Childhood Obesity May Be Caused by Missing DNA

[Uncayimmy]

I'd say we are all now speculating on just what these parents did or didn't do.

In what way?

 

[The Central Scrutinizer]

Imagine being told your child will be removed from your home because s/he is morbidly obese and you are a neglectful and abusive parent for allowing this to happen. I know that I have watched several tv programs about obesity and when I see an obese child I can't help but wonder what the parents are thinking to allow this to happen.

From AOL news:

"Some children get severely obese because they lack particular chunks of DNA, which kicks their hunger into overdrive, researchers report...The work, reported online Sunday by the journal Nature, has already produced a real-world payoff. Farooqi said four children with the chromosome 16 deletion had drawn the attention of British child welfare authorities, who blamed the parents for overfeeding them"

Read the news article here. http://news.aol.com/article/missing-dna-may-promote-child-obesity/803650

I am sure the parents are feeling a great deal of relief.

Every fat parent of a fat kid will now be using this excuse, ignoring the fact that they eat McDonald's for dinner 4 times a week.

 

[drkitten]

I'd say we are all now speculating on just what these parents did or didn't do.

I'd say not.

Regardless of your child's genetics, he didn't put on the pounds overnight. And equally regardless of your child's genetics, the only reason he put on the pounds is because he ate too much and exercised too little.

I do not consider it speculation to note that parents are responsible for making sure their children eat healthful food in appropriate quantities, and for making sure their children get enough exercise.

I do not consider it speculation to note that a 100kg ten year old has not been doing that, and therefore the parents have been remiss.

 

[drkitten]

"Deletion carriers exhibited hyperphagia and severe insulin resistance disproportionate for the degree of obesity."

Am I the only one on this thread who knows what "hyperphagia" means?

if these children are resistant to the usual factors that allow one to lose weight, and the parents were feeding these children normally, then yes the parents should not be blamed for the childrens severe obseity.

Fortunately, that's not an issue. By definition, hyperphagics are not being fed "normally."

Hyperphagia is a pretentious Latinate word for "eating too much." If you have a hyperphagic in the house, he is by definition eating too much and not eating "normally."

 

[Aurelian]

I worked on the fen-phen litigation and got to create a few hypotheses for why overweight people don't exercise, or exercise to extremes. (google phenteramine, or fen phen) A huge percentage of people who sought weight reduction had heart conditions, asthma, emphysema, had thyroid problems...and then there is diabetes, which is a whole other kettle of worms.

I have kids, and observe others' kids, one of the bigger weight gains is when a preschooler goes to kindergarten and has to sit down for a loooong time. Do we want more gym during school? What does the school lunch program do for "neglected" kids?

And in the case of my grown kids - I fed them healthy food - but Lunchables were like kiddie-food-porn - legal but morally questionable.

More questions than answers, I know, but Blame The Parent agenda is not going to fix anything with any permanency. Almost 100% of the parents I'm aware of don't want kids that are morbidly obese.

A.

 

[Uncayimmy]

Regardless of your child's genetics, he didn't put on the pounds overnight. And equally regardless of your child's genetics, the only reason he put on the pounds is because he ate too much and exercised too little.

And the fact is these quantities vary by individual and not just because of a fat gene. If you feed a future 6'10" adult athlete like he's going to be 5'3", he's gonna be skinny as a rail. And if you feed a future 5'3" dainty bookworm like she's going to be a 6'10" athlete, you're gonna have a porker on your hands.

It's just a part of life that some people will have work harder to be fit. Parents need to teach this to their children and understand that what seem to be "minor" problems in kids can turn out to be major problems when they get grow up.

 

[Uncayimmy]

More questions than answers, I know, but Blame The Parent agenda is not going to fix anything with any permanency. Almost 100% of the parents I'm aware of don't want kids that are morbidly obese.

And I bet almost 100% of the parents don't want to fight the battles with a hungry kid who is not interested in physical activity, especially when the dangers of letting it go are not imminent. That's understandable, but it doesn't divert responsibility.

 

[Fat Bottom Gurl]

In what way?

You're kidding right? Since none of us on this forum have any idea what these children were being fed, or how what kind of exercise they received.

 

[Fat Bottom Gurl]

I'd say not.

Regardless of your child's genetics, he didn't put on the pounds overnight. And equally regardless of your child's genetics, the only reason he put on the pounds is because he ate too much and exercised too little.

I do not consider it speculation to note that parents are responsible for making sure their children eat healthful food in appropriate quantities, and for making sure their children get enough exercise.

I do not consider it speculation to note that a 100kg ten year old has not been doing that, and therefore the parents have been remiss.

Totally disagree. You have no idea about these 4 children - they may be exceptions.

 

[Fat Bottom Gurl]

Am I the only one on this thread who knows what "hyperphagia" means?




Fortunately, that's not an issue. By definition, hyperphagics are not being fed "normally."

Hyperphagia is a pretentious Latinate word for "eating too much." If you have a hyperphagic in the house, he is by definition eating too much and not eating "normally."

Ok Dr. Kitten but what about the hyperphagia combined with the severe insulin resistance? Are you familiar with that? Let's keep in mind here that we are talking about 4 children. 2 of which were returned to the parents, the other 2 are pending further investigation. Maybe there is an extremely small (very small) group of people just not what anyone has seen. That's all my OP is about - that really small group.

 

[drkitten]

Totally disagree. You have no idea about these 4 children - they may be exceptions.

You're suggesting that these four children are exceptions to the laws of thermodynamics?

Goodness, bring them in and show them to Mr. Randi. The million will pay for any weight-loss treatment they like.

 

[drkitten]

Ok Dr. Kitten but what about the hyperphagia combined with the severe insulin resistance?

What about it? If you have a medical condition called "eating-too-much-itis," doesn't that suggest to you that you should eat less?

There are parts of the practice of medicine that are difficult and obscure. This isn't one of them.

Are you familiar with that?

Very much so; some of my personal friends have been diagnosed with insulin resistance. Insulin resistance simply means that cellular uptake of glucose (which is mediated by insulin) is less efficient, so blood glucose levels stay higher than normal for longer, which in turn means that more of what you eat turns to fat (since fat uptake is also controlled by blood glucose levels).

It's also primarily caused by too many carbohydrates in the bloodstream; one of the best treatments for it is a low-carb diet, precisely because this keeps insulin levels from building up and adding to insulin resistance.

If someone is insulin resistant, this makes treatment via diet and exercise more important, not less.

Let's keep in mind here that we are talking about 4 children. 2 of which were returned to the parents, the other 2 are pending further investigation. Maybe there is an extremely small (very small) group of people just not what anyone has seen.

Four or four million, we're still talking about basic thermodynamics here. Insulin resistance is well-understood, and the primary treatment is to eat properly. Similarly, the primary treatment for hyperphagia is, ultimately, to eat properly. And the reason for that is because eating too many calories will make you fat.

 

[Fat Bottom Gurl]

I do not know why people are so upset about my OP in regards to 4 children who may have a genetic problem. My OP was to imagine that you are the parent of such a child who was taken away because someone believed you were overfeeding the child...and then a study comes out showing that a very small percentage of the population "might" fit into that category (cateogry meaning the ones with the missing DNA). 4 children - 2 are returned to the parents due to the findings of the study. 2 aren stil pending.

 

[Pup]

Let's keep in mind here that we are talking about 4 children. 2 of which were returned to the parents, the other 2 are pending further investigation. Maybe there is an extremely small (very small) group of people just not what anyone has seen. That's all my OP is about - that really small group.

Honestly, it seems like two different things are being discussed at once on this thread. One is the very rare disorder noted in the article in the OP. The other is a general problem with increasing obesity in the U.S.

It seems to me that the disorder in the article is more of a mental health issue than a physical issue. The problem is not so much that the children gain weight, the problem is that they're living with insatiable hunger, way beyond "Gee, I love Big Macs." At least that's what I'm getting from reading the article in the OP.

So yes, in theory, one could restrict their food intake and they'd lose or not gain weight. That's not the problem. They'd come out of a concentration camp as thin as anyone else or close to it (if they managed to survive).

But in real life, they're going to be seeking food like an addict seeks drugs. Short of keeping the child a virtual prisoner, parents can't physically prevent a child from eating if that's the child's main obsession in life.

So yes, the "cure" for normal obesity in kids or adults is to eat less and exercise more, and it would work for these kids too. But for these kids, based on what it says in the article, that's like telling an alcoholic to solve his problems by just not drinking.

As I said in a post above, I still think some of the fault can lie with the parents if there's treatment for this that they're not getting for their child.

But to focus on the physical aspect seems to me like taking a person with OCD to the dermatologist for chapped hands, ignoring the fact that the real problem is that their brain is telling them to wash their hands a hundred times a day.

 

[drkitten]

It seems to me that the disorder in the article is more of a mental health issue than a physical issue. The problem is not so much that the children gain weight, the problem is that they're living with insatiable hunger, way beyond "Gee, I love Big Macs." At least that's what I'm getting from reading the article in the OP.

That's a pretty good description, IMHO. "Hyperphagia" is a behavioral syndrome; it describes how someone behaves, not their brain chemistry and whatnot.

But in real life, they're going to be seeking food like an addict seeks drugs. Short of keeping the child a virtual prisoner, parents can't physically prevent a child from eating if that's the child's main obsession in life.

... and that's where I disagree. That's a somewhat ironic simile you used, since one of the things that parents are supposed to be able to do is to keep their children under control enough that they don't go out and seek drugs. If you found a ten year old addicted to smack -- or for that matter, a ten year old alcoholic -- you'd hardly let the parents off the hook if they simply shrugged and said "we can't physically prevent him from getting his fix; that's his main obsession in life!"

For instance, put a lock on the damn pantry; a hasp lock costs less than twenty bucks, and it's -- literally -- your child's life at stake.

Again, these are ten-year-olds we're talking about. They're under adult supervision at school for eight hours a day and shouldn't have access to food except for the cafeteria meals (and normal cafeteria portions). They should be under adult supervision the rest of the time, either at day care or at home. (The Connecticut office of child safety, for example, mandates that children in general should not be left home alone young than age 12, a number echoed by Safe Kids USA. In the UK, the NSPCC makes a similar recommendation.

The parents are watching these children eat (or should be); they know (or should) how much the children are eating. They also know that 100kg is neither normal nor healthy for a ten year old. And, again, this isn't something that happened overnight; a 100kg ten year old was probably a grossly overweight eight year old as well.

 

[Uncayimmy]

You're kidding right? Since none of us on this forum have any idea what these children were being fed, or how what kind of exercise they received.

Not kidding at all. Nobody is getting into any specifics. What we do know is that humans don't have photosynthesis - we don't convert sunlight, water and air into mass.

What many of us are saying is that 100 pounds of fat is 350,000 excess calories. That's 497 Big Macs in excess of what should have been eaten. Assuming a 10 year old kid is breast fed for the first year, then that's one Big Mac per week every week to get him to that size. I'm gonna say that's noticeable and controllable.

Sure, maybe the first 25 extra pounds caught the family by surprise, but what about the next 75? At a time when there should be a calorie deficit the kid is still getting a calorie excess. When the next 25 pounds come on board, why isn't somebody slamming on the breaks?

 

[kellyb]

You're suggesting that these four children are exceptions to the laws of thermodynamics?

In a way I agree with you, but in a way, I think that's oversimplifying things.
Studies have been done exploring that position and the concensus appears to be that it's just not that simple. The genetic aspect is profound and not necessarily always amendable to lifestyle changes (calories in, exercise out) without invoking starvation syndromes.



That's not to say that cases like this...



http://womenofcaliber.files.wordpress.com/2009/04/childhood-obesity1.jpg


...aren't clear cases of most of the problem being parental behavior. Sometimes it is that simple. But not always or even most of the time. (And most "overweight and obese" kids aren't anywhere close to that fat, either. For a 6 yo, 5 lbs can make the difference between "normal weight" and "obese" according to the modern charts).

 

[Pup]

... and that's where I disagree. That's a somewhat ironic simile you used, since one of the things that parents are supposed to be able to do is to keep their children under control enough that they don't go out and seek drugs. If you found a ten year old addicted to smack -- or for that matter, a ten year old alcoholic -- you'd hardly let the parents off the hook if they simply shrugged and said "we can't physically prevent him from getting his fix; that's his main obsession in life!"

For instance, put a lock on the damn pantry; a hasp lock costs less than twenty bucks, and it's -- literally -- your child's life at stake.

Which is why I'm saying the parents do have responsibility. But putting a lock on the pantry isn't a simple solution. What do you do when the child is crying, frantic, throwing temper tantrums, unable to concentrate on school or anything else because they feel like they're starving? That's what I'd do if I was ten years old and nobody would let me eat at all, day after day, and I figure that's about what it feels like if the part of your brain that says you're not hungry is broken.

That's where the mental health or behavioral issue comes in. I suppose the parents could just shrug and say, too bad, I'm not letting you eat, problem solved. But then they'll be accused of mistreating the child (or leaving the child untreated) for the other behavioral problems, and the child still won't have a normal life.

Problem is, without the genetic marker being identified, it's hard to know whether the kid is just a "normal" spoiled brat who's throwing a temper tantrum because he's not being taken to McDonald's, or whether he has a mental/physical disorder that makes his suffering much more intense, which any compassionate person would want to alleviate. It's like the thread on objective measures of pain. How do you objectively measure hunger?

 

[Rasmus]

Might not be entirely safe for work. Tim Minchin being his usual self,

 

[Uncayimmy]

In a way I agree with you, but in a way, I think that's oversimplifying things.
Studies have been done exploring that position and the concensus appears to be that it's just not that simple. The genetic aspect is profound and not necessarily always amendable to lifestyle changes (calories in, exercise out) without invoking starvation syndromes.

Still not seeing evidence of that. Some of the references you cited directly contradict what you're saying. You also seem to be fighting a straw man. Nobody here has claimed that everyone's metabolism is the same and that it remains the same under all conditions. What we are saying is that for any given individual, there is a combination of exercise and food intake that will maintain a healthy bodyweight.

One of the articles talks about how obesity can arise without caloric overconsumption, but that statement presumes "overconsumption" to be based on a norm rather than the individual. What I and others are saying is that "overconsumption" is defined individually. That same article goes on to say in effect that a proper exercise program can prevent obesity.

And at the end of the day, regardless of how the body deals with food intake, fat is the result of consuming more than you expend. Not a single article you referenced disagrees with that premise.