Here's the first 150 words:

http://jama.ama-assn.org/content/306/2/206.short

Thoughts?

I have heard a few people discussing this today- with reactions from blaming parents to blaming schools, restaurants, etc.

Not sure how I feel about placing the blame solely on parents, but I do think this is a major issue that is going to add pressure to an already over-stressed system.

I do place most of the "responsibility" on parents, just as I do when kids end up juvenile delinquents.

Responsibility belongs squarely on parents and starts in infancy. Kids are overfed right from the start and food is used as a pacifier. I cannot believe the number of children I see eating in CHURCH! (I am not talking about infants who need a bottle or breast here either). If a child who has been weaned from bottle or breast cannot go one hour without eating, there is a problem, and it's only going to get bigger.

I see a problem of neglect in the extreme cases, e.g. a 500-lb 11 year old. However, I am VERY leery of setting a law based on extremes.

Once the rollercoaster starts, it's hard to stop. Where will the line be drawn? Will it expand to parents who smoke? Drink alcohol? Kids who are only modestly overweight?

Parents need to be encouraged to be parents, not friends. Having the state take over in doling out what's right and wrong takes part of the parenting away.

I take care of the parents. The point is, they don't understand or they have no concept of personal responsibility. They haven't a clue about nutrition, they have numerous "well thought out" reasons why they can't expend more calories than it takes to get from the couch to the fridge. So no wonder their kids are fat. I don't think it is intentional, it is just a very sick life style.

I don't think we are very far from Rome before it crumbled.

I think there is also the issue of electronics versus good old fashioned play outdoors. I see it in my own kids- "mom, can I play on the computer? They showed us this really cool website (!) in school that etc. etc. etc.

We live in an apartment complex full of kids, and you know what the majority are spending their summer doing? Playing video games. Not joking. AND where we live is mostly grad students, so you would think with the advantage of having more education, would push their children to get outside a bit!

And totally agree with being a parent versus a friend. I saw it far too often as a social worker- the kids who were the most out of control had parents who were trying to be 'cool' instead of parent.

But, all of that being said- I cannot support the involvement of CPS. That system is broken, foster care is ridiculous, and with this paper talking of 'temporary' foster care, you are still ultimately planning on putting the child back in the same environment so what good would removal be?

Agree that foster care is not a good plan, but perhaps some sort of monitoring in the home and education for the parents, particularly in the cases of extreme morbid obesity.

I live in a neighborhood where the "average" educational achievement is a Master's degree and the average income is in the 6 figure range. And many of the kids AND parents are overweight.

So the excuse of not knowing any better or not being able to afford healthy food choices is moot.

You know, I always find it interesting in these kinds of debates that folks usually go the "Sha-nae-nae and 'nem " route, forgetting what's going on in their own backyard. And while it is true that MANY women of color ARE overweight, the only difference I see between them and the women that live in my neighborhood is that women of color seem to maintain their self-esteem no matter how overweight they are.

I published a study (well, me and some others...) a couple months ago looking at pediatric obesity in an urban ED. Bottom line, we found that it really wasn't a knowledge gap issue.

Apparently, people know certain things are bad and unhealthy, and don't care.

At least, that's what we took away from it. (behavior gap vs knowledge gap.)

And that, folks, is what I spent hours slaving away on.
I'm totally tempted to cite myself here, but I'll spare you.

I think you hit the nail on the head - parental responsibility. Parents are beginning to forget how to be parents. Maybe it's just me, but I see people having kids and treat them like dolls or pets instead of children, who should be molded into productive members of society with the right balance of love and discipline. It was especially hard in my former career, when I saw it happening so early (I worked with birth-3 ages in their homes). And lifestyle or SES wasn't necessarily a factor.

I saw a lot of moms, and to some extend dads, who just didn't want their kids to cry, or want their kids to "hate them", or just didn't know the right things to do, as you said.

And, of course, everyone has a metabolism/thyroid disorder *insert rolleyes*

I'm getting a little sick of your unwarranted attacks.

You may disagree with my comments, but there is no "indirect", sly comments, no matter what you want to believe. Seek help.

There will be NO personal attacks or vendetta type writing zeroing in on any perticular member. keep it civil or this thread will be closed.

I find the major barrier to obesity education for kids is that the parents are offended that you have addressed it. The majority (certainly not all, probably near 60-70% if I'm guessing) of overweight kids have overweight parents, and it is a real uphill struggle to treat these kids when they have no healthy role models at home. Or the parents don't want to address their own issues, therefore they must also ignore the kids'. I don't know what the solution is, but I am sure that foster care is not it... traumatized kids are certainly more likely to seek refuge in overeating, particularly when that is their main coping mechanism at baseline. I usually refer to dietary education, and the people that actually attend generally get good results, but getting them there is more than half the battle!

Interesting discussion, which I feel drawn to even though I don't really think that I have anything to add. I grew up with a mom who struggled with obesity. During my adolescence, I took jazz, ballet and tap classes as well as playing for my school's soccer team. I didn't really understand my mom's struggle with obestiy. No, I'll take it one step further ... I was disdainful. I kept my opinions to myself but I often wondered why on earth she couldn't just "get control".

Payback is a bitch!

I gained 70 pounds during my pregnancy with my first child. As in 7 - 0. I couldn't understand it. My OB and her nurses admonished me every time I came in for a new monthly appt. and was up another 8-10 pounds. I cried. I logged my food calories. I walked every day. I didn't have a thyroid problem. I reached a point of full-fledged obsession by the time my pregnancy was finally over! I figured that it was calories in/calories out ... and try as I might I just couldn't lose the weight after the pregnancy. I lost about 40 pounds before getting pregnant again and once again I saw that balloon of weight. When I had baby #3, I actually weighed more after coming home from the hospital with him. I figured it was just fluid retention ... maybe it WAS, but it took me 6 weeks to get back to my DELIVERY weight.

Sob!

I have been working very diligently on my weight over the last 2 years after reaching a point of being 100 *gulp* pounds overweight. I got down 65 pounds with strict diet/exercise but fell out of that for a short period because of problems that I was having with neuropathy and starting neurontin. I immediately gained 30 pounds back. No kidding.

Getting back on track has been hard, but I'm almost back to my -65 ... again. Once I hit that, I'll still need to pony up for another 35 pound loss.

I work very hard to NOT have my weight issues bleed over into my children's issues.

Interesting twist? Before I started losing weight and was at my highest weight ever (and yes, steroids for the treatment of pulmonary issues WERE involved in getting there!) my daughter began struggling with anorexia. She was in the 8th grade. She was bullied into not eating by a girl who teased her mercilessly. That is how it started anyway.

When I sought help for her, I was the bad guy as a parent....because I was FAT ... there were some who felt that my daughter was somehow trying to escape a legacy of obesity passed on by me. The guilt I felt was enormous. The disdain that I was treated with by those people? Ick.

My daughter maintained the entire time that it was the bullying that sent her into a tailspin ... and it was me nursing her to health over the summer that brought her up to a normal weight ... but the sting has remained for me.

Do parents need to make better choices for their kids sometimes? Yes.

Are they the only ones to blame though? Not really. A quick trip to my children's middle school ala cart line tells a story of kids who can buy pizza, fries, cookies and sugary drinks every day. Forget that though. The elementary school here serves meals like fried chicken sandwich, french fries, mashed potatoes with gravy and corn ... and most kids are allowed to get two helpings. Physical education has all but been completely gutted from the system. To top it off, recess time is now just twice a day for 15 minutes each time.

After school, parents are guilted into having their children in as many activities as possible. This means that instead of riding bikes in the neighborhood they are being driven to piano lessons, kung fu or whatever. Even if these activities are sports-related, they are a far cry from the days where kids jumped off of the bus at 3pm and ran/biked until dinner time.

This is an issue that has multiple layers. I am by no means completely unbiased because of my struggle with my weight ... I can't see blaming parents though when there are so many factors involved.

Kris

There are temptations out there, from cradle to grave. But isn't it a parent's job to teach their children about wise choices? If a school lunch is not appropriate, what about packing lunch for your kid?

As far as activities go and shuttling, again the common denominator is the parents doing the shuttling and not encouraging the exercise to walk to these activities. Of course, I grew up in a smaller town, where I maybe had to walk or bike 1-2 miles at most for piano, swimming, softball, school, etc. I'm sure it's different for urban, suburban kids. And again, it's the parent's responsibility to make sure their kids aren't overextended in activities as well.

Being overweight is usually a behavioral challenge. And like any behaviors, children mimic what they see at home. Moderation seems to be a good principle.

I think it's very easy to place blame on other sources, like schools, pressures, etc because they are there. But at the end of the day, we are parents, and they are our kids. If we can't wade through those pressures and at least try (I realize parents are only human, too) to give our kids the best, then we let them down.

It is a parents job for sure. That being said, I continue to struggle with my weight but all five of my children are at a perfectly normal weight. We all just had the back-to-school appointments.

It is overly idealistic to believe that children can walk to their activities in today's world. Everything is terribly spread out and the streets are not made for biking children for the most part. My children play the cello/violin and their lessons are 15 minutes away by car through a busy part of town. I would consider it to be negligence to allow a 12 year old to bike there with his violin. He takes his music very seriously though and not giving those lessons to him would be a big deal in his book. I'm sure many would argue that there is great value in children playing musical instruments (and I agree). The same holds true for my daughter with her cello ... my son with his saxophone ... the lessons aren't in walking distance. Actually, neither are the art lessons, drama camps or even the soccer fields. My 16 year old plays frisbee disc golf and there is only 1 field near us that he can bike to. I am stuck driving him to all of the big frisbee disk golf games he plays with friends from high school.

Children do mimic what they see at home. Sure, we are responsible for replacing the juice boxes with water when we notice the weight bumping up ... yes, there is culpability and parents need to watch their children's weight in order to help them to be healthy physically. Do we treat the overweight children as victim's of child abuse and remove them from the care of their parents? I would think only in the most extreme of cases.

Here is something to think about then. How many of the users here are currently ... well ... at home after school when their kids get off of the bus to see what their children are snacking on? Are they nearby to watch them trade after school snacks with friends at daycare or sneak an extra bag of chips from the cupboards at home? How many of them are working 80 hours+ as a week for their residency programs or are having the babysitter step in so that they can study for exams? I say this in a provocative manner and most here will understand that I support moms in their desire to have a career. BUT ... do you blame the overweight mom for her overweight child when someone else is watching your children so that you can fulfill your own career aspirations? What are your children learning from that? Are you letting them down in an emotional sense? Should your children be removed from your care if you as a parent can't be the one providing them the physical care for several years?

This is my attempt only to bring it full circle here. Of course not. Of course a mom who is a resident and is relying on a nanny or childcare is not neglecting her child ... even if that person is responsible for her child's care. If something goes wrong in the course of training though (like her child becoming overweight) who gets the blame?

You don't want to place blame on other sources, like schools ... but holy buckets ... have you ever volunteered or worked in one? My son's first grade teacher gave out candy as rewards for completing stories, worksheets, and good behavior. He had at least a piece or two daily...at school. Fortunately, this child is in the 3rd percentile for both height and weight ... and so there is no damage done beyond the fact that he learned that food is a reward. He didn't learn this from me. Parties for halloween (Fall Festival) and Christmas and valentines always involve bags of candy being schlepped home...most of which is empty wrappers by the time it gets to me.

I am home every day after school waiting on the school bus with cheese and crackers and a small glass of milk ... or some other healthy snack. I'm there to see my children eat it ... and I'm there while they grab their bikes and head outside to a near empty neighborhood because every other mom is working or carting their kids off to lessons. I'd argue that I'm doing it right.....of course .... LOL ... but I wouldn't ask for your child to be taken away from you if it was overweight (unless grossly so and there was other evidence of neglect)...anymore than I would argue that your child should be taken away because of your physical/emotional absence as a parent during training. Obesity is a visible, tangible problem but that doesn't mean that other parental behaviors don't influence the health of their children.

The problem with packing a school lunch is allergies. I had tortillas sent back to our house with a nasty note about an ingredient. Not joking.

I don't want to cause any child a trip to the ER because some food item our child brings was next to peanuts/peanut butter. But school lunches are horrendous. So I feel stuck in the middle. We make healthy meals at home, send fruits and veggies for their snacks, and constantly push the idea of healthy food choices.

This is so multifactorial. Child Protective Services may have a role in the most extreme of extreme cases, but not sure their involvement would be productive.

Another problem with packing is the amount of time between morning/lunch. My son loves ham sandwiches and we end up with one of two problems. 1. The ham ends up making the bread soggy from the inside (which he hates) or the cold pack/condensation is making it soggy on the outside. I have to try to pack the bread and meat separately and keep the bread from the cold pack. It wouldn't be a big deal, but the first graders here actually had lunch at 12:30, so that sucker was packed for 5 hours and sitting in a locker. Frozen Go-gurts get to a normal consistency, but some might argue that those aren't as healthy as say ... greek yogurt with real fruit in them or whatever.

I did try to pack warm leftovers in his thermos, but they never really stayed hot ... more like lukewarm maybe by the time he got to them, which he referred to as gross.

Oh ... and of course the fact that the kids only have 15 minutes to gulp down lunch is another issue altogether....

Allergies? Really? So the needs of maybe 1-2 kids outweigh what a parent can pack for a lunch? I find that absurd.

I remember my parents packing my lunch, and doing my own when I got older (jr high). I never got a choice - just what they bought. Fruit, veggies, crackers and a sandwich made it with a cold pack to lunch. I really think we make life harder than it is or should be. In grade school, we had the option to go home for lunch, too, which has been lost by the wayside.

mommd2b - your kids only get 15 minutes for lunch? Really? Have other parents complained to the school board about this?

Public schools really are our children's worst enemy. From substandard, politicized curriculum to substandard, subsidized food they have created problems in our country that will haunt us for generations. I pulled my children out in the mid-90's. My older son insisted on returning to a public high school to play soccer for an abusive coach who shouldn't have been allowed in the school system, and made friends with supposedly good kids who bullied him into making some very bad decisions. My younger son home schooled. They are now in their 20's and home schooling made all of the difference. My older son doesn't know how to interact with anyone who isn't his age, and my younger is comfortable with people in general. No poorly supervised students to bully him or government teachers to force him into a politically acceptable mold. I could go on for pages, but i think most people are aware of the problems.

If I had it to do over again, I'd have forced my older son to home school (which likely would have gotten me a visit from CPS). Folks, the government is a problem. An even bigger problem is that we have come to expect them to fix all of our problems. When we become self-sustaining again, many of these problems will shrink. If we teach our children to be self-sustaining, some of them may nearly disappear. If no one uses government subsidized services, including bad public schools, they will eventually cease to exist.

My children get 25 minutes for lunch. Sometimes they don't finish. It's a definite issue. I do pack their lunch, and so far no allergy issues, but some schools are absolutely peanut free and whatnot... although I don't think the majority are, I can't say with any certainty.
Also when I had a nanny she served the children what I had at home for them, which was invariably (OK, maybe with rare exceptions) healthy food. If there is not junk in your home, your sitter can't serve it. My 2nd child flirted with obesity at 2 years old, we realized it was a portion control issue, and we became obsessive about watching her diet... it took 3 YEARS to return her weight to normal, and now her BMI is actually under 50%. When I counsel parents I know exactly what I am asking of them, becauase I have done it myself. I seriously doubt many foster households are prepared to deal with the constant vigilance an obese child requires, and I continue to think CPS is not the correct answer. Although, if there was a more humane CPS approach, such as not removing the kids, but instead ensuring access to dietary education, home visits to assist with barriers, etc, that might be useful. Unfortunately, that is so time consuming I am sure it is not in any CPS budget.

I don't have much else to add to this thread but I love how "the parents" is code for "the mom".

Aw, I don't mean to imply moms solely. I have seen some really poor parenting on behalf of dads, too.

I agree totally with latcatin, which is why our kids went to Catholic school for the most part. Oldest son went to public school from grades 1-7 because we enrolled him in the gifted program, but in retrospect I think he would have done better staying in Catholic school.
Unfortunately, the lunches in Catholic school were pretty much the same as lunches in public schools, but I recall getting that same food for lunch when I was a kid (on the rare days Mom sprung for hot lunch) and obesity in kids was rare. I think it has more to do with portion control and activity. We actually had an HOUR for lunch, so we spent a half hour outside playing, in ADDITION to gym class. Recess has pretty much been eliminated from schools, especially in the upper grades (5-8), which is a huge mistake. I'd be willing to bet it has more to do with teachers not wanting to supervise the playground and school systems not wanting the liability for injuries than any lack of time in the schedule for it.
And what is the deal with snacks in the classroom? Our kids were in SECOND GRADE before someone decided they could make it through two hours without eating. I don't remember even getting snacks in kindergarten when I was a kid.

Our child's lunch hour is also ~25 minutes...but this includes the time walking to/from the cafeteria as well as getting their milk or hot lunch, finding a seat and unpacking the meal. If the class of wiggly little first graders isn't quiet enough to suit the lunchroom para who is walking the kids to lunch (teachers don't do that now) then they will make the class stand and wait. At times, I have found the waiting to be excessive in relation to the noise or antsy movements of the kids.

Have parents complained? Yes. Have parents complained about the dwindling recess time? Yes. This is even worse in the winter when we have a large number of days where it is too cold for the children to go outside. We don't have a designated 'indoor recess' plan that is anything except letting the child sit in the classroom and have a movie. FYI ... in my son's first grade classroom this also involved an extra snack treat from the teacher.

Is parent code for "mom"? No. But we are moms here discussing this. Should both parents be responsible for 50% of parenting? In an ideal world, yes. We all know that as much as we desire that (and push for it) that this often isn't the case. I feel like my husband is a 50% dad now, but that is because I have delegated the jobs to him that he can do. Our tasks really don't overlap in parenting. He takes them to the dentist, is responsible for bath time, and does part of the driving (for example). He isn't the emotional caretaker of the teenagers needs because he doesn't have that skill set. He IS more organized than I am though, so that is why he arranges the dental visits, etc. We do a good job of balancing each other out. I don't expect him to be able to be like me and do what I can, and he knows my limitations too. Part of the problem with the mom=parent argument I think is that we want our spouses to be US sometimes and they aren't.

Mommd2b - I appreciate your comments. Thanks.

Allergies, yes. Every daycare room my kids have hit has sent home a nasty note for something in the kids lunches. No nuts of any kind, one other child has some fruit allergy (not strawberries, but I can't remember which, so I only send apples and bananas, which I remember are okay). Nothing can be brought in for treats. In the elementary school we literally got a one page note on what is allowed, and ingredients included in common products that cannot be in anything we send. Additionally a note was included from a parent with their child's picture detailing what has happened when they come in contact with items they are allergic to.

I refuse to be the parent that causes a full blown attack- but sometimes I do wonder how much of this is a true allergy vs. parent preference/child not liking certain items. Evil, I know- I would never send the peanut butter sandwich as an experiment, but one has to wonder.

My kids also have 25 minutes, travel time to/from the lunch room (which is the gym) included.

And totally agree a lot has to do with portion control and lack of activity. Isn't it interesting that as phys Ed time has decreased, so have test scores?

My daughter attends the best public school system in the nation where she's taking courses like Chinese and Engineering design, so I'll obviously strongly disagree with the statement about "ALL" public schools being the enemy. She also once attended tennis camp with kids from one of the best private schools in metro DC and it was a complete nightmare! Bullying, clicks, girls kissing in the locker room. Personally, I've found kids on BOTH ends of the financial spectrum to be, how shall we say.......EQUALLY challenging. So from that point on, we never, ever considered private school again even though we both attended them growing up (I stopped at middle school).

As it relates to health, I'd say the enemy to good health for many is laziness. How can a parent encourage a child to eat right and exercise when they don't? This is why I do NOT believe in universal health care without the stipulation that outside of some serious medical issue(s), normal BMI's must be maintained. And that as the BMI goes up, so should the cost for health insurance. Tough line sure, but we all know that being overweight, eventually leads to a plethora of medically expensive, yet sometimes highly preventable medical conditions.

Finally, I believe the majority of the time, if you want to know how a kid is going to "turn out" whether we're talking about education or weight, look at the parents. And to asunshine's point, unfortunately parents = Mom. My Mom runs 10 miles/week and literally has legs like Beyonce'. I won't pretend to be able "to hang" with that, but I do hold my own at almost 45. My kid plays tennis. We're ALL actively involved in eating right and exercising.

I think that as a parent we make the decisions what we feed our kids. Some parents should not be parents because of the example they set and the values that they teach their kids in what they eat. A healthy diet based on good nutrition is an essential part for a child to grow into a well balanced adult. Research tells us that Child Obesity is a growing worldwide problem. Diet is one of the major contributing factors causing child obesity. If you are to get your child to change their diet you have to make it fun, interesting and yummy to eat. Imagine if you could get them to make their own healthy chocolate snacks and treats. You have then dealt with making 2 behavioural changes 1/ Changed their diet 2/ Got them off the couch and away from TV/computer.
I recently bought an eBook called “Chocolate Against Child Obesity” by Pamela Vinten. In it she covers how to achieve this in a simple and easy way. Pamela actually uses natural, healthy chocolate to help win the war on child obesity. I was very sceptical at the start but after I bought the eBook and followed her guidelines I found it informative, helpful and most of all I really enjoyed the interaction between myself and my kids as we put together some of Pamela’s recipes, it was great. The kids loved making the recipes and then eating their healthy chocolate snacks and treats.

Re: allergies, my son's daycare is completely nut free and honestly, what a pain! I obviously don't want to send a kid into anaphylactic shock, but avoiding all the granola bars made in a non-nut free facility, plus no PB&J for lunch - ugh. I hope our elementary school is not nut free... I never even thought about this before becoming a mom

I actually told my husband about the nut-free thing that is seemingly present everywhere these days, and he wants to find a "non-stupid" school that doesn't do that. To be honest, when he and I were kids, we ate pb&j all the time for lunch. I don't remember a single kid going into shock over it. It seems ridiculous to go "free" for every allergy out there. Pretty soon, the kids are going to eat cucumbers and water for lunch and that's it.

Have some control and a close eye on the allergy kids. Let the teachers know which ones they are. Don't separate them, but maybe have the lunchroom teachers watch them more. And if your kid is going to go into shock because they are in the same room as a peanut, they will have a hard time going to conferences, college, work retreats, and board meetings as an adult. Perhaps if they are that allergic - they should be at a special school!

End nostalgic rant.

PS - I also miss Strawberry Shortcake, SHERA cartoons, My Little Pony (the original) and Rainbow Brite.

Ah, yes. Forever I will think that strawberries are cute, probably only because of a silly cartoon character. What about Smurfs, though? No love for little blue people in mushroom houses?

Also, I am eating oreos right now. I am concerned about childhood obesity, but have little to add other than I agree with what most of you are saying. I spent my childhood running around outside, and I ate home-cooked food. Knowing my mother, it probably had a lot of butter in it, but all the tree climbing and made up ball games seem to have counteracted it. I loved recess, and almost always spent it playing basketball or something like it. Something should be done, but I don't know what.

This is what I ate when I was a kid:
Breakfast: Cheerios or Trix in milk, and OJ on weekdays. Bacon and eggs on weekends.

Lunch: Peanut butter and jelly, bologna, or cheese sandwiches, a piece of fruit, and two chocolate-chip cookies

After-school snack: two chocolate-chip cookies and a glass of Kool-aid

Dinner: Pork chops, hamburgers, fried chicken, roast beef, BBQ sandwiches (i.e. some kind of meat with no attempt to limit the fat content), potatoes, rice, or french fries, and a vegetable. ALWAYS dessert--homemade pie, cake, cookies, pudding, or jello

Whole milk with EVERYTHING.

Mom kept a 5-gallon plastic bucket filled with chocolate chip cookies made with SHORTENING and handed them out to all the neighbor kids.

We all grew up thin, in spite of genetic tendency to overweightness on Mom's side of the family. Portion control and exercise.

Off-topic, but I couldn't pass it up.

I had a Strawberry Shortcake ROOM as a little girl. My mother is a great seamstress and made SS curtains, lampshades, pillow covers, comforters, sheets, and wall hangings of SS. Couple that with bright PINK carpeting LOL. I will never forget that!

Once the boy is here, I will probably go all Winnie the Pooh on him or something. Our theme is "Baby Bear", so why not! It's a family tradition now to drown our children in classic cartoon characters LOL!

I wrote a super long comment and then my phone died the gist:

Parents responsibility. For obese parents why would you subject your child to the mistakes you made. I'm obese but still manage to feed my child well and taught my former stepchild and former foster child good eating habits that stabilized their weight to a healthy level.

It's not hard to steer your kids in the direction you should have gone in in the first place. And junk can be moderated to the way it was intended...once every blue moon.

Just got back from a week long swimming vacation with the kiddos. I saw as many thin children from obese parents as I saw fat children from thin parents...go figure.

But since we're on this topic.....if we contact CPS in regards to children's obesity, can we pretty please have parents reported for smoking cigarettes (around their children is the risk of second hand smoke .... but even when the kids aren't there, it sets a bad example that can lead to smoking down the line) as well as parents who drink at the pool/on the beach and talk loudly on their cell phones while supposedly supervising their children at the pool or suffer from drug/alcohol addiction (even if it doesn't negatively affect their parenting, it is one of the greatest factors in the alcohol/drug dependence of children later)?

Being sarcastic ... sort of ... Where do we draw the line?



Kris

Wow-great thread. I have struggled with weight my entire life-overweight, not obese. My children are all healthy thus far, but we struggle with the playing outside and shuttling to activites thing. I have all of my girls in sports which I think is good for their health as well as their self esteem. We practice portion control, dessert can be 2 cookies or jello or fruit, depending on the night. I don't want to 'outlaw' certain foods, this way they won't rebel and eat a ton of them when they are older. My first two children at age three were 'obese' on the growth charts, but started huge due to good breastmilk LOL! The baby is on her way to being a chunky monkey as well. By age 4-5 they were all in the normal weight range due to diet and activity, I think. I don't put too much stock in the BMI charts anyway-my brother is a bodybuilder with like 10 % body fat and is obese according to those charts...but then again, I want my kids to be healthy so I used them as a guideline.

I still struggle with my weight, but I try to set a positive example by exercising and running. They all see me running on the treadmill 'so mommy can be healthy'-I try not to make it about losing weight b/c of the whole anorexia fear thing....

CPS removal-maybe in the most extreme cases...but I agree about the drug use and smoking-where do we draw the line...

@ Path-interesting what you said about women of color and weight not affecting their self esteem....why do you think that is? The same is true for Puerto Rican women for the most part-i think b/c having a booty is a good thing culturally. I never felt more sexy than when I lived in PR for a summer.....my curves were appreciated!!

It's definitely cultural, although I must concede that some women of color have taken this "I'm sexy no matter how big I am" thing way too far, LOL!!!

That is a great approach! Anorexia is terrifying. I had a friend who struggled with that as a teenager - 15 years later she still doesn't have a good relationship with food or accepting her body. I remember her saying a few years ago when her kids were smaller, "I eat, and I have to eat for their sake, but I don't think I'll ever like it." Now that our culture is so obsessed with obesity, which is a genuine concern, I worry about how kids will have healthy perspectives on food and fitness. I like the way you're doing it.

Speaking of JAMA and nutrition, check this out:

http://jama.ama-assn.org/content/306/12/1370.extract

Ridiculous!

I am a very nutritionally conscious person. Always very interested in holistic/integrative health and nutrition, and have read a lot. I enjoy cooking healthy and eating well. my husband and I both like to eat. our kids have good appetites too, and eat tons of veggies. but still I have to fight the urge "overfeed" them. I know that they don't need to eat every hour. but it is such an easy way to make them happy, or make them behave in the store. I find that if I have juice in the house, I will end up giving it to them even though I don't like them to have it. same with crackers and other junk. everyone on my side of the family is healthy/ thin, and my husband has lots of overweigh/obese on his side. I am so worried that my kids will end up overweight. I try not to buy any snack food. they love cucumbers and fruit. and they don't like us to bring our own food to daycare, so they get the group meals/snacks there. I see what a conscious effort it is for me to make sure my kids are eating healthy and not too much in a world that is just flooded with empty calories everywhere. and the ideal diet is so very very far from the typical american diet. it really requires a LOT more than small changed and an extra half hour per day of exercise. I am not surprised that this is happening. we have not evolved to handle excess.

there was a really wonderful talk by an integrative pediatric endocrinologist at stanford on youtube a bit ago on this topic, and how sugar, (mainly fructose) is the principal culprit. a little extra exercise can't make up for hundreds of extra calories daily, which you can easily consume in a single granola bar or bag of chips. it is a bit grim, but I think it may be too lofty an expectation to expect all parents to be able to keep their kids ideal weight in this society.

also, I heard a study once on audio digest talking about pediatric quality of life scores. Overweight kids scored lowest, worse than kids with cancer, HIV, developmental disorders or physicial handicaps. It is tragic, and epidemic. Sugary, fatty, salty foods cause dopamine release. it feels good to eat- just like drugs. it certainly is a huge problem.

Sorry I'm late reading this/replying, but regarding the peanut issue - I realize it is inconvenient, and may seem over-the-top if you've never lived it, but it is life-or-death. Truly is. I've anaphylaxed several times (getting worse every time) by eating things that weren't supposed to contain peanuts. I have nasty reactions when inhaling peanut dust (airplane, sitting in a room full of peanuts, talking to someone who just ate peanuts). I stop short of using the Epi-Pen in those situations, but need good doses of anti-histamines!

The thing with little kids and lunch is there is no way that teachers could enforce no contact between the allergic child and the other kids lunch. Kids share their food. Kids are in each's face all the time. They touch everything. They put stuff in their mouths. Little fingers full of peanut touch table/toys/clothing, other little fingers touch same objects and put fingers in mouth. That's all it takes. I had a patient anaphylax from eating chips from a bowl, when another person picked chips from same bowl after eating peanuts 30 minutes before! We're not talking bitefuls here. Trace amounts are enough to kill you if you're highly sensitized!

(agree though that banning food "made in a facility that processes peanuts" is over-the-top, as this is likely a CYA statement for foods that have zero peanut in them - I wouldn't give them to the child, but I would be okay for the other kids to have it. But real peanuts or peanut butter as an actual ingredient? No way. Thank god my kids are not allergic; I would have a hard time sending them to school!)