudge a factor in the obesity epidemic – and not just the kind on ice cream
Submitted by Debra on Sunday, 4 January 2009
4 Comments
How to kid yourself about the obesity epidemic without even trying:- Say "it's just baby fat" as the baby approaches kindergarten.
- Pretend that Pull-Ups made for kids up to 125 pounds are for potty-training teens.
- Believe a pediatrician who says a child's not overweight.
The last is kind of amazing. Checkups are supposed to tell use what's going on with our children, let us know what to look out for. But according to new research by Case Western Reserve University, a doctor's assurance about a child's weight is nothing to go on the overwhelming majority of the time.
"This is a bit of a wake-up call to pediatricians that as many as 90 percent of overweight children are not being properly diagnosed," said Dr. David C. Kaelber, an assistant professor at Case Western and the study's lead author.
According to an article on sciencedaily.com, researchers reviewed Body Mass Index measurements for 60,711 children who had check-ups between June 1999 and October 2007. That review showed 19 percent were overweight, 23 percent were obese, and 8 percent were severely obese.
Those figures alone are eye-popping: Half of 60,000-plus children had weight problems.
The truly troubling part, though: Only 10 percent of the overweight children were correctly diagnosed. Among obese children, 54 percent were correctly categorized. For severely obese children, it was 76 percent.
It gets worse. Even though an automatic electronic flag for high BMIs was used from 2004-07, researchers found that diagnoses did not become more accurate as a result.
So let me get this straight: Looking at the patient is a tip-off that there could be a medical problem. The data collected during the exam confirm it. In case you miss the first two signs, you get an electronic alert that something's going on and you still ignore it.
How does this happen?
Is it possible in this day and age that there are doctors who are not aware that childhood obesity is a serious medical issue? Are there physicians who would rather protect a patient's self-esteem by avoiding a label, but at the cost of exposing the child to a lifetime of problems ranging from diabetes to heart disease?
It's somewhat encouraging that as the problem escalates doctors are better at facing up to it, as demonstrated by the higher percentages of correct diagnoses in the obese and severely obese categories.
The tragedy, though, is they're letting it slide in children who could be helped early on.
"Better identification of this group of children who have just crossed into the 'unhealthy' weight category is essential for early intervention which will hopefully prevent not only a childhood of increased health problems, but also what now often becomes an ongoing battle through adulthood with life-long issues," Kaelber continued.
I understand that today's pediatricians face check lists longer than a growth chart and immunization records that practically have to be printed on legal size paper. Our doctor asks about everything from reading to drawing.
I also get that some parents would face a diagnosis that their child is overweight with either denial or outright hostility.
But, dang it, this is important. To overlook it sounds like malpractice by omission.
Copyright 2009 Debra Legg. All rights reserved.






Sadly, I was one of those undiagnosed children. I weighed 200 pounds when I was 10. I truly believe it’s not a matter of doctors not realizing a child is obese as much as it’s an unwillingness to deal with how parents would react to such a diagnosis.
I know my mother would have switched doctors had my pediatrician said anything about my weight. I don’t like the fact that he assured my mom I was healthy in spite of my size … or that I have had to battle the effects of long-term morbid obesity my entire life. But I’m not sure what he could have said that would have opened my mother’s eyes without alienating her.
So was I, Tonya, though my weight never climbed that high. At age 11, though, I was 5 feet tall and 160 pounds. That’s still a BMI of 31, though.
No one ever said anything — except classmates who were relentless in their taunts and the occasional relative who would make cruel cracks about buying back-to-school clothes at the tent and awning store.
By the time I was 12, I took matters into my own hands and went from a size 18 to size 6 in four months. I did it all the wrong way, of course, starting off with a two-day fast followed by a stringent crash diet. I did eventually start running, though not before my metabolism was hopelessly goofed up.
I suppose that’s why this is why childhood obesity is such a hot-button issue with me. I’ve seen the health effects — both physical and mental. Both linger through out life.
I commend both of you ladies for tackling childhood obesity head on(Tonya & Debra). I was not an obese child, but my best friend during elementary school was and I witnessed the horrible taunts and teases that she endured. The good news? I threatened to kick the crap out of this one particular skanky boy who kept teasing her. The bad news? The teacher called my parents. Good thing my parents agreed with my antics
Beating up aside, I agree that it’s important for doctors to do a better job of diagnosing the problem before it gets out of control for children. It’s also important for parents to stop “living in denial” that their child is “ok.” Naturally, it’s tough to admit your child has a problem of any sort (take it from a shrink, I’ve seen it all), but once you do, you and your child are on the courageous road to recovery and it’s well worth the battle.
Dang it, Elizabeth, I like you more every day. Particularly with your history of taking on the bullies. Maybe you need a Mr. Clean-type logo for your site: Parenting Pink: Tough on human dirt.
You’re absolutely right, too, that denial doesn’t make problems go away. I’ve never seen a single case, in fact, where it hasn’t made them worse.
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