Note: Through two posts on the modern obesity epidemic, Riya and I live up to our name, Dual Perspectives, by examining the issue from two viewpoints. I describe how nurture leads to childhood obesity while Riya examines how your nature can make you genetically prone to the condition. Neither one of us denies that nature and nurture both contribute to obesity, but the end of Riya’s post delves into how genes interact with the environment. Thus, we suggest that you read my post first and end with her explanation. Thank you for taking an interdisciplinary approach to studying issues by reading both of our posts.
Introduction
Since I was five, I have considered myself overweight. Although doctors were unconcerned and nobody severely bullied me, I eliminated numerous foods from my diet and opted for baggier clothes that hid my figure. Little did I know that I was only slightly overweight. Millions of children struggle with even worse weight issues and thus social trauma. I believe that the childhood obesity epidemic is more rooted in nurture, or environmental factors, than nature, and here is why.
What Causes Childhood Obesity?
According to Boston Children’s Hospital, there are a few primary reasons behind childhood obesity that fall into five main categories.
Category #1: Diet
Sugar-sweetened beverages have played possibly the largest role in childhood obesity. These drinks may be heavily consumed because, as liquids, they are not thought to cause considerable weight gain. The hospital’s New Balance Foundation Obesity Prevention Center conducted a trial revealing that adolescents who omitted sugary drinks from their diets for a year were roughly 4 lbs lighter than those who maintained their diets.
All ultra-processed products also contribute to childhood obesity. Unlike any natural food, these products are made in factories and include numerous artificial ingredients. They are high in calories but have barely any nutritional value. Thus, they cause weight gain and chronic diseases.
Diet is part of nurture because the food a child is fed contributes to the environment in which they grow up. A child’s willingness to consume this food is influenced by their food preferences. Although your biology predisposes you to certain foods, these predilections change with time, so they are not purely genetic.
Category #2: Physical Activity
Today, children get an excessive amount of screen time instead of exercising, the main reason for childhood obesity after sugary beverages. Consequently, they continually view advertisements for high-caloric, substandard food. Children who are socioeconomically disadvantaged and live in the inner city, in particular, may not have PE on a regular basis or active after-school programs. Thus, they are not guaranteed to engage in consistent physical activity.
Overall, aspects of children’s environments, whether it be money-hungry restaurant chains or under-resourced schools, affect their levels of physical activity.
Category #3: Family
Many believe that the world beyond the home promotes unhealthy eating. Parents often do not shelter their children from these negative influences or appropriately address them. In addition to providing inadequate defense against external forces, parents may actively inflict as much harm at home. They may serve their children unhealthy foods that they continue eating as adults. If they do not make healthy dietary choices themselves, their children may inherit their poor eating habits (although this inheritance is not genetic!).
Family influences are undeniably part of a child’s environment or the way in which they are nurtured.
Category #4: Stress
When you are stressed, you lose sleep. When a child is stressed and sleepy, they succumb to their food cravings rather than wanting to engage in physical activity. Additionally, significant stress and sleep deprivation may affect children’s hormones and metabolisms in ways that cause weight gain.
Factors that affect children’s stress and sleep levels (schoolwork, issues at home, friendships, a negative self-image, etc.) are all environmental.
Category #5: Neighborhood
Currently, some suburbs do not have any public transportation, including sidewalks. Instead, residents often use cars. Many neighborhoods lack community parks, playgrounds, and bike paths, all of which promote safe physical activity.
The layouts of children’s neighborhoods relate to their environments and thus nurture.
Childhood Obesity in Britain
I decided to write a blog post on childhood obesity after watching a video on a British weight loss camp. As I browsed more videos on the topic, I noticed that they focused on British children. Nearly one million British students are obese. Paula Watson, a principal researcher in childhood obesity, shares why the issue is so prevalent in modern-day Britain: residents get less physical activity but more exposure to fatty, sugary foods. There are now cars and online shopping, which limit physical activity. Similarly, modern technology is very appealing but encourages children to remain seated and inactive. This explanation resembles that of Boston Children’s Hospital, so these issues clearly apply to many countries but may be exacerbated in Britain.
A group of seven British children (pictured below) was filmed and tested to research childhood obesity. I would highly recommend watching the documentary linked in “Sources,” but here are the aspects of their stories that resonated with me.
The Older Children
Lauren
Lauren is 10 years old and initially appears to be the most focused on weight loss. She worries about continuing to be bullied and having no friends at school due to her weight. Thus, she is determined to lose weight before the next school year arrives and has joined the Weight Watchers club despite her young age. Since Lauren is the only child in the group, she cannot easily contribute to the conversation. Although she is losing weight, her BMI indicates that she is still obese. Lauren’s mother, Julie, joins her at Weight Watchers meetings and also aims to lose weight. I observed that many of the participants in the study have overweight parents who simply hope their children do not experience their same struggles.
Julie is asked if she worries that joining an adult club will force Lauren to mature too quickly. She expresses that she is unconcerned because the club does not promote a strict diet but rather “food awareness,” which children should learn from a young age. Julie is referring to the fact that Lauren uses a point system to control her weight. She can still eat all foods but has 23 points a day, and each food is worth a certain number of points. Personally, I find this approach more sustainable than omitting foods but worry that it may cloud such a young mind with too many food-related thoughts. However, I admire that Lauren and Julie flip through recipe books together, so Lauren has become involved in meal planning. By knowing how to compose nutritious meals, she can maintain a healthy lifestyle as an adult.
Jake
Jake is also 10, yet he is six feet tall, is over 17 stone (238 lbs) and has a BMI of 34. Even an adult with Jake’s height would be clinically obese. Thus far, he does not seem to have a genetic disorder. Watson explains that obese children are typically very tall because they are eating more than what they are burning off through exercise. Jake resides in Southwark, London, which is in the top ten British boroughs with childhood obesity. As an inner city, it is socially and economically deprived, and it contains a dense collection of fast food restaurants and corner stores. (Additionally, its school system and layout promote obesity as Boston Children’s Hospital mentioned.)
Jake’s mother, Tina, shares that when onlookers see that she is heavy and has a heavy son, they assume that they stay at home and overindulge in unhealthy foods. Many of the other children’s mothers feel similarly. Tina is also a single mother and receives money from the government due to her financial struggles. Thus, people assume that she feeds Jake junk food because it is inexpensive. In reality, she tries to buy healthy foods. The family even has caviar despite their low income! Tina claims to have tried to put Jake on strict diets, but he still does not lose weight.
Jake is unique in that he enjoys fruits and vegetables. In fact, he used to be a moderate size but gained weight after infancy. Jake admits that he spends considerable time on his computer and stops only for meals. Watson later determines that Jake eats healthily but must get more physical activity. Tina agrees that Jake’s lack of exercise contributes to his weight but says that she has trouble convincing him to go outside.
By the end of the video, Tina is taking cooking classes for parents who want to prepare nutritious dishes for their children. Jake finds he enjoys basketball and that his classmates, who realize he is an asset due to his height, now pick him first. Finding a sport you genuinely enjoy and at which you excel allows regular exercise to be more sustainable.
Sabrina
Sabrina is a Pakistani nine-year-old. A healthy BMI for her is roughly 14 to 19, but Sabrina’s BMI is 25. If she continues her current lifestyle, Sabrina could get type 2 diabetes. Her mother, Azra, claims that she eats the same food as the rest of the family. That being said, much of her family is overweight, and diabetes as well as heart disease run in the family. Her older sister, Selena, expresses that progressively younger people are facing such issues.
Unlike the rest of the family, Selena is dedicated to fitness. She describes her family’s food as extremely heavy, for everything is fried with high levels of oil and salt. Largely due to their culture’s cuisine, Pakistani girls are three times more likely to become obese than other girls. Selena disapproves of Sabrina and her brother lying down to watch TV. They also eat frequent snacks they find in the kitchen without parental intervention. Selena blames her mother for her siblings’ weight issues because she is the one feeding them. I have considered that children born into unhealthy families may develop healthy habits after witnessing the consequences of their relatives’ lifestyles.
Sabrina’s mother cooks all of the family’s meals and teaches Sabrina how to make traditional Pakistani dishes. According to Azra, in Pakistani culture, girls are expected to know how to cook by the time they marry so they can provide for their new families. Once a week, Azra takes a break from cooking, and Sabrina’s family orders takeout. Progressively more takeout restaurants are offering halal meat, which follows Islamic law according to the Quran. Sabrina’s father, Shabir, expresses how convenient and inexpensive quickly grabbing a family meal from a takeout restaurant is.
Shabir is overweight partly because, as a taxi driver, he sits all day instead of getting physical activity. His wife worries that he will eventually have a heart attack, and Azra suffers from health issues herself; she has had high blood pressure for roughly four-to-five years. She acknowledges that she consumes a lot of salt and is not active outside of performing housework.
Overall, Sabrina’s culture, an aspect of her nurture, has significantly influenced her weight. Shabir shares that since Muslims do not drink alcohol, food plays a larger role in the culture.
The Younger Children
Libby
Libby is seven years old and is a picky eater. Thus, she mainly consumes carbohydrates (pasta, pizza, baguette, etc.). Libby dislikes the food served by her French pen pal’s family because she does not eat such food in Britain. Perhaps the fact that British cuisine is limited and unhealthy contributes to the country’s obesity epidemic. There is also a snacking culture because chips and fries, for instance, are staples. Since Libby had a heart condition when she was a baby, her mother, Tracy, worries that too much physical activity will put her daughter’s heart at risk. Tracy feels that Libby’s eating habits have caused her to have digestive issues and to be three stones, or 42 lbs, overweight.
Tracy is a single mother as Tina is and works for much of the day. Once she returns home, she is tired and not overly concerned about what Libby eats. She does not want to spark conflict between her and her daughter by forcing Libby to eat foods she dislikes. Tracy admits that, with regards to food, she acquiesces more than she should, but she has trouble getting Libby to listen. Regardless of whether Libby’s heart can withstand exercise, Tracy does not have time to encourage Libby to get exercise either. Due to Tracy’s size, she cannot join Libby for physical activities.
After school, since Tracy is working, Libby’s babysitter prepares her dinner at friends’ houses. Libby tends to consume whatever her babysitter cooks, including vegetables, but her babysitter forces her to finish her meals even if she refuses. Tracy speculates that Libby acts differently with her because she knows that if she argues, she will eventually win.
Libby is 54.2 kg, or approximately 119.5 lbs. Her BMI should be between roughly 13 and 18.5, but hers is 34.5, off the BMI chart. A healthy body fat percentage is between around 15 and 25%, but hers is about 52.1%. When Watson displays drawings of girls’ bodies, Libby picks the thinnest one although the girl is clearly anorexic. In the previous episode on the older children, Jake picks the boy in the middle, with a moderate weight, a selection that shows he does not want to be anorexic. Younger children may not be aware of the dangers of both extreme body types.
After Libby’s fitness and body image assessments, she and Tracy participate in a nutrition and exercise program for overweight children, MEND, which stands for Mind, Exercise, Nutrition, and Do it! The program has encouraged them to eat healthier and be more active. Libby now eats a wider range of foods, such as various fruits. She also swims with her father, who has been absent much of her life, and thus forges a relationship with him.
Lucas
Lucas, another seven-year-old, lives near his extended family. His mother, Kelly, struggles to monitor Lucas’ caloric intake because so many relatives feed him without knowing he has already eaten. In the video, his grandfather serves Lucas his meal as the boy lounges on the couch. His grandfather says that Lucas does not eat more than anybody else in the family. However, he admits that Lucas and his cousins likely grab food from the cupboards without permission “because they are kids.” Letting children get away with such behavior simply because of their age can be dangerous. As Sabrina would, Lucas would benefit from more adult supervision and structure.
Lucas’ grandmother feeds him candy, but he no longer eats it often due to his efforts to diet. Also because of his new diet, he cannot eat as much as his cousins. Lucas’ mother expresses that she sometimes lets Lucas stray from his diet because she does not want to be overly strict, a recurring obstacle in these children’s weight loss journeys.
If Lucas and his cousins do everything together and Lucas now eats less than they do, why is he the only one who suffers from obesity? The answer to this question lies in other parts of their nurture. First, Lucas’ school allows him to get seconds and thirds at lunch. Although it provides fruit, vegetables, and salad, Lucas does not eat much of it. Second, Lucas got pneumonia when he was three years old and was given steroids to help him recover. Kelly claims that he has been overweight ever since he got on steroids and thus blames them for his weight. However, she eventually admits that the medication is only half of the problem and she is the other half, for she must be stricter with his dietary choices.
Lucas is 51.8 kg, or roughly 114 lbs. His body fat percentage is around 37.7%, which is problematic but far lower than that of Libby despite their similar ages, weights, and heights. Since he has a high percentage of lean muscle mass, he must be fairly active.
By the end of the video, Lucas is no longer having seconds at school. Instead, he is packing his lunches so that his mother can control portion sizes. He has also started playing rugby in addition to soccer, which he played before. Due to these healthy lifestyle changes, he has dropped one clothes size.
Kelsey
Kelsey is seven years old and is two stones, or 28 lbs, overweight. Her body fat percentage is 39.6% when it should be between 15 and 24%. At 28%, a seven-year-old girl is obese, so she is off the chart. Kelsey’s mother, Melissa, also confesses that she should be stricter, but she does not want to be a disciplinarian. When Kelsey was younger, she and her mother had a tenuous relationship, which Melissa believes caused her daughter to find comfort through food. Melissa feels that “part of nurturing your child is feeding your child” but admits that she is the reason Kelsey is overweight.
According to Melissa, both she and her daughter have slow metabolisms and are genetically prone to obesity. In the last episode, Lauren claims that her younger sister can overeat without gaining weight while she gains weight easily as her mother does. Watson states that genetics can play a minor role in childhood obesity, but diet and physical activity give you control over your weight regardless of your biology. Despite her biological excuses, Melissa does acknowledge that the family’s eating habits are sometimes unhealthy. She has also struggled with her weight her whole life and tried various diets, her most recent one composed entirely of liquid shakes.
Kelsey’s older sister, Charlotte, does not trust that her mother’s current diet is healthy. Since liquid shakes are not real food, Melissa has not eaten in over a week. Charlotte worries that if this diet helps Melissa lose weight, she may impose it on Kelsey. Melissa’s diet does, in fact, cause her to lose a stone, or 14 lbs, in a week. Although she continues feeding Kelsey real food, she tries to use half fat cheese and pasture-raised whole milk. However, Kelsey reveals that outside of filming, the family gets takeout. A problem with this series, Generation XXL, is that families may not be fully transparent. However, Melissa protests that they get takeout only once a week now. Overall, Melissa does not feel Kelsey eats extremely unhealthy food; the primary issue is her large portion sizes.
After some time, Kelsey picks up snorkeling to be more active. She enjoys that her weight is somewhat concealed in the water. However, Melissa has struggled to change the family’s eating habits and has given up on her liquid shake diet, a fact that underscores its unsustainability. They still have takeout once a week, but Melissa is trying to cook more healthily.
Bethany
Bethany is six years old. She lives in the northeast of the UK, where obesity is especially prevalent. As Lucas’ school does, Bethany’s school discusses nutritious foods and provides them during lunch. Her head teacher encouraged parents to pack healthier foods in an attempt to combat the obesity epidemic, but parents could not understand why this action was necessary. Even if parents’ children are a moderate weight, the head teacher shares, the school hopes to educate their students (and, through them, their parents) so the children make healthy choices as adults.
Kelly, Bethany’s mother, is one of the parents who dislikes the healthy eating policy. She believes that everyone should “just eat what they want to eat” and states decisively, “If it’s going to make them happy, eat it.” Kelly shares that, as a child, she could eat whatever she wanted and thus consumed a lot of fast food. Since she has remained slim, she argues that her eating habits did not negatively affect her. Although Bethany’s teacher once told her to avoid sweets, her mother claimed she “need[ed]” sweets and that her opinion overrode that of her teacher. Kelly goes as far as to say that bigger children “look better” because they look “cuddly.” Thus, she is happy with her daughter’s size.
The head teacher explains why parents had similar diets, consisting primarily of junk food, to their children yet were not as overweight. Echoing Watson’s words, she states that when today’s parents were young, children played on the streets and ran around. Modern children stay inside on screens instead not only due to technological advancements but also because their parents view the outside world as too dangerous for children’s play.
Bethany’s BMI should be between roughly 13.5 and 17.5, but hers is 26.4. Kelly claims her BMI does not surprise her while Bethany’s father, Mark, admits that it does and that he is worried. Kelly says that she just wants to make her daughter happy, so Bethany chooses what she eats. Watson shares that although Kelly may be satisfying Bethany’s immediate needs, she is not accounting for her long-term success and happiness.
Kelly claims that, after her visit with Watson, Bethany was eating a more balanced diet but soon wanted to revert to her previous lifestyle, with more junk food. Kelly agreed in order to maintain peace. Although Mark is slightly concerned about Bethany’s weight, he feels she will lose much of it as she grows up. He is glad she has become involved in more physical activities.
Conclusion
Despite the range of personal stories above, each child’s obesity issues stem from a common set of factors, many of which Boston Children’s Hospital describes and all of which fall within nurture: 1) their culture (such as British and Pakistani culture), including cuisine and the importance of food; 2) their family’s traditions and mindsets; and 3) the structure of their neighborhood. Another recurring idea is that parents are in denial and deflect blame. Their inability to fully accept their culpability has prevented them from creating salubrious environments.
To look on the bright side, since nurture plays a significant role in childhood obesity, our weight is largely in our control. Help yourself and those around you achieve healthier lifestyles so that we can live longer, happier lives and shed the name of Generation XXL.
Sources
- https://www.youtube.com/watch?v=HBTUcBgBVV4
- https://www.youtube.com/watch?v=ow76G6_JwHQ
- https://urbanhealth.org.uk/wp-content/uploads/2020/11/Bite-size.pdf4.
- https://www.youtube.com/watch?v=bvc7-ZEG0Fc
- Feature image: https://www.news18.com/lifestyle/what-is-childhood-obesity-a-look-at-its-harmful-effects-and-preventive-measures-8566678.html