Too Heavy, Too Young

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Indeed, any program that treats kids successfully has to involve the entire family, says Leonard Epstein, a psychologist at State University of New York at Buffalo and director of one of the most successful pediatric-obesity programs in the country. "You really need to include the parents as part of the treatment," he says, if only because parents of obese children are often overweight or obese themselves. Usually, the entire family could stand to modify its diet and reduce high-fat foods and sweets. Epstein encourages families to build exercise into their daily lives, taking walks together after dinner, for instance, or turning off the TV on weekends.

If parents want to protect their kids from obesity, they need to look beyond the home to their children's schools, where phys ed and recess are going the way of art and music. At the same time, hundreds of cash-strapped school districts around the country have turned to soft-drink bottlers, who offer as much as $100,000 a year for exclusive "pouring" contracts to place vending machines in school hallways. Principals have opened their cafeterias to such fast-food franchises as Taco Bell and Burger King. "If your task was to make the American child as unhealthy as possible, could you do much better than fast food and soft drinks in the cafeterias?" asks Kelly Brownell, a psychologist at Yale University.

Parents can try to change some of these things, but they can do only so much by the time their children reach adolescence. Restraint and self-control have never been America's strong suits. It's tough for parents to teach teenagers to listen to their bodies, to eat when they are hungry, to taste what they are eating, to eat appropriate portions and to leave food on their plate. Lasting behavioral change cannot be imposed from the outside. These are internal battles and will ultimately have to be fought by the kids themselves, one chubby bulge at a time.

--Reported by Ellin Martens/New York, Jeanne McDowell/Los Angeles and Maggie Sieger/Chicago