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.