Most doctors won’t be able to help an overweight child

I asked many doctors over the years to help me with Juliana’s weight.  What was going on?  What do I do?  I got no help.  Her family practice doctor, whom I loved, told me frankly that doctors had no idea what was causing the obesity epidemic among children.  She asked Juliana what her favorite vegetable was.  Juliana replied “broccoli.”  That was the extent of our nutritional counseling.  All of the doctors I consulted prescribed “watchful waiting,” what I now think of as the hope that she would “grow into her weight.”

Why does the “grow into their weight idea” persist in the face of the evidence that most overweight children will become overweight adults?  In part because it’s almost impossible to lose weight and keep it off on the Standard American Diet if you are sensitive to carbohydrates (and all of us become more sensitive over time if we continue to eat carbohydrates–this is one of the reasons people tend to gain weight as they age).  Your doctor knows how little success he or she has counseling patients to lose weight–almost none of them do.  The myth allows everyone to postpone the day of reckoning for overweight or obese children.

A friend of mine provided a perfect example of this phenomenon recently.  She took her 14 year old to the doctor for a yearly physical, and wanted the doctor to help her discuss weight management with the teen.  The teen had recently gained a lot of weight without growing taller, and was clearly becoming uncomfortable with her appearance.  But the doctor didn’t.  Instead, she said that since the teen was “only” in the 80th percentile for Body Mass Index, she wasn’t overweight, and not to worry about it.  The doctor didn’t advise doing anything, even though the teen had gone from the 42nd percentile BMI at her last checkup a year prior to 80th percentile at this checkup.  I bet the doctor was relieved that the teen hadn’t crossed the 85 percent threshold, where she would technically be considered overweight, because the doctor knows she doesn’t have any effective information to offer on how the teen can slim down.

When I ate a vegetarian diet, I was heavier

As a former, 18-year vegetarian, the information about carbohydrates was very surprising. Being a vegetarian entails eating even more carbohydrates than an omnivore, and I considered that eating plan to be super healthy. When I thought back, however, I realized that I had generally been heavier as a vegetarian than I was as an omnivore. I weighed more in college than I did after having three children.

I thought about our efforts on the Packard program. Juliana and I had gone heavily into a plant-based eating plan as a way of eliminating reds. We ate a lot of bean soups, with a small amount of meat for flavoring. I went even further in that direction then Juliana, adopting an “Eat to Live” style diet in which one eats mountains of vegetables and fruit.

I also, in accordance with the red/yellow/green system, stopped eating any dessert.  I lost 3 or 4 pounds over a month. I had noticed that while I was satisfied enough after eating a mountain of vegetables, I really, really craved the whole wheat pita bread with lowfat cheese I had alongside it.  It wasn’t a particularly yummy carb, whole wheat pita bread, but my body was acting like it was chocolate cake.  Hmmm…what was it about carbs?

Her grandfather had type II diabetes

I also remembered that Juliana’s grandfather, although healthy overall and not overweight when I knew him (he had been heavier when he was younger), developed diabetes in his 70′s, a few years before he died.  He was able to control it without medication by limiting his carbohydrate intake to less than 200 grams a day.

Type 2 diabetes doesn’t just appear overnight–it’s the end result of an ongoing process.  A person is classified as diabetic when their insulin response crosses a certain threshold.  But before it crosses that threshold it’s been approaching it for years.  And the stimulus that creates the insulin reaction is carbohydrate.

Juliana’s grandfather’s diabetes was a further clue that Juliana could be predisposed to carbohydrate sensitivity.  The effect of carbohydrate sensitivity is more insulin production in the body for the same amount of carbohydrate relative to a non-sensitive individual.  More insulin production causes weight gain.   If you or your child’s other parent is overweight, or his or her siblings or parents; or your siblings or parents; or if there is type 2 diabetes in either family even if no one is overweight, these are further indications that your child may have a low tolerance for carbohydrates.