Sample text for Ending the food fight : guide your child to a healthy weight in a fast food/fake food world / David S. Ludwig with Suzanne Rostler.


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INTRODUCTION
During my pediatrics residency training in the early 1990s, I helped care for
Grace, a three-year-old girl who was admitted to the hospital with failure to
thrive. This condition -- usually caused by a chronic medical problem,
improper nutrition, or neglect -- results in poor weight gain and stunted
growth. However, Grace's condition was unusual: she had gained no weight
at all in nine months, but her growth had continued at an entirely normal rate.
In addition, her appearance was striking, especially compared to photos
taken of her in infancy. Over the previous year, all of her normal baby fat had
melted away, yet her muscles were remarkably preserved, making her look
like a tiny bodybuilder.
After a few days of fruitless investigation, we finally discovered
that Grace had a rare abnormality in a region of the brain called the
hypothalamus, which controls body weight. Somehow her brain was sending
her body the message to shed every single ounce of fat. But since she was
otherwise healthy, the growth of other body tissues continued uninterrupted.
Unfortunately, the surgery needed to treat Grace's condition produced
damage to the part of the brain that controls satiety, the sensation of fullness
we get after eating. Almost immediately after recovering from surgery, Grace
developed a ravenous appetite and a significant problem with overeating.
Through the next few years, Grace gained a great deal of weight, going from
being substantially underweight to seriously overweight. Grace's mother, with
support from our medical team, struggled to control her daughter's hunger
and slow down her weight gain.
By the end of my pediatrics training, the obesity epidemic in the
United States was in full swing. Influenced in part by my experience with
Grace, I decided to pursue a career in obesity and joined a basic research
laboratory studying the biological factors that affect body weight. I became
fascinated by the beauty and complexity of the body's weight-regulating
systems. Under most circumstances, these systems help maintain a near-
perfect balance between calorie intake and calorie expenditure. Without
these systems, our weight would fluctuate wildly, as did Grace's. Just the
calories in an extra bagel and cream cheese each day could cause a thirty-
five-pound weight gain in one year.
During my five years in basic research, I helped discover a gene
that can make laboratory mice fat and might contribute to human obesity.
However, I came to believe that the discovery of new genes was unlikely to
provide a cure for obesity anytime soon. After all, our genes haven't changed
much in the past thirty years, but rates of obesity have more than doubled.
So in 1996, I left the basic laboratory, began researching new dietary
approaches to obesity in people, and developed the Optimal Weight for Life
(OWL) Program at Children's Hospital Boston. Since then, OWL has grown
from a staff of two to one of the largest clinics for overweight children and
their families in the country.
When people find out what kind of work I do, they often say
something like, "You treat overweight children? That must be so sad."
Sometimes I do feel sad. Overweight people, and especially children, are
subject to incessant teasing, abuse, and discrimination. The stories of our
patients can at times be heartbreaking. And sometimes I feel angry. Soft
drink companies spend millions of dollars on advertising targeting children,
but OWL has to fight with insurance companies for only a few hundred dollars
to cover the treatment of an obese child. More often I feel joy. In addition to
the small, day-to-day victories that you'll read about throughout this book,
there are great triumphs. For instance, in chapter 2 you'll meet Michael, who
came to OWL at age fourteen. At that time, he was 5 feet 4 inches tall and
weighed 220 pounds; he had high cholesterol, high triglycerides, fatty liver,
and insulin resistance. Now nineteen years old and 5 feet 10 inches tall,
Michael has reached an optimal weight of 155 pounds, and all of his obesity-
related complications have resolved.
If you are the parent of an overweight child, or if you want to
prevent a problem from developing in the future, this book is for you. In the
following pages, I'll share with you what we've learned from fifteen years of
research and from working with thousands of families just like yours. I'll
introduce you to OWL patients who have made dramatic breakthroughs and
others who are still struggling. And I'll walk with you, step by step, as you
and your family take this journey to health.

Copyright © 2007 by David Ludwig. Reprinted by permission of Houghton
Mifflin Company.


Library of Congress subject headings for this publication:
Obesity in children -- Popular works.
Weight loss.