A 5-year-old leaving an exercise program for overweight children. A new study suggests that the epidemic of childhood obesity finally may be leveling off. (Matt Slocum/Associated Press)The above photo appeared with a recent post I wrote about childhood obesity. Readers were critical of me not only for showing the picture, but for my later comment that I found the picture to be “sad.” I see a child who likely is teased by peers and is at risk for a lifetime of health problems. But readers disagreed.
“It’s also very unfortunate, TPP, that you felt the need to say a photo of a little girl having her hands held lovingly by two adults is ’sad,’” wrote reader Cathy W. “Yes, her weight is unfortunate and unhealthy, but you don’t know anything else about this little girl, so please refrain from judgments. I know it’s shocking to believe, but an overweight child can still be happy and loved!”
“I was an overweight child 40 years ago,” wrote reader Janet V. “But I was never sad, so I really am offended by your characterization of the child’s picture as such.”
I asked Dr. David Ludwig, director of the childhood obesity program at Children’s Hospital Boston, to talk about overweight kids and the controversial picture. To hear our conversation, click the link below. To read the original post and comments, click here.
Listen to the Podcast (mp3)
Healthy living doesn't happen at the doctor's office. The road to better health is paved with the small decisions we make every day. It's about the choices we make when we buy groceries, drive our cars and hang out with our kids. Join columnist Tara Parker-Pope as she sifts through medical research and expert opinions for practical advice to help readers take control of their health and live well every day. You can reach Ms. Parker-Pope at 
The easiest and most pleasurable way to eat well is to cook. Recipes for Health offers recipes with an eye towards empowering you to cook healthy meals every day. 
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This little girl obviously does not grocery shop herself or prepare her own meals. Adults need to take responsibility for feeding their children a healthy diet just as they do their 4-footed, furry “kids.”
— janet_sawyerWhat Tara really said was “I see a child who is not healthy, who will grow up with a lifetime of obesity-related health problems who likely will be teased by other kids about her weight.” She didn’t say I see a child “at risk” - she declared firmly, knowing nothing else about the child, that the child was “not healthy” and that the child “will [not "might"] grow up with a lifetime of obesity-related health problems.” The US Preventive Services Task Force on childhood obesity doesn’t seem to agree that there is clear evidence for this statement.
It’s time to stop making arbitrary and prejudicial assumptions about a child based on appearance alone. Most children are healthy. Most young adults are healthy. Many older adults, regardless of weight, have health issues. That doesn’t mean that weight has no impact on health, but it means that weight is hardly the overriding factor that some people make it out to be. There is no point to these exaggerations, which just contribute to public misunderstandings and misinformation.
— carolynYour offended readers should take a step back.
The potential health problems of overweight children are sad, so in that context her description is accurate. Health is an important topic in everyones lives (and gee, it also happens to be the subject of this blog), but no one suggests it’s the only thing.
— AaronTara, some feedback for you and a question re your Podcast on childhood obesity: your podcast is well-produced and listenable. You have a pleasant speaking voice, which is a plus. You could do a radio program to good effect.
Question: is there a transcript available of your podcasts? I find podcasts to be a waste of time in this sense: I can generally read the same amount of content in much less time than it takes to listen to a long podcast (yours on childhood obesity clocks in at a little over 9 minutes). The other thing I can do more easily with printed content is review parts of it in order to understand the material better.
Re the topic of childhood obesity, this is where I get philosophical. One of the things I don’t think is appreciated in Western medicine is that different people have different temperments. These temperments have a cluster of traits associated with them. These traits exist on all levels from physical, to physiological, to emotional, and mental traits, or characteristics.
Some societies and some eras of these societies feature a bit more of one temperment than another, but all the basic temperments exist to some degree in every society. Nobody knows why this is, and they likely never will.
Now the world is seeing an entire cohort of people who tend to be overweight, or obese. In general, these people are appearing in the wealthier, industrialized countries, but other countries are also seeing the rise of problems with obesity. Nobody knows why. We can say it is diet, stress, lack of nutritional education, etc, but there must be other factors involved that defy understanding.
Certain illnesses and syndromes are more associated with particular temperment types. Obese people are no exception to this truth.
This is my long way to say that there is no one answer to this obesity phenomenon, and no one “cure”. These people are supposed to be here, and they will produce whatever good and bad effects on their various countries that they are supposed to produce.
One of the worst things I think we can do is expect that rigorous dieting, bariatric surgeries and all the other techniques known for dealing with obesity should be, or must be applied to all of these people to affect a “cure” of their conditions.
There is no cure for a particular temperment. It is like believing that we should turn all of the oak trees in the world into maple trees because we prefer maple trees to oak trees. It is insane and misguided to attempt such a thing.
FROM TPP — I’ll look into your question about transcripts. I don’t know the answer.
— Rob L; N Myrtle Beach SCOkay, let’s say everybody’s exactly right: an adiposey childhood is proof of a tragic medical condition that equals health problems all your life, every time. Now, if you had a story about a bunch of families attending a seminar to learn how to eliminate or mitigate the effects of some OTHER tragic medical condition, would it be a great idea to post a picture of a child demonstrating visible signs of the medical condition, shot from an angle that plays up the condition in the most unflattering-to-the-child way possible? Not unless you’re working for the Weekly World News. Would even the Weekly World News call such a picture “sad?” No way! I’m pretty sure even Bat Boy didn’t get “sad,” and as far as I know he wasn’t even *trying* to do anything about his stigmatizing medical condition.
The walking-away-in-stretchpants pics favored by our national media prove Dr. Ludwig right when he says overweight is the last physical difference we can stigmatize without feeling like mean people. Our society will benefit if people in the media start feeling mean about posting them to illustrate every story about obesity.
I don’t think you’re mean, TPP–I don’t think you mean to hurt people with the picture. What do I know, maybe there is a law that says you HAVE to post pictures of fat people walking away for these stories. But could you for the love of god at least find another picture of a different fat child and give this poor kid a rest?
— Nom, nom, nom!Obesity is sad, obesity at age 5 is tragic. No need to apologize for stating the truth.
— W. StephenYou know what, you can justify it any way you want to but it’s still sad. It’s sad that at five years old this little girl is already on the path to problems in the future (both physical and emotional). It’s sad that bad eating habits have already been ingrained in her and are unlikely to be overcome in the years where it matters most. And it’s especially sad that we live in a society where people are offended when the truth is pointed out.
This girl may not be sad at the moment. She may be surrounded by loving people who don’t know better. But the fact of the matter is that she is a lot less healthy than she should and could be.
— DanYou just love to stoke the fire- don’t you? Why beat a dead horse at this point. you know you offended many readers, yet you are still coming back for more.
— annaI just see a fat kid walking and it makes me angry at the parents and I feel a bit nauseated.
— Alisha“No particular concerns about her weight” - exactly - quote from the podcast about the woman on the right.
Whether you oglers out there find her attractive I care not one whit, but she isn’t lining up for health issues just based on weight.
Also Dr Ludwig hit the nail on the head - it is the discrimination which is one of the key things about this issue, not just the health problems of obesity. We now know that being literally a few pounds overweight makes no difference at all to health outcomes and may actually improve them. Yet the discrimination kicks in at that point and not when obesity occurs which carries real risks.
The obsession with thinness, pandering to men and open discrimination is causing obesity to soar just as much as HFCS.
BTW you should do a take on HFCS on this blog, it is one of the single worst things about the American diet that differs from the rest of the world. The correlating fact is that sugar has a tariff so you get horrible tasting sweets as well as ones packed with more calories. Go up to Canada sometime (where you can get both American and Canadian chocolate) and taste the difference. I’ll wager most Americans have never tasted real chocolate and eat more in the vain search for satisfaction.
— JillyFlowerI’m proud of being fat and I don’t think the picture is sad. What is the ideal person? What is the ideal life? There is, in fact, no such thing as human excellence. No one is perfectly healthy. No one lives an ideal length, in ideal conditions, or in the ideal manner. Do people think that if you’re thin and take care of yourself that you’ll life forever? Or have no sorrow? Would I like to be thinner? Yes. Has it affected my life? Yes. But so has losing my hair, growing up poor, going to graduate school instead of working. Challenges in life are not avoidable. We should have all the information we can about how to lead the best lives we can, but the best life is only for the individual to decide. I’m sure it makes some readers sad to see this picture — but that doesn’t make the picture sad. It makes the viewer sad because of their own fears, not that of the child’s. Why are we all worried anyway about a child none of us know? Perhaps we should work on the problems closest to us since those are the problems we can best solve.
— FatandHappyIf discrimination is the real problem, why play into it by applying adjectives like “sad” and “tragic” to a picture of a happy little girl? It seems to me that you’re just validating the old saw about how thin people are happy and fat ones miserable, and implying that it’s the fat people’s own fault that they’re not thin and happy.
Take on the industry, TPP. Don’t take on seven year olds.
— Elizabeth DunnHow can anyone be offended by that?! Childhood obesity is serious!! There’s no reason why that child should be overweight! It’s the parents fault… that’s all there is to it!! Being that overweight at AGE 5, will cause that girl to have a lot of health problems… if the parents don’t change her diet! It is kind of sickening… and it makes me upset with the parents, like one person already said.
— Michigan, USAI honestly believe people love to get offended and unleash criticism at others. Childhood obesity is almost certain to become a lifetime struggle and it is a sad situation to be in. I don’t think TPP meant the girl is a “sad person” and I believe the tone of the article made that abundantly clear. It’s a hard truth to hear, but it’s a depressing reality, and getting offended because it is being discussed isn’t going to fix anything. Adults must evaluate their lifestyles (eating, fitness, etc) even before they become parents, because kids are little sponges and they will adopt all of our bad habits and suffer the consequences. It’s a sad reality, let’s not deny it, let’s confront it and solve it!
— MarthaBecause you just KNOW, right, Dan and Alisha, that this kid is fat because of the bad food the bad parents are feeding her. Everybody who just KNOWS all about the child from looking at her photo needs to take a peek at the picture in Gary Taubes’s book of the woman who’s insanely emaciated above the waist and insanely fat below. Poor bitch is ana AND a fatty: DOUBLE sad!
— Nom, nom, nom!I’ve worked in education for many years and the increase in obese children is amazing. I have especially noticed this difference over the past 10 years. I don’t know what we’re doing wrong but we definitely have to work together to find ways to help our children live healthier lives. It breaks my heart to see a child who can barely run a lap or climb a jungle gym. Quality of life is a great issue.
— RunningTPP needs a voice-over, she is very hard to understand in the podcast.
— ElenaThat little girl is not that overweight. I am not sure for girls but for guys a lot of fat they have as a young child can just melt away as you go through growth spurts and puberty. So highly doubt that being slightly overwieght at that age is a guarantee someone will be overweight in adulthood.
— Bill BraskiTara Parker-Pope
You are a big fat fat-o-phobe! I’m sick of it!
— betsyBat Boy wasn’t fat. The girl in the photo is. The cause? Bad parenting.
— Mason Jar“she declared firmly, knowing nothing else about the child, that the child was “not healthy”.
“It’s time to stop making arbitrary and prejudicial assumptions about a child based on appearance alone. Most children are healthy.”
I don’t understand these statements. Being obese is unhealthy, period. How could someone try to contest that? I think the people who take issue with calling the situation sad or unhealthy are in some sort of denial.
You don’t need to know anything else about this child to know she’s unhealthy. She’s not just overweight, but very obese. Her body is not made to sustain that kind of weight. And yes, I don’t know anything about this particular girl, but I can tell just from looking at her that she would not be able to participate in the endless games of tag and running around that most kids participate in. I’m not judging her, I’m just stating facts. The situation is sad. It is.
— poppyNo need to apologize, Tara, it is sad, because that dear girl may be loved and given everything in her emotional toolkit to become a happy adult, but her health will be impaired and her longevity affected by the excess weight she carries now at a very young age. Your readers who disagree can make poignant arguments about the unfairness of attitudes toward the overweight and obese, but the health risks are real.
— CollyCollyTara, I think your statement on the child’s potential struggles being sad is valid, but pity is not what the situation calls for. We need better education.
— Robert CowartIt has taken me years to realize how much i prefer fresh, healthy food because once i started feeding myself, the easy choices were all so awful, health-wise, that I accepted them as the norm, and not as the trash that they are.
I am still overweight and battling, but I have finally, after years of attempts to balance excersize and diet, started to move in the right direction.
Behavior is learned and it is important that we start teaching our society how to be strong and healthy, instead of fat and lazy. So you health nuts out there yell it out. Get the word out. Its OK to be fat. Its not OK to be unhealthy. Eat fresh food. Eat the foods that make you feel like you want to get off the couch instead of making you want to lay on it.
A friend of mine was out with her family recently and she ordered a “california quesadilla” which had several types of cheeses, avocado, artichoke, tomato, things like that in it. She asked if anyone wanted a bite to which her father replied, “Its got all of that disgusting stuff you like in it.” It is sad to me that so many feel that good tasting food is different from healthy food.
And its tough to re-educate your palate when the doctor starts mentioning “cholesterol” and “heart disease”.
The overweight 5 yr old = Mama wasn’t loved and affirmed by Dad and maybe by her own Mama - or boyfriend/husband, Mama substituted sugar and white flour for love and became somewhat overweight, and then fed her little one sweets and junk so the little one would love Mama - Mama is bright enough but so hurt and twisted out of shape she can hardly see the end of her nose and does not recognize that “Love must be tough” sometimes. And Dad, if there is one around, has yet to assert himself and say cut out the junk already, you’re killing her (him). And around and around she goes, and where it will stop we all know - at the doctor’s and drug store -tranquilizers, and much too soon - at the funeral directors’s. Needed - more real love one for another - maybe if we prayed more to bless and heal their souls ? in Jesus name. Amen.
Made most of those mistakes.
— John FunkCompassion Street.
It IS sad. Sad that the adults are not monitoring the child’s diet properly and probably substituting food for time, attention and true affection.
The good news is that one or both of the parents took responsibility and acknowledged the problem, placing the child in a program to break the pattern. Otherwise this child who may feel quite loved by being indulged with any food she wants any time she wants may not live to see 50.
What is really sad is adults who do not take responsibility and make excuses.
— Kim