childhood obesity sucks

[green_amber]

THis story hit the papers at the weekend and there's been some discussion of it at hfnuala's LJ, based (unfortunately, I think) on the rather addled version from the Metro. I read it in the Observer and assume the Guardian story is basically the same.



Essentially the story suggests that leptin, a hormone in breast milk not currently put in formula, can inhibit childhood obesity by "chemically restructure[ing] the metabolic system of children to ensure they never became obese.

Studies in mice have found that large doses of the appetite-controlling hormone leptin during infancy permanently prevent excess weight gain and reduce the chances of type 2 diabetes."

Nuala argues that this points towards encouraging, or possibly even mandating breast feeding, as opposed to adding leptin to formula milk, as the scientists suggest. Another person on her LJ suggests that why can't childhood obesity be better avoided by diet and exercise, as was the case with all of us slim things here ? :-)

My (annoying) view: Frankly if a *safe* way exists, or can exist, to reduce or eliminate childhood (and hence adult) obesity with all the health risks and expense for the NHS and sheer misery attached to it, I'm all for it. In fact I think it'd be a fucking miracle. I've known the sheer bloody misery of growing up as a small fat child; even leaving aside health risks, it was pretty shit. (Probably less so now, I guess, when it's so common?)

If this stuff exists naturally in breast milk AND is proven to be safe, however that needs to be done, why NOT add it to formula, for god's sake? Also it might be that higher doses than naturally exist in breast milk need to be added for it to be fully effective (again safety testing clearly crucial). We've already been trying to push breastfeeding for decades and there's no question it isn't the best approach, or that we'll stop promoting it - but some people, whether because it's uncomfortable, inconvenient, incompatible with work, or for whatever reason, are just not going to do it (or not for long enough). Should they be excluded from these benefits? Should their children? Especially given they're likely to be the least middle class segment of the population?

25% of UK women are now obese and children are heading that way . (And yes I know not all women who are obsese are unfit, and that BMI sucks, but c'mon we all know what these figs imply for the NHS. You just have to look around Southampton, or Glasgow, or the average sf convention:-) It's all very well for us smug middle class people to say, exercise and better diet are the way fwd. Huge numbers of people don't have the opportunity, the money (fresh veg, lo fat food, cost more, take more time to prepare, are less easy to obtain, we all know that) or simply the nous or motivation to take that path. Like me, who can afford all the pomegranates and gyms in the world, I'm so thin already ... :) If we can help people. especially children, and especially our least well resourced and most ignorant people, we should.

The Observer article emphasised that tests would need to be done to ensure safety for both mother and child and that this would be very difficult as few people would want something tested on a new baby - OTOH they said the drug might be viewed as a natural food supplement and not a drug. This needs supervised carefully.

I get really irritated with the kneejerk response that any medical advance is (a) a dangerous drug being imposed by a consiracy of drug companies (b) designed to discriminate against the people with the condition it's designed to eliminate. I'm as keen as anyone, being er plump myself, to ensure that fat people aren't discriminated against in a world where it's bloody hard to do anything about it. But in a world where you CAN - why on earth would we want to hold out against it?

OTOH there is this possibility..:-)

Comments

[failing-angel.livejournal.com]

Mmmmm Reavers

[surliminal.livejournal.com]

Ah there's the intelligent discussion I was hoping for :-)

[failing-angel.livejournal.com]

Of course

[bellinghman.livejournal.com]

Or, in other words, they've discovered a component of breast milk that has to date been missing from formula, and they are suggesting that it now be added.

If it were calcium, there'd never have been this fuss. Mind you, if it'd been calcium, it'd have been much more obvious why the little dears weren't actively running around at nursery school - it'd have been because their legs had no bones.

My 2 cents :)

[meaningrequired.livejournal.com]

My MSc was in Health Psychology... and my PhD is in promoting the general public to become more active.

To me that article feels as though its assuming that obesity is genetic, and to a certain extent it is, apparently :). However, to me, its more to do with our lifestyles. I dont have the research but it is claimed that our diet has not really altered that much, and 100 years ago obesity was not the same problem it is today, and some people owuld suggest its the lack of activity thats causing the weight (although I'm sure fast food outlets help). So to me, its deifnately a lifestyle change.... But its really hard to increase physical activity if you don't have somewhere to go do it.

My PhD is hoping to encourage people to join in group acitivities that are fun and social and make you forget about the fact youre exercising. But that requires some knowledge of where to find these groups or how to play some team sports.

This article is aimed at kids, and I would love to see physical activity becoming an enjoyable thing for them (I HATED PE at school) so that they already have the knowdlegde of how to play team sports, what to wear and where to do it and to have found some sort of activity they enjoy.

When I was doing my undergrad I was very interested in hormones and neurotranmsitters. My mums been trying to lose weight for a very long time, and I would have loved to have got my hands on some leptin to see how it would effect her. Though, we're not supposed to experiment on our friends and family :)

I think its really interesting scientiests are beginning to understand how our genetics, and biology make us the way we are.

I also worry that rather then we humans do physical acitivty and not eat at burger king every day, that drug would reduce the liklihood a person would get obesity... emaning they could eat burger king all week and sit on the sofa at a hard day at school/work (also sitting down) and not put on weight. Great some people may say, but this is still bad for health. I think we need to treat the cause, not the symptoms.

:S I really rambled :S Though I know its *really* hard though to improve health... and its not as simple as it might appear that I think it is :)

Re: My 2 cents :)

[andrewducker]

We should _definitely_ be encouraging people to have healthy lifestyles.

But then, so far as I can tell, we really do.

But most people will never pay much attention to it, so it makes sense to help them out in other ways as well.

Re: My 2 cents :)

[blue-condition.livejournal.com]

Team sports? Fun?

You will be assimilated.

From there, a half-step to Winston Smith's telescreen telling him to exercise more vigorously.

No ta.

Re: My 2 cents :)

[surliminal.livejournal.com]

I tend to agree..
tho I did like badminton when i tried it, at the ripe age of 32. But it's hardly "team".

Re: My 2 cents :)

[clarehooper.livejournal.com]

Ditto that (well, change the age down to 23, but still!). Everyone hates PE in school, and doesn't know how to do team sports. Right?

Re: My 2 cents :)

[blue-condition.livejournal.com]

Exercise is like self-pollution. It should be short, strenuous, and solitary ;) Oh and you should go for a long cold shower afterwards. ;)

Re: My 2 cents :)

[surliminal.livejournal.com]

short, strenuous, and solitary ;)

Aren'y you mixing it up with masturbation?:-P

Re: My 2 cents :)

[andrewducker]

*waits for Mr Condition to inform Ms Liminal of the meaning of the phrase "self pollution"*

Re: My 2 cents :)

[surliminal.livejournal.com]

Ooh bugger. (Wait, that's something else again , isn't it?)

I think i read it as self flagellation..

Re: My 2 cents :)

[del-c.livejournal.com]

Well, self-flagellation is beating yourself, so you were close.

Re: My 2 cents :)

[surliminal.livejournal.com]

I find it incredibly hard to believe we have the same diet as 100 years ago - 1907? No fast food, no ready meals, no monster chocolate bars, no hydrogenated fat, no Whoppa burgers?

If we could be made slim by a miracle drug WOULD it matter if we ate at Macdonalds and sat on the couch all day? I like some exercise - swimming and yoga make me feel good. But god I'd pay good money never to go to a gym again:-)

I agree that the article does seem to discount the non genetic components of obesity.

Re: My 2 cents :)

[meaningrequired.livejournal.com]

Sometimes I worry when I voice an opinion that it wont be regarded well, I'm supposed to be doing a PhD and I'm supposed to come up with reasoned ideas.... and sometimes I don't sometimes my heart speaks louder than my head, and my heart is infinately more optimistic :)

See I though the same about the idea that our diet hasnt changed, I've spoken to 2 lecturers who say that it has not changed. I bet even 20 years ago families didnt eat as much fast food. I remember when we got our first McDonalds in my hometown! Though I do believe we are a lot less active... and I think that because theres fewer jobs where you have to be active... and computer do so much.

Theres this idea of thin on the outside, but fat on the inside. When your organs are surrounded by fat but you don't appear overweight at all... but thats another health scare :D

Re: My 2 cents :)

[surliminal.livejournal.com]

Is it possible they meant that we don't take in more calories than we did 100 years ago - that I could believe - if you look at old menus , with four, five courses, meat in all of them, huge breakfasts etc etc? But that all came to an end during WW II pretty much..
Also there's the point that manual work really used to be manual. i remeber reading that colliers used to dink 10 or 11 pints of beer a day - nowadays they'd be alcoholics, then they were just rehydrating from the working conditions.

Re: My 2 cents :)

[devilgate.livejournal.com]

I believe the beer was much weaker: like 2%. Still, that would be like four or five pints today.

Re: My 2 cents :)

[failing-angel.livejournal.com]

On a related note:

My Wartime Menu
http://news.bbc.co.uk/1/hi/magazine/3847041.stm

[andrewducker]

I'm with you.

Technocratic solutionising for the win!

[despotliz.livejournal.com]

If a safe way to remove childhood obesity exists, then I am all for it. My worry is that I can't see a way to test if the amount of leptin needed to reduce obesity has any other problems in humans without just trying it out, and it's not something you can test on adult volunteers.

[surliminal.livejournal.com]

The obvious parental volunteers would be those having kids from families with a strong apparent genetic predisposition to obesity. parental consent does do for experiments on babies, arguably subject to a best interests test.. - and we do experiment on babies - just ask sushidog..

[supergee.livejournal.com]

I'm with you. I'm sick of "Breastfeeding/exercise/heterosexuality/etc. is so wonderful that those who don't do it should get sick and die."

[hfnuala.livejournal.com]

Wow, way to construct a straw argument.

[supergee.livejournal.com]

Point taken. I'm a nurturing-mommy liberal whose first impulse is to protect people. I should refrain from telepathic claims about those with other priorities.

[hfnuala.livejournal.com]

I really did mean to comment on how appaling the Metro article was rather than the science. I don't read the research anywhere else and didn't have the patience to work out which bits of the nonsense came from the reporter and which from the scientist.

I was and am more appalled by the suggestion the hormone should be given to pregnant women than I was by the suggestion it should be in formula milk. Research into why breastmilk is good for us should indeed feed into the making of artificial milk but that is the second step. The first is encouraging breastfeeding, which is good for both mother and infant. And also cheaper :)

And, yes, I do wish breastfeeding were seen as the norm with formula milk as a medical intervention but luckily I dont't rule the world.

[surliminal.livejournal.com]

Yes sorry, you were rather my starw man woman) - I had been meaning to post about it anyway.

pushing my luck

[surliminal.livejournal.com]

...But if there was a pill you could give pregant women so their babies wouldn't grow up obese, and it was tested tolerably safe, would you oppose giving it?!

Re: pushing my luck

[hfnuala.livejournal.com]

What percentage of the babies would grow up obese without it? What effect would it have on the mothers (not just will it serious harm them, but side effects)? Would it have a 'better' outcome than feeding babies the way they evolved to be fed?

To be honest, I don't believe such a pill is ever likely to exist so I think it's a silly question :)

Re: pushing my luck

[surliminal.livejournal.com]

What percentage of the babies would grow up obese without it?

Does it matter? We take folic acid even though most our babies won't have spina bifida..

Side effects? if it was a bit of nausea or the equivalent of anti deopressant side effects, I would say it was worth it for the value to the baby and society.

It might not be a "pill" but the Observer article predicted such an effect being available via supplements within 10 years. And I though "god that's amazing".

I do think at root here there's two things going on here of which I am suspicious - (1) natural is always best (not in any way always true or we'd be a society of polio, rickets, syphilis, people dying of pneumonia and, facial deformities, etc etc.

(2) what is harder to achieve is always best =Calvinist syndrome. Why CAN'T I just take a pill and be thin? Why do I have to do it the hard way?

I want to live in Varley's Six Worlds, where I can be thin, fat, male, female , beautiful or reptilian any day I want :-)

Re: pushing my luck

[hfnuala.livejournal.com]

But we're not talking about you as an adult taking a pill so you can be thin. We're talking about an adult woman taking pills because she is pregnant and then babies being given a supplement of something they could get in a non-interventionist way. And all this occuring without any way of knowing if the babies would have been fat in the first place.

(Folic acid is a red herring - it occurs in table food, leptin doesn't.)

..on a slightly different note (and I'm avoiding work)

[meaningrequired.livejournal.com]

... I am absolutely terrified of breast feeding. The whole concept is enough to send my brain reeling into avoidance! If I had to, I think I'd need therapy after it.

But then maybe when the crazy pregnant hormones kick in, it'll feel like the most natural thing in the world....

Re: ..on a slightly different note (and I'm avoiding work)

[surliminal.livejournal.com]

I think this quite a salutary piece of evidence from you as a health professional! . I personally think people's responses to breastfeeding is less to do with hormones than upbringing, body image, peer group etc. No one in my family breastfed. I like to think I would if it happened to me, knowing what I do, but it would be head over instinct for me too, though I don't *dislike* the idea the way you do - but I don't much fancy getting my tits out in public on a constant basis, nor the idea of expressing for work ...

[ophelia-complex.livejournal.com]

I live with two flatmates. The one you haven't met is female, 6'2" and a size 10 (or thereabouts). I mentioned in passing I was fat, she said I was more curvy and it started me thinking. I used to be about a size 18 (depression, old life and many problems). My problem wasn't genetics it was bad diet. I didn't really eat that much, but what I did eat was saturated fat and exercise was something other people did. So now I'm a 14 and definitely larger than Karen but I what I realised is that if I *really* wanted to be thinner I'd devote more time to exercise and would work on my diet even further. Ergo, I'm not too unhappy where I am!