November 20 2019

What We Get Wrong About Childhood Obesity

By Mark Sisson
97 Comments

Weight Watchers (recently rebranded to WW) put out an app for kids and teens who want to lose weight a few months ago. It’s called Kurbo, and it assigns “traffic light” color codes to different foods. Green foods like fruits and vegetables can be eaten freely, yellow foods like low-fat dairy, lean meat, and bread can be eaten in moderation, and red foods like full-fat dairy and sweets should be eaten sparingly or “planned for.” Kids under 13 need to sign up with a parent, while older kids can sign up on their own. Online coaching is available for an extra fee. Users are urged to track their food intake and body weight, even if they choose a goal like “Have more energy.”

Critics hit back. The Atlantic claimed that using apps like Kurbo won’t make a difference for the kids who need it most—those living in “food deserts,” those exposed to junk food marketing, those whose parents can’t afford healthy food and haven’t the time to fix healthy meals. Outside Online warned against the potential for Kurbo to create unhealthy fixations on food and “clean eating” in kids, setting the stage for eating disorders that can increase the risk of mortality, depression, and anxiety later in life. They called for an overhaul of “food policy” instead.

It’s wrong. They’re all wrong.

The childhood obesity epidemic isn’t a single, double, or even triple-issue problem.

It’s not caused by a lack of green light foods and a surfeit of red light foods.

It’s not caused by food deserts either. Unfortunately, introducing grocery stores full of fruits and vegetables into “food deserts” always fails on the macro level at least: not enough people end up buying the food.

It’s not caused by a lack of “food policy.” Official governmental food policies are arguably what helped get us into this mess.

Outside Online mentions an “overhaul of culture.” That’s closer to the mark, but it’s probably not broad enough.

Childhood obesity is far more multifactorial than people are willing to acknowledge. People give lip service to multifactoriality. When they say “childhood obesity is multifactorial” or “we need an overhaul of culture” they’re really just talking about calorie intake and recess cutbacks at school (although neither of these help matters).

In reality, childhood obesity has dozens of causes. You can’t fix one or two things and fix the problem. You have to fix the entire structure of modern society. All the things we talk about on here—the sleep, the industrial seed oils, the sedentary living, the light at night, the excess carbs, the inadequate strength training, the overreliance on “cardio”—also affect children.

But changing “food policy” won’t do it. Nothing “top down” will accomplish it, because society is made up of individuals and families. Change must start down there, not at the top.

I read a dozen research studies every week suggesting some new and simplistic answer to the child obesity issue. 

Prebiotics reduce childhood weight gain? Great. Does that mean prebiotic powder in the water fountains is the fix? That might help, but we have to go deeper. Prebiotic supplementation helps because children are designed to eat foods that contain prebiotics. You could just give the isolated prebiotic on top of their refined diet for half the benefit, but it’s more effective and provides more micronutrients when you let kids eat whole foods that contain prebiotics instead of refined foods bereft of them.

Oxytocin reduces the desire for rewarding junk food? Great. Does that mean we should mix oxytocin into their milk bottles? Give your kids MDMA microdoses? No. Instead, spend close physical time together as a family. Hug your children. Wear your babies—go skin to skin. Do the normal, everyday human things that promote oxytocin secretion.

Oh, it’s not food deserts but food swamps—an overabundance of fast food joints and food marketing—causing the obesity epidemic in kids of lower socioeconomic status? Now we’re getting somewhere. But does that mean we should lobby government to force fast food restaurants to close up shop and stop advertising? That’ll never happen. What actually works is turning off T.V. commercials, limiting exposure to marketing, and saying “no.”

You see what’s going on here? Local decisions are the only way forward. You can say “no.” You can hug your kids more. You decide what to buy at the grocery store and make for dinner.

The crux of the issue is that if we want to fix childhood obesity we have to fix ourselves. We have to change how we, as parents, eat, move, spend our free time, consume media, interact with our kids. We can’t expect our kids to eat good food if we’re not. We can’t expect our kids to refrain from digital device addiction if we’re logging eight hours a day. We can’t tell our kids to read books and play outdoors if we’re glued to our screens and bingeing Netflix.

It’s not easy. Few things that are worthwhile are easy. But here’s the secret to all this stuff: It’s way, way better than what you were doing before. It’s more fun and more rewarding. We just have to get over that hump of complacency, of habit, of resistance—and then we’re home free. You know how you’re always happy you forced yourself to go to the gym? How not only are you happy having worked out, but you enjoy the actual workout itself in the moment. That applies to everything else that’s good for you. Getting out the board game and corralling the kids is worth it. Family game night is better than everyone zoning out or hanging around on devices separate and together. On every level, it’s better.

It’s easy to despair. The world is unfair and set up for kids to get fat. They shouldn’t have to think about what they eat. The idea of a weight loss app for kids shouldn’t even enter a developer’s mind.

They shouldn’t have a dozen varieties of gluten-free cereal to choose from. Their milk shouldn’t be skimmed, their chicken shouldn’t come in finger form, their days should be full of rambunctious play and exploration.

They shouldn’t have to think about food at all. They should simply eat the food that’s available, and the food that’s available should be nutrient-dense and unrefined.

The problem, you say, is that we don’t live in that world anymore. We can create little islands of ancient nutrition in our homes, but they aren’t impermeable. Your kids will go to school, go to parties, go to friends’ houses. And they’ll realize that the small world they live in isn’t “normal.” They’ll get exposed to candy and video games and everything else that increases the risk of obesity. And they’ll probably bug you about it. They might even whine.

So what? Hold fast.

None of these other solutions are going to work. Not the apps, not the public policy. Societal change for something this personal can’t happen from the top down.

Real change happens around the dinner table. It happens when the heads of the family decide to make the change happen at the hyper-local level—the only one they can hope to control.

Oh, so what about everyone else, you might be asking? How can I guarantee that my neighbors and the other parents are my kids’ school are doing the same thing? Or those unfortunate kids on the other side of town? Or the impoverished ones in that other country?

You can’t. That’s how it works. You can’t control it. And once you allow the experts to start dictating how everyone else eats and lives, you’ve lost. You won’t like what they come up with. No government official will ever advocate or enforce the kind of diet we believe in. The best hope you’d have is for a Primal Caesar to cross the Pepsi Rubicon and wrest control of the government from the corrupt bureaucrats and establish a Primal regime. I’m too busy for that.

As a final note, a word on dieting in kids. I may take flack from readers for this one, but so be it. Kids shouldn’t be “put on” specific diets. Don’t make them go keto or carnivore or (especially) vegan.

Look: if your kid only wants to eat eggs and bacon and steak and full-fat milk, awesome. Don’t force your kid to eat anything in either direction (but keep it available—because their whims change quickly and thankfully). And if your kid is dairy-intolerant, don’t give them cheese. But if your kid likes potatoes and berries and bananas, those are completely legitimate foods for a growing human to consume. I just can’t advise restricting any whole Primal-friendly foods on the basis of macronutrient ratios. Kids are in constant go mode. They’re running and moving everywhere. They’re laying down new tissue at an astonishing rate. They may even still be building brain tissue, depending on their age. Stay away from the aberrant foods like industrial seed oils and massive amounts of refined grains. Sugar should simply be kept out of the house, out of reach. Provide healthy vegetation even if they’ll only eat 2-3 things in that category, give some animal foods at every meal, and don’t worry about carbs or fat.

If everyone did that, we wouldn’t have an obesity epidemic in kids. Thankfully, you can choose to do that. Right here, right today.

And that’s good enough.

What about you folks? What do you think about childhood obesity? What can we do about it? What should we do about it? Do you agree with my stance?

Let me know down below, and thanks for reading!

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97 thoughts on “What We Get Wrong About Childhood Obesity”

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    1. Charlie, I linked to that article in a WLL when it first came out. This kid’s case was, indeed, tragic, but his was also an unusual situation in that he had eaten a fully nutrient-deficient diet for at least several years and perhaps his entire life. While the extreme case is certainly cautionary as you suggest, I’d guess most parents (particularly in this community) aren’t dealing with this level of problem. The regular shifts of a child’s preferences don’t need to be a major stressor when we’re offering them whole foods to begin with.

  1. Excellent! Common sense. The easy answer is rarely the correct answer. Thank you for writing this.

  2. You’re right on pretty much all fronts. Offer your children only what you want them to eat. The hell with what the neighbors allow! Will they discovered some point that a lot of other kids get sugar-laden processed cereals? Yeah. So what? Parents need to get it out of their heads that eliminating those “treats” is deprivation. They need to stop thinking of sugary stuff as “treats”! Create your own special foods to celebrate with.

    My 5 year old granddaughter’s favorite snack is a bowl of fresh cherry tomatoes and raw green beans. When her dad was little, a coveted treat was a hollowed out raw sweet pepper from the garden, filled with assorted carrot curls, cheese sticks, nuts, etc.

    Children are little sponges and soak up what we present to them. We owe it to them to provide a positive countering influence to commercial marketing.

    1. Totally agree with you on the sugar as treats idea. Letting go of that concept is how I finally kicked sugar out of my life for good. There are so many delicious real foods out there!

  3. Spot on. You nailed it, buddy.
    As my dear departed mama used to say, “Monkey see, monkey do.”
    I wish I had seen parents who took care of themselves and I pray that as many people as possible take your words to heart.
    Thank you, Mark.

  4. Loved this!! We have three littles and this is pretty much how we raise them. And, while it drives me nuts that “other” family members feel the need to shove them full of pizza, candy and fast food when they visit, after 8 years I’ve finally realized that I can not control everything. Just give them the building blocks to make good decisions around food and an active lifestyle. And, as always, lead by example.

  5. Well said! I agree with your comments.

    I’d add that many food/obesity problems also come from child abuse, broken homes and molestation. We need to protect our children from traumatic emotional stress and to help them deal with it if we want them to have healthy bodies!

    1. childhood trauma is a major cause of obesity – couple high levels of cortisol and sedentary nature of our society, and it is a recipe for all kinds of dis-ease

    2. Childhood abuse is the one cause you completely miss on obesity. As Lissa Rankin points out, you need to deal with and heal the trauma that causes chronic dis-ease, including obesity.

      I dropped 60# in 2017 on primal/keto. At that point, the sexual abuse I was subjected to as a 3yo toddler came roaring back up in my memories. I’ve regained 30# as I cope with, and move through, the trauma of purposefully being handed over for abuse.

      I have access to all the clean food in the world. Until I can heal the trauma I will continue to go back to what gave me a tiny bit of comfort during those times.

      Heal the underlying trauma, the need for running to sugar/drugs/alcohol ceases to exist.

  6. Wholeheartedly agree. Be the change you want to see and kids will most likely follow suit. If parents make time to shop, prep and consume real food, it may become their default. Likely they will feel the effects of processed junk so immensely that they learn to make the connection and put on the breaks when things get out of hand. What we can show them is that there is a connection between each meal and how we feel for the next 4-6 hours. I think that is powerful information and most kids want to feel good.

  7. One thing that has always bothered me about the “food desert” argument is how that term is defined. When I first heard the term, it was part of a push to get farmer’s markets into the areas that had cheap grocery stores, a case of perfect being the enemy of good.

    You can go to a cheap grocery store and get canned/prepackaged meats and vegetables. No, they’re not as good as fresh, but they’re a huge step up from cereal and microwave pizza.

  8. Amen Mark!! It starts at home. A growing kid can handle a birthday-party cupcake if he eats real food at home.

  9. Mark, I love your thought process on this and completely agree. Thanks.

  10. You hit the nail on the head, Mark. Not only with kids, that’s a great place to start, but also with adults looking to improve or reverse health problems and shed some excess pounds — it starts from within. If more people would get that spark from within, perhaps we could ignite a shift in food philosophy and improve our food supply with easier access to organic fruits and vegetables and wild or grass fed protein sources. Bravo. Great insight!

  11. Hello Mark,
    Great article. We have three children and would love for Whole Foods to remove canola oil from their salad bars and inside grill. WF has access to Olive, Avocado and healthier oils. Hope they start using your avocado oil – it’s the simple changes that make a difference!

    1. Amen! I hate that about Whole Foods! As expensive as they are, they routinely cheap out by using canola oil in almost all of their prepared foods. You can’t even find pesto made with olive oil there. So the only foods I buy from their prepared assortment are the salmon salad and their pumpkin pesto, which are made with olive oil, and the raw salad bar.

  12. It hurts to know that this common sense has been completely forgotten and/or dismissed. It sucks to live in a world where this is some controversial new fad to turn inside out and criticize up and down. It makes me angry to see backlash regarding the concept of simply eating REAL food. Yes, it is that simple…

  13. “those living in “food deserts,” those exposed to junk food marketing, those whose parents can’t afford healthy food and haven’t the time to fix healthy meals. Outside Online warned against the potential for Kurbo to create unhealthy fixations on food and “clean eating” in kids”

    I’m not sure how to go about this. The reality of extreme poverty in the US is how I interpret these criticisms. All of these things are part of the problem. People with families often work two jobs, each around 33 hours a week x2, because the companies don’t want to hire full time workers. I worked with such a person who was a store clerk and delivery man. In my quest for full time work I worked a series of part time jobs at barely above min wage. The most heartless companies are those that are largest and employ the most people. Bernie was spot on about targeting large min wage employers. For every person like me who made it into a decent career with benefits, there are thousands who never do. And millions who have no chance at all because employers want only certain workers for certain jobs (try to get a farm labor job and you’ll see, but it’s a great way to get in shape and stay fit).

    I compare the experience of a typical single mom family struggling today to the one I grew up in. I think you’re right about culture playing a role. By the time my mom and I were in the US, we’d had two years of refugee camp starvation, and before that, we had even more years of “you can either live on rations and pickles, or you can buy real food on the black market.”

    I think one difference is that my family never once saw poverty as fair or a source of despair, and simply developed a contrarian attitude that was almost spiteful. We would buy a pig in the fall and process it, the whole family together. If it broke “laws” like you can’t slaughter a pig in the yard of your apartment, tough. Think about all the policies in places where people who don’t own a home live. Think about how it limits their options for nutritional self defense. I think my family developed the attitude that we weren’t willing to starve so that we could be “nice” to our neighbors.

    In the US this issue could be solved by permitting hunters to sell their catch, and processors to be hired by individuals. A CSA could offer services in inner cities, delivering 1/4 of an animal or even 1/8 if there isn’t anywhere the person could keep it. The attitude that everyone can go to a grocery store and find what they need is not true. They may not even have time to shop.

    Or even if a cultural change happened, and they started shopping for grass fed or at least high quality meat, there may not be enough, because supermarkets don’t keep much of the good stuff around. I have NEVER succeeded in buying prime rib of any kind in any supermarket, including Whole Foods, Zagaras, etc. I can only get it from mail order, or local butchers. These are not good options for a poor family. Mail orders will get stolen. And local butchers don’t tend to be near bus stops.

    A cultural change needs to happen, but it’s not the parent’s entire fault that it hasn’t happened.

    When I was living on my own and poor, I limited my buying to chuck and chicken thighs. Ham was too frankenfood for me but bacon was included. I’ve noticed it’s harder to find stew meat anymore, even conventional. Meat department workers no longer ask in a friendly way if I want things cut up more. There are no signs that show you what part of an animal the loin comes from, etc. An 18 year old single mom who has annoyed her family by not getting married properly won’t know what a skirt steak is, or whether it has more or less fat than a rib eye.

    And the more we shame red meat eating the harder it will be for her to make good choices. Plus, buying fresh food is a risk for her, a huge risk. Here’s a woman who explains why: https://www.youtube.com/watch?v=-SCB1t28nDU

    Our entire culture needs to support her better. She knows what she’s doing is wrong, but she is young and in Maslow’s hierarchy, she’s glad to be holding on to the first level of self realization.

    1. Angelica, you raise nuanced points that go beyond just the “food desert” rationale. You also propose some intriguing suggestions about allowing individuals greater freedom to sell and distribute food products with fewer restrictions. Community gardens in neighborhoods whose stores offer less in the way of healthy produce have made inroads in many places, and they’re an interesting counterpoint to other methods that have met with less success. Thanks for contributing to the conversation. — M

      1. Thank you, Mark. Your article really inspired me to think about this in a new way. I really appreciate the deeply thought provoking articles lately.

    2. Angelica, THANK YOU for pointing out what this article and all those who praise it completely missed! Your comments are spot on!!

    3. Hurrah for your Mom! It couldn’t be easy to buck the rules and attitudes of the neighbors to slaughter a pig in the back yard! But she managed it to keep you and her healthy and well fed. Keep on looking for the best way around the edges of our foolish culture!

  14. Mark, if I could kiss you, I would! Your column today is spot on, and applies to so much more than childhood obesity. We must stop looking to the government, the schools, the medical establishment, or anyone else to solve our problems, and take responsibility for our and our families’ well-being…or lack thereof.

  15. Love love LOVE this! Couldn’t agree more with every single word. Just wish I knew how to get this message wider spread. Keep up the good work.

  16. Well, let’s see…
    Primal Caesar qualifies for real Caesar since it allows for parmesan (raw, full milk), for the ones who are tolerant, and anchovies. Without these we have no real Caesar.

    Mark is known to consume and promote these so he logically qualifies for Primal Caesar. Too bad he’s busy… or not?

    I would take on the challenge but I hate paperwork and stubborn people. So Mark has a point there too…

    Great article Mark! I have no kids and will likely never have but I totally agree when I see my nephew and nieces fed stuff I so disagree with. Just make it unavailable! How many times I have skipped a bday party because I didn’t wanted to be sickened by the sight of sugar, artificial flavors and colors as a buffet for the tiny ones, on top of the “regular” meal along with it, aka. carbs, seeds oils, lean protein, some decent food which they usually don’t touch.

    After the cake it’s always the same… like a bomb dropped and a tornado ensues!!!

    Social pressure is tough but be smart, parents! Teaching your kids how to eat properly AND to take a position toward others in life will just help them potentially live longer and happier you can imagine.

  17. “…don’t worry about carbs or fat”

    Unless eaten together, a combination that is rare in nature and promotes fat storage?

    Otherwise, full agreement!

    1. He’s talking about kids here, eating real foods with fat and carbs. I can tell you my kids eat potatoes or bananas and animal fats in the same meal and they are very lean. Kids burn a lot of energy and are very efficient at it. I could be wrong, but I believe that fat/carbs together promoting fat storage only applies to sedentary adults?

  18. You’re right about not putting kids on a particular diet just because you follow it. And the weight watchers app is a super bad idea—a surefire way to set up an obsessive relationship with food. I do think, how’, you seriously underestimate the power of food deserts and a big food industry that designs food to be as unhealthy and addictive as possible. Education on nutrition is key and that isn’t going to have on an individual micro level and affect change.

  19. My son won’t touch any fruit or vegetable. Since he was six months old and his first food was sweet potatoes, he’s been resistant. I’m so worried about his health. My partner and I eat very healthy and offer meat and veggies but he only eats the meat. No amount of bribing or cajoling or discussing will change his behavior. I feel horrible, but I don’t know what to do. Can anyone help? He’s already 8 and these habits are deep.

    1. Mandy, thanks for sharing your concerns here. I imagine you’ll get great feedback from fellow readers here, but I’ll also take up your question after the Thanksgiving holiday in a Dear Mark. Best — M

        1. Mandy
          I was fed the SAD going up for the most part, with excessive processed foods and sugar. I was fortunate, however, in that I never lost my inner sense of what I needed and when liver was served at school, I always ate mine and at least two other kids servings, who wouldn’t touch it. At home we did have roast beef, meat loaf, roast chicken, hamburger, etc. and my mother often made us chicken giblets – livers, hearts and gizzards because it was cheap and again, I couldn’t get enough. Later, I often found myself clawing handfuls of raw hamburger mince out of the ‘fridge when no one was looking. After being considered “the fat one” as a child, I started lifting weights at age 14 to try to strengthen myself against the bullies in my life and drinking gallons of whole milk in the process. Now, decades later, I am the fittest and leanest person I know and the only non-obese person in my family. I still eat mostly fatty beef and organ meat with a few tubers, plus whole raw milk and cream, kefir, cheese and lots of butter. What I am trying to convey to you is that you can trust your child’s instincts of what he needs rather than an outside “authority”. Check out Joe and Charlene Anderson’s boys breast fed then raised on 98% ribeye steaks. http://web.archive.org/web/20150421094955/https://eatmeatdrinkwater.files.wordpress.com/2015/03/image38.jpg

          1. This is really helpful. I used to eat raw hamburger too as a kid. Maybe I need to remember that I grew up eating the SAD and I grew out of those tastes. I think a combination of keeping up the offering of healthy food and not buying the junk he wants is maybe the best I can do. Thank you!

  20. Our children’s schools are feeding kids junk– from bags and boxes. The poor quality of that cheap food has long term consequences. Jamie Oliver is making changes in this area, but he’s only one man.

    Why isn’t the a bigger outcry over the junk that passes as a school meal?

    1. So true, it makes me sick to see what they get for lunch. I grew up where there were people cooking in the school kitchen and it was real food and so good! We even got homemade peanut butter and fresh bread on special occasions. I was on free lunch which I thought everyone had but loved my school lunches. Today is processed junk and they keep forcing milk on my little one. She doesn’t need milk!

  21. OK- agree- mostly. But we shouldn’t say “no policy changes”. Food policy in the form of subsidies causes over production of corn, leading to feed lot cattle, hyper-production on soybeans, etc. So, we create artificially low prices for food, but only food that is processed and full of surplus corn and surplus soybeans. Then we pump $70 Billion into the buy side of the equation in the form of food stamps which provide few, if any, restrictions on what can or should be purchased.

    It’s really nice for suburbanites to talk about going to Whole Foods but rural and urban poor lack the familial infrastructure to learn to eat properly and, in many situations, the education to understand their own health. They wouldn’t know a “nutrient-dense and unrefined” food choice if it ran them over.

    Mark’s right- you have to “fix the entire structure of modern society”. But telling people to make better choices isn’t going to cut it.

  22. Ah it’s finally great to read someone point out how something like this is REALLY complicated. You can look at all sorts of meta data, but it’s all made up of individuals. Much like student achievement and test scores – it is so easy to blame the schools and teachers – but every failing student is an individual. It’s complicated.

    I was a chubby kid and a fat adult. I managed to lose weight (3 times, though times 2 and 3 were post pregnancy). My kids are relatively lean. They spend too much time on electronics, sure – but because we live in So Cal, they get lots of outdoor time, every day. Teenager has daily PE, elementary kid gets multiple outdoor recesses per day. Neither is in organized sports, both eat the (very healthy) school lunch. Dinner time is generally homemade (though there are chicken fingers once a week!)

    There are plenty of obese kids at school, and I cannot fix that. I don’t know these kids personally, and I don’t know what they are going through.

  23. “potatoes and berries and bananas” eh?
    dont agree with this idea at all.
    beef, raw eggs and raw milk.

  24. This is a stunningly insightful, albeit obvious in many respects, article.

    All modern problems are due to complex causes. Childhood obesity is no exception.

    Thanks for writing it Mark.

  25. Mark, I love your straightforward attitude. Great article, thanks for dedicating your time to write these gems!

  26. Mark
    You are spot on I couldn’t have put it better myself. Stop pandering and listening to the people and corporations making money out of the industry and pander to yourself and listen to yourself this is best for your kids as you are the one with their interests at heart not the above mentioned.

  27. I agree with you Mark. We also need to teach kids to eat mindfully. Sit at the dinner table with them and talk. Too many people eat while sitting in front of the TV and are unaware of how much they are eating. Kids need to see the social and mindful connection to eating modeled for them.

  28. We need to educate adults. I was a sickly child. My father insisted I drink whole milk and eat grilled cheese sandwiches on wheat bread. No one understood lactose intolerance back then even though they knew that, as a newborn, milk made me so sick I lost instead of gained pounds. As a young teen, the doctor put me on a bland diet so I had to go to the cafeteria to see what I could eat–if the meat had tomato sauce they gave me cottage cheese instead. Major fail.

  29. Fantastic post Mark! Spot on in my book, especially your point that this “fix” begins in the home and keep the government out of it! Thank you for investing your time reading and bringing your findings to light! I appreciate what you do and what your organization is accomplishing the world of health and wellness! Remember, your health is your most valuable asset my brother!

  30. “It’s easy to despair. The world is unfair and set up for kids to get fat.”
    But it isn’t.
    On the way into the world, the microbiome is seeded for optimum healthy. 12-15% of the time, surgery is required for survival, and we need to mitigate for that loss of beneficial bacteria, but currently AT LEAST 33% of babies are having that initial biome disrupted for no good reason.
    After the birth, human mother’s milk provides human babies with pre- and probiotics, AND babies regulate their own intake (if not forced to ‘finish’ a bottle of pumped milk). It’s nearly impossible to overfeed a breastfed baby. They just simply refuse the breast.
    Most babies (especially if not breastfed) will end up getting abx in the first 6 months to a year of life, and then regularly after…which disrupts the biome.
    And finally, the sugar is often the first ingredient in mother’s milk substitutes…and/or soy, which is worse.
    THEN the other factors come into play. But by that time, even if we were able to change those, any genetic predisposition to obesity has been epigenetically triggered and it is much more difficult to overcome.

    1. I had such faith that these things would protect my daughter from a family history of weight gain, but, at least for us, it has not. My homebirth, no-bottle, never any abx, never in a stroller, yet-to-wean 4yr old has the same size issues I had as a kid (I was surgical birth, formula, constant abx, etc.) 🙁
      I guess I can take pride at least in her superb dental health and wide palate, at least!

    2. I agree that formula is less than optimal, but is preferable to starving your baby to death. I would have loved to have breastfed my 3, but it didn’t work out. Guess what though, they’ve all had antibiotics a grand total of once in their entire lives (now 14,16, and 19 years old), they’ve had less than the average number of illnesses, and they’re strong, smart, and healthy. Thanks to Bradley Birthing Method classes we’ve always appreciated the importance of protein in our diets. More meat, less wheat. Fat is good for you. Don’t snack, but eat until you’re full at meals. Granola bars and juice boxes aren’t really food.
      I do agree that epigenetic factors play a role, but I think we need to back that up to what the mom has eaten, and possibly Dad too. I look at my 3, and my oldest, who I had while still eating SAD is the only one who struggles with weight at all. He’s firmly on the right path to health, but his younger brother could survive (not thrive) on jelly beans and donuts and still have a 6 pack.

  31. It’s well and good to say our first step has to be personal responsibility, but saying that no positive change can come at a public/policy level is going too far. There are many very good gardening and nutritional programs that have been enacted at the community, school district, and even national level (eg. French school lunches).

  32. I grew up in the 1970s, and childhood obesity was rare. Quite rare. Like there was one boy in my 300 kids who had a weight issue.

    We ate mostly whole food, we didn’t get to drink soda very often, nor did we get many snacks. We got dessert sometimes, but not all the time.

    And that seemed to work pretty damn well.

    1. You’re right of course. I’d like to see more itemizations of things that changed over time. Here are a few I know about. My MD has been a doctor since the 1970s, so we sometimes play “guess what changed” and it’s always insightful.

      1. MRSA outbreak in 1990s wasn’t countered by decontamination programs like those used in Denmark (decon the nose of the person when they enter or leave the hospital).

      2. Agriculture changed to use no tilling and instead, they spray herbicide then mow the dried leaves, then plant. The herbicide is usually glyphosate/ Roundup. There have been lawsuits and more to come about that.

      3. The toxicologist Bruce Ames PhD changed his opinion that it wasn’t chemicals that were causing cancer, it was poor nutrition, so he became a research nutritionist. Both his original theory and his later one didn’t get much press. But he was roundly criticized for changing his mind. I happen to think he was just being honest.

      4. No cell towers. TV signals were not digital yet.

      5. Less pressure on municipal water supplies to recycle water that may be iffy to use. We hear more stories of incomplete water treatment now, not to mention pharmaceuticals in water.

      6. Less plastic yet, in the water and elsewhere.

      7. We’re recovering from the 2008-2010 recession still. People have said it’s worse than the Great Depression was. I can’t say. But I can say that I can feel the economic pressure in a way I haven’t felt before.

      I’m not saying this is the cause, just that these are different also. The differences are the place to look and I’m a bit surprised that we don’t seem to be systematically looking for the problem.

      Millenials got the full blast of the changes in the 1990s and the Recession. I’m less inclined to blame them for their struggles to live independently and well, as I am to blame the changes.

      1. TV signals were still electromagnetic though, it doesn’t really change with digital vs. analog it’s just that you can transmit a lot more data with digital encoding and of course more of the spectrum is used (though less power to transmit).

  33. Spot on article! I’d love to read more on genetics regarding childhood obesity and how to combat that. I see little kids drinking juice and soda, eating Mac n cheese every day, cereal for breakfast, etc. and they’re normal weight. Meanwhile, my little one has okra & plantains, eggs & sauerkraut, homemade yogurt & bone broth, goes to free forest school… And yet she’d be classified as obese. She has the complete opposite of my childhood (trauma & junk food), yet she is facing the exact same weight issues! I always believed environment was more important, but I’m feeling left in limbo with my own kid!

    1. I’m very interested in any responses to your situation. I was one of those eat nothing but junk food kids who was always skinny, but I was breastfed and I was a very active kid. My mother was a very skinny child as was my sister who was not breastfed, and my brother from a different father also was not breastfed and was an overweight child. Genetics are definitely interesting.

  34. Hear hear! Common sense. That’s it. Lead by example – as grok would have. Kids rarely listen to, and do, what we say, moreover they are amazing at copying us and doing as we do.

  35. This is something I struggle with a lot. I was one of those rare kids in the eighties who *was* the fat kid in the class when everyone else was still skinny. All my sibs were thin, as were my parents. And my parents policed my food – of course giving me low fat high carb stuff which kept me permanently hungry – and all that did was make me obsess over what I wasn’t allowed, and sneak it in secret, so that I felt guilt and shame about my eating as well as about my weight. To my mind, if my parents kept focusing on my weight, it meant that they didn’t love me as I was. I was desperate for them to accept me. I had to get over a *lot* of low self-esteem issues because of the way my parents dealt with food. I have been low-carb now for eighteen years. I was able to give up all those foods I loved (and lived on to the exclusion of almost all else) because – of course – a) I finally felt satiation and b) I wanted to be thin badly enough to be different from everyone around me and to keep saying no to food I loved. I was in my late twenties, after failed low fat diets had seen me balloon from an already obese 185lbs in my teens to 250lbs in my twenties.

    My husband is tall and thin and never had any weight or health issues. He can eat carbs and then just stop. He is clearly insulin sensitive. We have two growing sons. Our eleven year old is slim and athletic. He eats junk but he will also eat protein and fats and vegetables. I try my best to minimize seed oils at home, and use brown rice pasta rather than white wheat pasta etc. Recently when I make bolognaise he actually *prefers* it on roast eggplant slices than with pasta. But he still likes pasta, and he still wants chocolate etc. I buy potato chips made in avocado oil even though I have to pay to import them because they’re not available in my country. I make my own mayonnaise. I buy the whole fat milk even though it’s more expensive than the 3%. I make them smoothies with cream and cream cheese and eggs and 70% chocolate and bananas. At home we talk about the foods that will build your bodies – protein, healthy fat – and the foods that won’t. I never mention weight. I try and ensure that they eat whole foods first, and dessert after. I don’t want them to be obsessed with food and feel like freaks because their family eats so differently from everyone else, so I try and find a middle ground.

    My younger son is an incredibly fussy eater. We have so many struggles with him. The only vegetable he will eat is red pepper, raw, or carrots roasted in a particular way. He refuses to eat any form of egg, any form of fish unless it’s a processed fish stick, any form of cheese unless it’s hidden in the aforementioned smoothie or on pizza. He will just about eat burgers and kebabs (I buy ones that are just meat and seasoning), and chicken. He is a carb fiend. He gets meals at school that include protein, carbs and veggies – he just eats the bread, or the pastas, or the couscous. And we have had so many struggles around food that I worry about it impacting our relationship and creating major hang ups. Until this summer he was skinny but just these past few months he’s got a bit of a belly. He’s still ‘normal’, but the ‘slim fit’ trousers his brother wore at that age, which had to be pulled in tight, are tight on him – I have to order ‘regular’ fit trousers (although not husky).

    I am super conscious of this issue because on the one hand I don’t want my kids to go through the misery that I did of being obese as a teen, but I *also* can’t forcefeed him healthy food, and I can’t *make* him stay skinny. He is active and healthy. He has a mother with a tendency toward obesity and a father who was almost underweight most of his life. He is taller than many of his peers, whereas my other son isn’t. My bottom line is that I try and feed him as nutritiously as possible. i make him pancakes with eggs and coconut flour and chia seeds – and a bit of sugar – because that way he gets eggs and coconut flour. I make him the smoothies so that he gets dairy and eggs. I make home-made shnitzel so that it’s mostly chicken with a few wholewheat breadcrumbs and fried in healthy fat rather than the processed ones which are 60% filler and fried in seed oils. But there are so few meals he’ll agree to eat and I can’t make everything a fight and I have given in more times than I wanted to and given him the pizza and fish sticks he wants, because I’m exhausted from the fighting, and because I believe in psychological health as well as physical health and even if he *does* end up obese, I believe that he will be better able to fight that obesity as an adult if he is given the right tools (which foods to eat) and he doesn’t have emotional hang ups around food because I fought with him about what he was supposed to eat each and every day of his life. Of course I hope that he won’t gain weight, and it’ll just turn out that he’s more solidly built than his brother, but if he does gain weight and become ‘fat’, I want him to understand that I love him no matter what. It sucks to be a fat kid, but it sucks more to be a fat kid who feels like there is no safe place to be accepted and loved for what and who they are.

    1. I want to hug you! You are doing the best you can and that is perfect. I really appreciate you sharing your story.

  36. Well Written. As an RD who works with mostly adults, but also with kids/teens sometimes it’s easier said than done even when real foods are available. Much of what you wrote when it comes to feeding kids echos Ellen Satter who states that parents choose the what, when, where of eating and kids choose how much. As a mom with a selective eater (working on some sensory stuff) it’s challenging and frustrating when you want so badly for your child to eat the steamed broccoli but all they will touch is the crunch broccoli from trader joes that is cooked in rice bran oil. Oh well….we plug away and one day he will again eat the ‘real’ stuff.

  37. All I ever wanted to be, was like Dad…..If Dad is bad to the bone and eating a sensible diet, the kids will follow. It all starts with parenting and a kitchen table.

  38. Mark, have to say you really nailed it this time. Its what I always thought but too busy/lazy to put into words. Great post. If only all the parents out there could tap into this line of thinking, the world (especially for kids) would become a better place. Thanks! for this.

  39. I see this post getting a lot of praise, but it’s fundamentally wrong. Not “wrong” in arguing that individuals can and should do more, but wrong in the sense that it describes a collective action problem and then suggests individual action in response. That can’t work — if everyone is standing in a football stadium, it doesn’t work for an individual to sit down because s/he’s just worse off.

    No, the solution is to create an environment in which healthy eating is the default. That has to be done society-wide, the way we eventually reduced smoking. We didn’t *just* tell individuals to quit, though we did do that. But we also put warning labels on cigarettes and created an *environment* in which smoking was disfavored: bans in restaurants and bars and places of employment, for example.

    What does the same approach mean for eating? It means an end to subsidizing grains, perhaps subsidizing vegetables and pastured meat and eggs. It may mean high taxes on sugar or bans on supplying sugared products to kids under 18 (as we do with smoking and drinking).* It means bans on advertising sugared products. It might mean bans on where stores can locate sugared products on their shelves. It means public relations campaigns based on a proper food pyramid (not the current one).

    This is a social problem, not one of individual willpower or judgment. It has to be addressed collectively.

    *Before anyone jumps all over me, such bans wouldn’t apply to parents.

    1. I agree with you and would love to see some of those restrictions in place because sugar IS poison. However, my mom and my sister and I’m sure millions of others still smoke even after the warnings put on cigarettes, etc. It’s not *that* easy. I’m sure less people would choose the sugary junk food if more restrictions were in place, BUT habits are hard to break, and I think those who were already addicted to sugar would still find ways to eat those things. I had a cookie addiction and used to eat $1 cookie 10pks in a sitting. I went gluten free, and guess what? I sacrificed some things and searched around and bought $6.49 packs of gluten free cookies that had just as much if not more sugar and I still ate the whole thing in a sitting. Went out of the way to get them at whole foods (because cookies are totally a whole food *sigh*) when previously I could get a box of gluten filled cookies for a buck at the dollar general at the end of my street. I can think of more instances, but really, in the end the only thing that changed my choices was me. I decided to quit poisoning myself because I learned for myself how unhealthy it was and I felt long enough the damage it was doing. I think Mark’s emphasis on changing your behavior is well placed. Maybe not everyone will go out of their way to still get sugar and junk food, but as a country we are seriously addicted.

      1. It’s absolutely a combination. It takes individual action, but it also takes creating an environment. I hear you on the cookies. For most of my life I couldn’t resist eating sugar. What worked was keeping it out of the house. If it wasn’t there, I couldn’t eat it. Testing my willpower by having it in the house never worked. Changing my environment so that sugar wasn’t easily available is what did the trick.

        And that’s what I’m suggesting as the environmental strategy for society at large. Make it more expensive. Make it harder to find. Make it socially unacceptable. It may be that addicted individuals can’t or won’t quit. But there will be fewer new ones to start. We didn’t rely on individual willpower to reduce smoking — and we had 350 years of experience to show that didn’t work — but changing the environment has worked pretty well.

        1. I get where you’re coming from. I tried the keeping it out the house thing because that’s what blogs always say to do. Didn’t work for me, as I never kept it in the house anyway (I’d eat the whole stash in a day if I did). If I wanted sugar, I’d go out and buy some. In my situation a sugar tax definitely would have helped me quit sooner, though not if I’d never found Mark’s blog. 🙂

    2. You are right. BUT it is highly unlikely that we would see any society-wide response. The only thing that is under individual control is our own homes. Which is why the individual response is the best one.

  40. We the parents (aunt and uncles, grandparents as well) are models for our children. It starts day one. Food choice, snacking quality and quantity, device use, sleep quality and quantity, tv time, outdoor fun, priorities, respectful language, temper, gratitude, understanding, compassion, expectations – all of it.

    Wonderful article, thank you.

  41. I totally agree. As parents we are helping our kids develop an internal standard that they will use to make decisions for the rest of their lives. They may not always agree when they are young but as adults they will measure their own food decisions based on that standard that was developed during their childhood.

  42. I have been a long time reader of this blog and I have to say this is one of the very best articles written. When my three boys were younger and I forbade video game playing on school nights they complained for years that all their friends were allowed to do it. The same rule went for treat foods. They are all adults now and have thanked me for those guidelines when they were young.

  43. Hi Mark,
    Thank you for taking the time to address this issue and call out some hard truths. As a dietitian who works in public health tirelessly trying to fight for the health of children I really resonate with this particular post. I have chosen to dedicate my career to advocate for changing what is on the end of the fork, especially when it comes to children who don’t get to decide. I try to educate and inform parents and students and facilitate discussions surrounding local and federal policy, food marketing, fast food, food desserts, etc. In some of my classes we even talk about nutrigenomics and nutrigenetics! Do I see any improvement in the health status of my students? Rarely. The only time change occurs is when they take personal responsibility. I encourage my students to get their bloodwork done and 80% of the time they find out at 20 years old they are pre-diabetic, have high triglycerides and are hypertensive. If this is enough to scare them then we have a talk, I give them a whole food list, and challenge them to eat from that list MOST of the time…and voilà! By the end of the semester all of their markers are back to normal. Not vegetarian, not keto, and not even organic (enter gasp here). Just getting people accustomed to eating whole foods after 20 plus years of pop tarts, hot Cheetos, soda, and top ramen is a nothing short of a small victory. My question to you is how do we continue to fight for these children when their parents won’t or in many cases, have no clue how? Let me take your life, your career, and your voice as an example. You took a leap into the unknown and shared your story. Because you were willing to be a voice of truth you have changed the lives of thousands. But you didn’t even stop there. No, you created a line of supplements and food, making things like clean salad dressing easily accessible when shopping at the grocery store (or let’s be real, ordering on Thrive). I do agree that it is our personal responsibility. But what about our responsibility as health advocates to “lead the horse to the water”? Can we make them drink? Nope. But I have to hope that we can surely march with tenacity towards that river, leading others to a place where they have the opportunity to drink and take ownership of their own health and health of their children.

  44. THANK YOU SO MUCH MARK. Seriously. Thank you.
    I have a 3 year old daughter and an almost 5 year old son, both breastfed and eating only primal, whole foods since they could eat solids. They’re both very lean, especially my daughter who was actually not putting on weight for 6 months. I really appreciate your comment/advice to let them eat bananas and potatoes and not worry about carbs (while including animal foods at every meal). I would sometimes worry they ate too many bananas, but now I’m feeling better about it. I don’t even know if it’s possible to become overweight let alone obese if you start kids eating whole foods the way they’re supposed to instead of starting an early, lifelong sugar addiction.
    I’m so grateful to you, Mark, for putting information like this out there for free. It is because of you that my children are being raised on a real food diet, and that I too am finally eating a primal diet.
    I can’t thank you enough Mark, and everything about this article is fantastic.
    Best wishes,
    Tiffany

  45. All good examples and healthy cooking doesn’t cut it with some teenagers. My son was a “primal eater” as a little boy who didn’t eat grains much by choice. All he wanted was meat, milk, cheese and some veggies and fruit. Now, if it’s healthy he’s not touching it and leaves the room……. Live and learn at this point. Hope he can figure it out soon.

  46. What about the frequency with which everyone seems to eat today? Parents seem to encourage snacks constantly, both as rewards, and as a way of distracting their kids. There is cake and cupcakes nearly every day at schools. Every kid’s stroller is armed with bags and bottles and canisters of food, and littered with cookie crumbs and cheddar goldfish. There’s an expectation that food will constantly be available. I grew up in the 70s when everyone was thin. Really thin. We ate junk food. We had crappy school meals. But once the kitchen was closed, it was closed. We didn’t eat again until we ate dinner at home. And then we went to bed. There wasn’t nearly the same obsession with food as there is now. I wonder if we just tried to de-emphasize it a bit and enjoyed our meals – at mealtime.

    1. Completely agree with you. My kids snack more than I want to admit, but it’s just fruit, nuts, or pork rinds. We also stop eating around 430-530pm everyday and don’t eat in the morning until 7-730 so they are intermittent fasting longer than most American adults these days. We’re definitely a food obsessed society.

  47. We served healthy food at our home, unfortunately my daughter’s daycare did not. That’s where we lost control. She’s an adult now and unfortunately a total carb addict. She’s done 3 weeks of keto and felt better than ever but relapsed. Those crappy grains and sweets are so seductive.

  48. Amen! I hate that about Whole Foods! As expensive as they are, they routinely cheap out by using canola oil in almost all of their prepared foods. You can’t even find pesto made with olive oil there. So the only foods I buy from their prepared assortment are the salmon salad and their pumpkin pesto, which are made with olive oil, and the raw salad bar.

  49. Yes Mark, simple but not easy. Positive change – improvements – only last when they are inner driven. A real struggle when faced with ignorance and embedded interests. Even the “Wholesome” food store is what? approximately 5% raw organic food on a square footage basis. One-sixth of our economy (food business) makes people sick, and one-sixth keeps them sick (Health industry).
    I have an acquaintance who just came back from a visit to one of his docs. I asked “Roy, how are you doing” – he says “My doc says my numbers are good”. He is in third stage renal failure with diabetes.

  50. Growing gardens? Going to the local market? Teaching kids to cook? Preparing homemade, real food for a family? Sounds like the job description of most every mom or grandma until a couple generations ago. “Hm,” says the society with skyrocketing rates of childhood obesity and chronic disease, desperately scrambling to implement expensive government programs that repeatedly fail to solve any problems, “Maybe traditional women’s work was less meaningless and retrograde than we thought…”

  51. Thank you for this, Mark! It is NOT a simple problem! And to me, the worst of it is that the parents struggling with two or three jobs are in the worst position to do anything about it.

  52. I was born in 1954, and there were very, very few fat kids when I was a child. The kids that we thought were fat then were not fat by today’s standards. We had electricity back then, and there was light at night. There were screens: people were obsessed with TV in fact.

    The main differences between then and now are: (1) there was almost no fast food. It didn’t appear until the mid-60s, and people didn’t go to fast food places every day. (2) There was a lot of junk food (sodas, sugary cereal, koolaid, white bread) because “health food” had not yet been invented. But the Cokes came in very small bottles of 6 ounces. (3) People still cooked at home. (Let’s be honest: women cooked at home.) (4) We played outside, a lot, in all weather, from the time we got home from school until dark. (5) We had a long recess after lunch, and sports every day at the end of the school day. (6) There were no video games or ipads. There was one black and white TV and everybody watched the same thing, mainly at night. Daytime TV was awful. Kids’ TV was only on Saturday morning. (7) There was no concept of “low fat food” at all, much less the idea that it was somehow “healthier.” (8) Women went on diets and women smoked to stay slim. This was not a good thing. My mother took speed for depression and to stay “slim.”

    Yes, there were hardly any fat kids, but it was not a paradise! I was raised on cold cereal, koolaid, and pb and jelly sandwiches, but my grandmother had a farm and brought us a huge basket of homegrown food every week. That probably saved me.

  53. I completely agree with this. “Local decisions are the only way forward. You can say “no.” You can hug your kids more. You decide what to buy at the grocery store and make for dinner.” My little one has been considered obese since 4 months old and I have been so conscience of giving her real food, limiting refined and processed foods, sugar other than fruit, juice and she loves all kinds of great healthy foods, knows what’s healthy and not, is very active and hit all her milestones and couldn’t be a more well rounded, empathetic smart little one. MY choices at home are key and how I conduct myself. She joins me at my gym when it can work and loves it. I have talked with so many other parents that just think their kid won’t like real food, often and give them the “kid foods”. No ipad at home either.

  54. Fantastic post.

    I will say that I do support one top-down approach: modifying the farm bill. Seems to me that the subsidies on wheat, corn, and soy are a BIG part of the reason “food swamps” exist. What would the food landscape look like if it was far less economical to buy Big Macs and Domino’s pizza?

    I’m just sayin’…

  55. “The best hope you’d have is for a Primal Caesar to…….I’m too busy for that.” I so love! your sense of humor, Mark.

  56. One other thing to consider is inadequate vitamin D. Luckily enough for him, my son’s level was tested after my husband was found to have low B12 due to malabsorption. My son’s B12 was fine but his D was very, very low. After we got the level up he was like a new kid and had the energy to grow into his weight (meaning he got taller without gaining, rather than needing to lose what was an extra 15 or so pounds). I’m grateful we were able to intervene so easily, but wish testing of vitamin D levels in kids (and adults!) was more routine.