The Childhood Obesity Dilemma: How Something So Simple Got Complicated

Feb. 10, 2010— -- This is the first of a weekly coulmn by Dr. Besser that examines public health issues across the nation.

In a large shopping center in Northeast Atlanta, St. Joseph's Mercy Care provides a medical safety net for some of the city's poorest residents. I have volunteered with Mercy for more than a decade as a general pediatrician. Most patients have no insurance and pay what they can to be seen. One half day each week, I switch gears, taking off my public health hat and putting on my clinical one. There is something wonderful about the immediate experience of being with a child and a mother, focusing on their concerns, and trying to help them maintain or regain health.

What I've seen in my clinic is being seen across the country and is captured in statistics. More than one out of every three of children are overweight or obese, according the U.S. Centers for Disease Control. Type two diabetes -- a disease linked to obesity and previously seen almost entirely in adults -- is on the rise in children. Kids are exercising less and eating more; going outdoors less and video-gaming more.

As a pediatrician, I talk to all children and parents about healthy choices -- food and exercise are always part of the conversation.

I remember one of the many times I talked about this with a mother of Jorge, an 11-year old Latino boy who is overweight but not yet obese. Being Latino, his risk for developing diabetes was high. His mother was very concerned.

"What does Jorge like to drink?" I asked.
"Soda! I tell him no but he drinks three or four bottles a day! I know it isn't good for him."
"Where does he get the soda?"
"I buy it for him."

We talk about healthy choices: foods that should be eaten or offered every day and foods that are called "sometimes" foods, those that should only be given occasionally. Soda fits into that category. Soda consumption by children has risen by 30 percent in the past decade and now accounts for 10-15 percent of their total calories, according to a 2004 study in the American Journal of Preventive Medicine.