More Than a Stat: My Son is Obese

More Than a Stat: My Son is Obese

By Erin Ruggaber Howard

howardThere are lots of words I would use to describe my seven-year-old son “Ben.”  Sturdy comes to mind.  Solid also gets thrown around a lot.  And yet, after Ben’s recent well-child appointment, I had to throw out Solid and Sturdy and replace them with two far less pleasant adjectives—Overweight and Obese.

The pediatrician flashed her electronic tablet at me, pointing to the Blue Zone—the healthy BMI range—and following my Ben’s line up the chart as it shot straight into the White Zone.  The Danger Zone.  She tilted the screen away from Ben so he couldn’t see.  Almost guiltily, she made a few brief suggestions about healthy foods and increased activity, and we moved on.  Quickly.  I guess she didn’t want to embarrass him.  Or me.

Ben just doesn’t look obese.  Not to me, anyway.  I’m sure a trained eye would detect the slight pudge around his middle, the thin padding that smooths over the ridges of his rib cage.  To me, he looked healthy, and that’s scary.  Normally, I’m pretty on top of this Mom thing.  I’m quick to pick up on symptoms—the wheeze that denotes an allergy trigger or the rash that’s our first clue of Strep.  I’m observant, darn it!  How could I miss this one!

Looking back, there were clues.  When he was a toddler, Ben’s sister found some of my banana scented Burt’s Bees hand cream and fed it to Ben with a doll spoon.  He ate it.  All of it.  He’s always been a big eater like that.  It doesn’t matter if he’s hungry.  I guess it doesn’t even matter if it’s food—he seemed happy enough with hand cream.

And of course Ben’s swimming in my husband’s gene pool.  Phil is the very definition of a Big Guy.  We have to order his Size Sixteens from a website called “BigShoes.com.”  No joke.   When I do laundry and pull out a pair of pants that is almost bigger than I am, I think, “Wow, these are ‘Big Man Jeans’.”  Then I chuckle to myself, because my husband has both “Big Man Jeans” and “Big Man Genes.”  I get really bored when I do laundry.

Just like his Dad, Ben has “Big Man Genes.”  Undoubtedly, he will someday also have “Big Man Jeans.”  Does that mean I should throw up my hands, throw out the BMI chart, and go on as I’ve been?  So.  Tempting.

Since that fateful doctor’s appointment, I’ve taken a good look at our family’s eating and exercise habits, and the truth is we aren’t perfect, but we aren’t doing that bad.  It’s not like I handed Ben a bag of Cheetos and a six pack of Coke with a cheery “Enjoy your video games, Dearie, I’m off to Bingo.”  We’re an active family who eats home-cooked dinners around the kitchen table.  It’s all very Rockwell-ian.  Those “Big Man Genes” must be a big part of the equation because Ben’s three siblings (who all happened to have joined the family through adoption) are perfectly balanced.  The three of them are nestled comfortably in the healthy Blue Zone on their own nicely curving growth lines, while Ben’s chart shoots straight up into the Danger Zone like a profile of Mt. Everest.

I could shrug this whole BMI thing off.  Ben’s a Big Guy and that’s the way it is.  After all, I’m sure Phil went through his whole childhood hearing, “Oh, he’s just big boned” and he turned out all right.  Ok, not exactly all right when it comes to this issue—it’s a struggle for him to stay under the 300-pound mark now that his football and wrestling days are behind him—but he’s got low blood pressure, low cholesterol and normal blood sugar.  And he’s charming, well-adjusted, spontaneous, and a great Dad.  That has to count for something.

But from long years of experience watching Phil’s battle to stay under 300, I know it is much easier to maintain a healthy weight than to try to shed unhealthy extra pounds.  Even if Ben is “big boned” I need to teach him how to make healthy choices—now.

No more hot-and-ready pizzas when I’m running late.  No more ice cream every sweltering afternoon.  No more granola bars for breakfast.  But the biggest change needs to come from Ben himself.

When we were out to lunch a couple of weeks ago, Ben and I split a club sandwich and tomato soup.  For the first time, I noticed that we ate the exact same amount—me a grown woman and him a seven-year-old boy.  As soon as his food was gone he glanced over at his little sister’s plate.  There was half a grilled cheese sandwich, just sitting there, all tempting.  “Are you going to eat that?” he asked casually, already reaching across the table.

“Are you still hungry?” I asked.  He thought about it for a second.  ” I’m not really hungry anymore … but I’m not full either.”  Ah-Ha!  Breakthrough!  Still holding his hand gently, I looked him in the eye.  “This is what full feels like”, I said.  “Right now.  ‘Not hungry anymore’ is the same as ‘full’.  You don’t want to eat until you feel sick, do you?”  Sadly, I think he had to consider it.  Eventually he shook his head, and I quickly removed little sister’s temptingly half-empty plate.  One small victory.

It’s a weird balance—teaching Ben to make healthy choices without getting carried away.  I feel a sadness that Ben is now a national statistic—one more of those 31% of American kids who are overweight or obese—and it would be easy to get carried away trying to “fix” him.  But doubling down to reduce his BMI percentage?  That’s the wrong goal.  That BMI thing is just a tool.  It doesn’t tell the whole story.  It’s not a one-size-fits-all proposition.  Like those black knit winter gloves I naively bought home for my ham-fisted hubby when we were newlyweds, the BMI chart is at best one-size-fits-most.

The goal has to be a healthy Ben—whatever that is—and not a dot on a chart.  I’ve got to let go of my Mommy Guilt and admit that healthy Ben might never be a Blue Zone kind of guy. But healthy habits, healthy choices for the whole family, will go a long way toward making sure those “Big Man Jeans” never get too big.

Erin Ruggaber Howard is a freelance historian and writer, and a SAHM to four children.  She has written for Adoptive FamiliesAdoption TodayChicago Parent, and Brain, Child exploring issues of parenting, adoption, and racial identity.

The Biggest Baby

The Biggest Baby

By Natalia Cortes-Chaffin

On her second birthday my daughter Leah pushed her chocolate chip cupcake towards me: “Eat it,” she said. It was about the fifth piece of cake she’d been served in her life. Yet despite her love of chocolate and frosting and all varieties of sprinkles, and despite how infrequently I let her indulge, she wanted to share the cupcake with me. She wanted to share it with her feet, too, but mostly she wanted to share it with me. I recorded our little exchange on my phone. I replay the video sometimes when I need to sugar up my day.

Leah is almost three now and, according to the weight guidelines set by the Centers for Disease Control, she is obese. The CDC designates as obese any child age two to fourteen with a Body Mass Index measurement that falls within the 95th to 100th percentile. BMI represents how much of weight comes from fat, as opposed to the more desirable muscle and bone. It’s determined by an intricate math formula that incorporates weight, height, age, and gender. Studies estimate that 19.6 percent of children ages six to eleven have BMIs that fall into the obese category, and this number is climbing rapidly.

Researchers have also found that a majority of obese children were obese as babies, before they had a single lick of ice cream. Findings like these, along with early obesity’s negative impact on future health, last year prompted a Colorado health insurance company to deny a 4-month-old coverage because he had reached the 95th percentile for his height and weight. The parents were blamed. I guess they were supposed to put their baby on a diet and set him on the infant equivalent of a treadmill.

I suspect this insurance company would point an accusing finger at me, too. My daughter Leah, with an average BMI of 98 percent, has been obese all her life. A typical two-year-old girl is about 33 inches tall and weighs approximately 26 pounds. When Leah turned two, she had reached 35 inches and weighed a whopping 35 pounds—just two pounds shy of her nearly five-year-old sister, whom she loves to topple to the ground while giggling. After the birth of our first two daughters, my husband had hoped Leah might be a football-playing boy. I used to joke that he’d gotten his linebacker.

Admittedly, Leah’s toddler proportions were shocking, the kind of future surprise I didn’t anticipate during pregnancy, when I was worrying about random genetic disorders. That surprise was even greater because Leah wasn’t a large newborn. At birth, she weighed a slightly above- average seven pounds and twelve ounces, just like her two sisters before her, just like many other bouncing babies with all their ten fingers and all their ten toes. She scored the neces- sary scores to be swaddled in a striped hospital blanket and earn a thumbs- up from our pediatrician. We took her home. Family and friends dropped by to slip pinky fingers into her palm and present her with tiny clothes. We never expected that she’d outgrow those new- born clothes within two weeks. At first, we thought nothing of her rapid weight- gain. Everybody loves a fat baby.

“Way to go, mom,” her pediatrician said to me, when we put her on the scale at one month. She’d gained almost four pounds, 50 percent of her body weight. Babies are supposed to get fat, not extremely fat, but plenty fat. They are programmed to eat and sleep and grow. By plumping her up, I was doing my motherly duty. Again her pediatrician pointed his thumb at the sky. Family and friends called to see how much she’d grown, how much she’d gained. They oohed and aahhed at the numbers.

I was told horrid stories of other babies, the ones who refused to eat, who wouldn’t gain weight, who were prodded with tubes and sliced open for intestinal surgery. I was lucky to have a healthy and hungry baby. I was lucky my body adjusted so easily to the role of dairy cow and produced a farm- worthy abundance of fatty milk. And it wasn’t just that I was lucky. The subtext in every “how’s your baby doing” conversation is always judgmental, always blaming or praising the mother for circumstances that may or may not be under her control. Leah was doing well and, yes, I had a hand in it; I was nursing her and changing her diapers and bathing those ten little fingers and ten little toes. The conclusion was automatic: I was a good mother, an exceptionally good mother at the rate Leah was expanding. I expected us to be put on a poster.

I reveled in the thought that this incredible growth was the first inkling that my baby was extraordinary. My husband and I soon discovered that Leah was indeed extraordinary, with an emphasis on extra: extra rolls around her arms, extra chunkiness around her thighs. Healthy babies double their weight in four months. Leah doubled hers in two. But this was the kind of growth that usually comes with green skin, torn clothing, and gamma radiation. At Leah’s two-month check-up, the plucky nurse with blue scrubs and an I Dream of Jeannie hairdo weighed her in at 14.2 pounds. Though she’d also grown three and a half inches, month two was when Leah stepped off the edge of the growth chart and waved bye-bye to the black dot that represented the 100th percentile for weight. We have yet to swim back to the shores of that growth chart, and I can’t remember the last time we saw land.

About this time, when Leah was two months old, the Discovery Health Channel broadcast a report about a seven-year-old boy who weighed 100 pounds. It was part of a show about rare diseases that aired while my husband was away on a business trip, which is usually when I indulge my obsession with rare diseases by watching the Discovery Health Channel. Leah, who was then four months old and shaped like a giant pumpkin, looked like that boy’s baby pictures. Tragic scenarios tumbled through my mind as I watched the program. I pictured strollers collapsing under her weight, kids pointing long fingers, parents steering their eyes towards normal children. I dreaded her wanting to fly like an airplane and me not able to help her soar. For the first time I understood my husband’s distaste for these shows. I feared Leah might have a genetic disorder like this boy did, some kind of disease that would have her ballooning like Violet Beauregard turned blueberry in Willy Wonka. I raced to the side of her bassinet, watched her sleep under a white cotton blanket. Her tummy rose. Her tummy sank. My love for her was like a primal ache.

“It’s brown fat,” the doctor said with a nonchalant air that mocked my maternal instincts and addiction to WebMD. He explained that some breastfed babies put on an enormous amount of weight. “She’ll slow down at nine months. You’ll see.” I Googled “brown fat.” According to various web sites, brown fat is a mutant form of fat whose cells produce heat and thus help newborns stay warm in the absence of actual cuddly fat. Without it, infants run the risk of dying. Eventually this kind of fat vanishes. It’s not the kind that leads to chronic debilitating issues.