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Laurie Udesky: Obesity is an American epidemic. Two thirds of adults are overweight. Nearly one third of adults are obese. The epidemic is more apparent now than ever among children. The percentage of children and teens that are overweight has more than doubled to 15 percent in the last two decades. And as more and more young people are tipping the scales, they're showing signs of the same conditions that a generation ago only struck adults: Pediatricians are now seeing heart disease, high blood pressure, and adult-onset diabetes in their young patients, conditions that could greatly shorten their lives. Families, medical facilities, schools and community groups are testing a number of innovative ways to try and curb this deadly trend. I'm Laurie Udesky.

Udesky: Eighteen-year-old Annie and her 56-year-old mother Susan discuss their lunch choices in the family's kitchen in Berkeley, California.

Annie: What are you going to eat today, Mom?

Susan: Today I have committed two ounces of roast beef and one ounce of cheese ...

Annie: I don't like roast beef.

Susan: I have ground meat that has taco seasoning.

Annie: Nah.

Susan: Ratatouille and cheese?

Annie: I think I'll do that.

Susan: I have carrots and celery. Oh, and you have babaganoush.

Annie: Does that count as protein or vegetable?

Susan: Veggie.

Annie: Sweet.

Udesky: By the sound of their apparent pleasure in discussing meal options, you wouldn't think that Annie and her mother Susan are deadly serious about what they choose to eat. But they are. In fact, they see it as a matter of life and death. Annie lost 75 pounds in the last year. Her mother shed a 100 several years ago. Susan says her own effort to lose weight was motivated by wanting to help her daughter.

Susan: I [know] it's hard for mothers and daughters in the teen years to talk about almost anything, but I don't think anything gets harder than food and weight issues. So I realized that the best thing I could do for her was to solve my own problem. Instead of talking about it, I had to model the solution.

Udesky: But it took a few more years for Annie to heed her mother's example. The 5-foot-2 college freshman remembers binging secretly on junk food after school. By the time she was 17, she weighed 236 pounds, felt winded walking up a flight of stairs, and had signs of a type of diabetes usually seen in adults. Her mother and a doctor made her understand just how serious a health hazard her weight was.

Annie: Basically my mom and I were eating at a restaurant one day and she just said point blank, "Annie, if you don't fix this, you're going to die." And that was just sort of, "Huh? Oh, my gosh. I'm 17. I'm invincible. It's really shocking to hear that."

Susan: My recollection of what I said was, "You will have Type 2 diabetes that will result in a foreshortened lifespan and a great many other things and … I don't want you to look at me some day and say you didn't tell me. I want to make sure you've heard this, because this isn't about not loving you because you're not a size 8. It's about loving you because I want you to live."

Udesky: Annie's doctor said she had three choices: She could lose weight and exercise on her own, take medication with harsh side effects, or choose surgery.

Annie: That was the point where I said, "Okay, you know what, I'm not going to take pills that make me feel disgusting. I'm not going to have surgery. I can't do that." That just struck a chord with me that was off limits. That was the point where I thought, "This is do or die."

Udesky: Annie says her mother's support is what's helped her stay on course. In order to convince young people to get serious about losing weight, many researchers are also asking youth directly what messages they think would get through to their peers. One researcher queried a focus group of students at Roosevelt Middle School in Oakland, California.

First student: You can try and sit down and talk to them and let them know that it's not good what they're doing just going home every day and eating and eating. It's not good. It's not healthy for their body. You should just be able to tell them. You know ...

Second student: Give them like a meal that's real healthy, but it's like hecka good, not like the powdered milk. That's nasty.

Udesky: Judging by her patients, Dr. Cam Tran says that even the most basic messages about nutrition and exercise are not reaching the population her clinic serves.

Dr. Cam Tran: The information that we all know, common knowledge has not reached this population, things like drinking too much soda, having just a very simple 30 to 60 minutes of walking a day. None of our patients know that information.

Udesky: Based in San Francisco General Hospital, Dr. Tran's pediatric clinic for overweight children and teens is treating patients at the core of the obesity epidemic. The hardest hit are children of color. Dr. Tran's patients are from low-income families and are mostly African American and Latino. Besides educating the children and their parents about eating nutritiously, her team tries to find realistic ways to get these children exercising more. Many live in neighborhoods where it's just not safe to go outside and play. A lot of her patients spend hours cooped up inside in front of the TV. This 12-year-old girl admitted to occupational therapist Carey Kozuszek that she watches six hours of television a day. Kozuszek is trying to negotiate reduced TV time and show her some exercises to do during commercials.

Carey Kozuszek: Put your shoulders way back. Good. Does that hurt?

Twelve-year-old girl: A little.

Kozuszek: Okay what I want you to do is roll your shoulders back and pretend you're holding an egg right here. Okay, squish it. Yes. Right, like that. Okay, stick your feet out. How old are you?

Girl: Twelve.

Kozuszek: Okay, do 12 more. One, two, three ...

Udesky: On the other side of the bay in Berkeley, California, a community group, Berkeley Youth Alternatives, is trying to reach similar children and teens before they become statistics of the obesity epidemic. The teenagers play team sports in the organization's gym. With a lot of encouragement from staff and volunteers, the younger children are kept moving for 15 minutes.

Renda Davis: Come on Raffie, you can do it! Give me five! Good job, Luis! Good job, Rashat. Outside the cones, Lakwan.

(Sounds of breathless kids in background)

Udesky: The fitness program for these young kids is part of a carefully crafted after-school program designed to reward them for simply making the effort, says Renda Davis, assistant sports director.

Davis: They have to finish their homework, then they get a healthy snack. And then they come out and they have to walk or run or continuously move for 15 minutes. And we have volunteers so that if a particular youth looks like they're having a hard time, we'll hold their hand, and we'll skip, we'll hop, we'll have music. We keep them moving. We make it fun. It's a lot of positive reinforcement. We have athlete of the week that we honor on this big board, and we have incentives. When they have incentives, they usually use it for [an] athlete who can jump the highest or run the fastest. Well, we try to motivate that youth on the other end of the spectrum.

Udesky: After they run around, the children return to the group's indoor gym to do crunches, pushups, and stretches. On the nutrition side of battling obesity, Berkeley Youth Alternatives has developed organic garden sites and is teaching their teens to plant and harvest. They're also showing teenagers and their parents how to prepare healthy meals using the bounty from the gardens. It's necessary, explains Renda Davis, because the community they serve, like poor communities elsewhere, often have little access to healthy food.

Davis: We know for a fact that there's probably more liquor stores in this community than there are fruit stands, then there are places where people can buy healthy food. There's no affordable supermarkets where people can shop in this neighborhood.

Udesky: Ultimately, providing more access to healthy food, educating families about nutrition and exercise and the health hazards of obesity may make it less likely in the near future that children will suffer adult diseases.

For Consumer Health Interactive Radio in San Francisco, I'm Laurie Udesky.

First published April 12, 2004
Copyright © 2004 Consumer Health Interactive