|
|
||
|
|
The
Health Zone Newsletter In
this issue: The
Shape of Things to Come
When the world was a simpler place, the rich were fat, the poor were thin, and right-thinking people worried about how to feed the hungry. Now, in much of the world, the rich are thin, the poor are fat, and right-thinking people are worrying about obesity. Evolution is mostly to blame. It has designed mankind to cope with deprivation, not plenty. People are perfectly tuned to store energy in good years to see them through the lean ones. But when bad times never come, they are stuck with that energy, stored around their expanding bellies. According to the U.N., the number of people short of food fell 920m in 1980 to 799m 20 years later, even though the world's population increased by 1.6 billion over the period. Mankind has won what was, for most of his time on this planet, his biggest battle: to ensure that he and his offspring had enough to eat. But every silver lining has a cloud, and the consequence of prosperity is a new plague that brings with it a host of interesting policy dilemmas. As a scourge of the modern world, obesity has an image problem. It is the world's biggest public-health issue today-the main cause of heart disease, which kills more people these days than AIDS, malaria, war; the principal risk factor in diabetes; heavily implicated in cancer and other diseases. Will public-health warnings, combined with media pressure, persuade people to get thinner, just as they finally put them off tobacco? Possibly. In the rich world, sales of healthier foods are booming and new figures suggest that over the past year Americans got very slightly thinner for the first time in recorded history. Everywhere else in the world, people are still piling on the pounds. That's why there is now a consensus among doctors that governments should do something to stop them. Governments and people seem to agree that ensuring the safety and stability of the food supply is part of the state's job. But obesity is a more complicated issue than food safety. It is not about ensuring that people don't get poisoned; it is about changing their behaviour. A better argument for intervention is that dietary habits are established early in childhood. Once people get fat, it is hard for them to get thin. Britain's government is gesturing towards tough restrictions on advertising junk food to children. Sweden already bans advertising to children, and it's young are as porky as those in comparable countries. A second plausible argument for intervention is that thin people subsidise fat people through health care. If everybody is forced to carry the weight of the seriously fat, then everybody has an interest in seeing them slim down. Society has a legitimate interest in fat, because fat and thin people both pay for it. But it also has a legitimate interest in not having the government stick its nose too far into the private sphere. If people want to eat their way to grossness and an early grave, let them. Mental
Illness Common in Childhood Obesity Defiance,
Depression Cited in Study Chronic childhood obesity was associated with a greater likelihood of depression in boys and hostile and defiant behavior in both boys and girls. But it did not appear to increase the risk of chronic anxiety, substance use, attention deficit disorder, or other psychological problems. The Duke study included almost 1,000 mostly white children between the ages of nine and 16 living in a rural North Carolina region where childhood obesity was at least three times more common than in the nation as a whole. The children were evaluated annually over an eight-year period to determine height, weight, psychiatric disorders, and vulnerabilities to such disorders. The findings are reported in the latest issue of the journal Pediatrics. Childhood obesity was associated with a 2.5 times greater likelihood of a disorder known as oppositional defiant disorder, defined as an ongoing pattern of uncooperative, defiant, hostile behavior toward authority figures. The disorder is more common in boys, but the researchers found it to be elevated in both boys and girls. Childhood obesity specialist Sarah Barlow, MD, says a child with defiance disorder is less likely to set limits for himself or follow those set by parents, and this could easily lead to obesity. Barlow is an assistant professor of pediatrics at St. Louis University School of Medicine "For so many families with overweight children, setting limits is a big issue," she tells WebMD. "For these kids, making the lifestyle changes necessary to lose weight may be low on their list of priorities." Mustillo says it is not clear whether environmental or biochemical factors drive the tendency toward these depressive disorders in kids with childhood obesity. Studies in adults suggest hormonal abnormalities associated with obesity play a role in depression, but little research has been done in children. The children participating in this study were largely homogeneous, and Mustillo says it is possible different associations would be seen among different ethnic populations. "From a biochemical standpoint we probably all pretty much have the same makeup," she says. "But if environmental or social factors are involved, you might see a difference. There might be fewer of these problems among ethnic groups where [childhood] obesity is more accepted." |
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
