Ending the Food Fight:
Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World

by: David Ludwig M.D., Ph.D. with Suzanne Rostler M.S., R.D.

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   Q & A with Dr. Ludwig:


What is Ending the Food Fight about?

Ultimately, the solution to obesity is simple: eat less and exercise more. However, for the vast majority, and especially children, this simple solution hasn’t worked. According to recent surveys, about 1 in 3 men and 1 in 2 women are trying to lose weight. Countless weight-loss books have been published in recent years offering easy answers. Yet rates of obesity and diabetes continue to soar. To address the problem at its roots, I use the metaphor of a battle that takes place on three levels. 

The first battle occurs within the individual, when eating foods that work against our basic biological makeup. A diet based on highly processed, high-glycemic foods sets into action hormonal changes in our body that lead to increasing hunger and falling metabolic rate. The mind might say, I’m too heavy, I need to eat less, but the body says, I’m hungry, feed me. And in the battle between mind and metabolism, metabolism usually wins, especially with children.

The second battle takes place within the home when a child with unhealthy eating and activity habits starts to get heavy. At some point, the parents become alarmed and try to control the situation with coercive behavior change methods (criticisms, punishment, nagging, pressure to eat certain foods, etc.).  All too often, however, these attempts only make matters worse, as the child rebels against well-meaning but misguided parenting practices. Ground zero is, of course, the dinner table.

The third front is all around us, in our communities and our society. The government exhorts us to eat well and lose weight. We hear that the childhood obesity epidemic may shorten life expectancy in the United States and bankrupt the health care system. But parents’ efforts are undermined at every turn: TV commercials for junk food targeted at young children; schools that have literally franchised their cafeterias to fast food companies; neighborhoods that lack sidewalks and parks, discouraging physical activity.

Bookstore shelves are lined with simplistic weight-loss plans addressing just part of the problem. But even the best possible diet won’t work if people can’t (or lack the motivation to) follow it. Conversely, the best possible behavior change plan will ultimately fail if it advocates a diet that exacerbates hunger and diminishes energy level. Ending the Food Fight aims for a comprehensive solution. First, we must make peace within ourselves by learning to eat in a way that works with our basic biology. Next, parents must learn effective, age-appropriate strategies so that they and their children work together, not fight. In our present “toxic” environment, the family is the last bastion of protection for the children. Finally, having brought healing to our children within the family, we must turn our efforts outward, making changes in society that will support a healthful lifestyle for all of us. Then we can lay down our arms as the food fight ends. 


Isn’t obesity mostly a question of biology? If you happen to be born with “fat genes,” isn’t there really very little you can do about it?

It can seem overwhelmingly difficult to maintain a healthy body weight in America today. But this hasn’t always been the case. Since World War II, most people in America and Europe have had plenty to eat, but obesity rates didn’t start rising until the 1970s in the United States and the 1980s or ’90s in Europe.

Just as there are biological forces that push body weight up, there are powerful forces that keep weight down. Just think about having a large Thanksgiving dinner: afterward, you didn’t want to even look at food for a while, and you probably ate less the next day.

The bottom line is that the obesity epidemic is caused by our environment, not our genes. If we could return to the environmental conditions of the 1960s, the obesity epidemic would vanish. It may take some time to make the world a healthier place to live. But until then, we can create a protective environment around our children at home. We can guide them toward a healthy weight, as thousands of families in the Optimal Weight for Life (OWL) Program have done over the past twelve years.


What is the Optimal Weight for Life Program?

The OWL Program, based at Children’s Hospital Boston, is among the oldest and largest clinics anywhere in the country for overweight children and their families. Because many factors affect body weight—including biology, diet, physical activity level, emotional well-being, family dynamics, and our environment—we have a multi-specialty staff that includes pediatricians, nurses, dietitians, and experts in child behavior. The OWL Program and our patients have been featured extensively in local and national media, and clinical outcomes have been published in prestigious medical journals. Ending the Food Fight translates years of OWL experience into a practical and scientifically proven plan that families can follow at home. Dozens of actual OWL patients and their families share their real-life stories of struggle and transformation with the reader.


Your book gives families a 9-week program and recipes to follow at home. Why not just skip the science?

Some people can be intimidated by science, though I mostly blame this problem on scientists, for speaking in too much jargon. I find that most people, and especially children, are fascinated by the inner workings of the body, and by the remarkable events that take place inside us every time we eat. This knowledge can give us a visceral understanding of what the body needs to be healthy and increase motivation to take good care of ourselves. But the science also helps to focus our energies on lifestyle changes that really make a difference and to avoid wasting time and energy on ineffective approaches. For many people, trying to lose weight is like pedaling a bike in the wrong gear: we go through a lot of motion but don’t get very far. Science helps line up biology and behavior, shifting weight loss into high gear.

Even young children can learn the basics of healthy nutrition if the science is explained in an interesting and accessible way. In five minutes, a five-year-old can learn the difference between real food (from nature) and fake food (from a factory), or that too much refined carbohydrate sends blood sugar on a roller coaster ride that makes them hungry a short while after eating.


Where have previous weight-loss diets gone wrong?

For much of the last half-century, the most common approach to preventing and treating obesity has been a low-fat diet. It seemed to make sense: if you don’t want fat on your body, don’t put fat into your body. The problem is that it didn’t work. Recent research from our group and others has shown that the relative amount of fat in the diet isn’t an important determinant of body weight. And low-fat diets have been notoriously unsuccessful. In the past five years, the pendulum has swung very far in the other direction, with the enormous popularity of the Atkins’-type, very low carbohydrate diets. These diets do produce significant weight loss for a few months. However, studies show that by one year, much of the weight is regained. How long can one go on bacon double-cheeseburgers, hold the bun? The basic problem with many diets is that they lack an accurate understanding of how food affects our hormones and metabolism, and ultimately our well-being. Diets that restrict an entire class of nutrients, fat or carbohydrate, produce biological and psychological deprivation that we can ignore for only a short time. Instead, we advocate a low-glycemic diet designed to stabilize blood sugar and insulin after the meal, promoting long-term satiety and supporting metabolism. This approach, focused on nutrient quality rather than quantity, offers the widest possible range of food choices, providing a sense of abundance instead of deprivation. Dozens of scientific studies suggest that this approach may be remarkably effective, not just for weight loss, but also to prevent heart disease and diabetes.


Why is it so hard to stick to an exercise program?

It’s no surprise that Americans are remarkably sedentary. Many teenagers, especially girls, do virtually no physical activities apart from gym at school (and due to budget cuts, gym isn’t offered very often these days). Most conventional weight-loss programs aim to get sedentary people involved in regular vigorous exercise. Unfortunately, most exercise programs don’t produce significant weight loss. The problem is that jogging, for example, burns off only about 70 calories per mile, whereas just one super-size fast food meal can have over 2,000 calories—equal to jogging four miles a day for an entire week! Children, especially younger ones, are not well-suited for sustained vigorous exercise: their bodies aren’t built for it, and they lack the ability to concentrate on one activity for long. A more effective approach is to discourage sedentary pursuits (especially TV, the granddaddy of them all) and encourage all sorts of physical activities in daily life: play (the most natural physical activity for children), sports, dance, walking, active chores, and so on. Don’t even mention the “e”-word.


What is the most common mistake that parents make when dealing with an overweight child?

When it comes to behaviors affecting body weight, some parents raise young children permissively, perhaps in reaction to excessive strictness they experienced in childhood. But if parents don’t provide firm limits and guidelines, our commercial culture will happily fill the vacuum. The extremely unhealthful eating and activity habits taught by TV and other media become deeply ingrained over time, often causing a weight problem by adolescence. At this point, parents become alarmed and try to clamp down. But strict limit-setting at this developmental stage usually makes matters worse, resulting in an escalating power struggle. Coercive parenting practices (criticisms, punishment, nagging, pressure to eat certain foods, etc.) at any age may seem to work in the short term, but they can be very counterproductive. These practices take a toll on the parent-child relationship, they leave children feeling upset (and no one learns well when upset), and they actually keep children from accepting responsibility for their behavior.

The key to successful parenting is to establish a parent-directed system that provides firm limits and guidance when the child is young. Then, over time, these limits are gradually released as the child matures, giving rise to a child-directed system that encourages autonomy and responsibility. With proper parenting practices, we can avoid many of the problems that commonly occur in families with overweight children and possibly help prevent overweight from developing at all. When conflicts do occur, constructive parenting practices (modeling, praise, goal-setting, problem solving, and self-monitoring, for example) help us avoid making matters worse and begin to turn things around.


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