first to meet the axe with any significant district budget cuts. Gym was not going to crack Xander’s case.
Obviously, Xander’s physical exam was not good. Belly skin full of stretch marks. His midsection looked like pulled peach play-doh. The back of his neck had dark velvety skin -- acanthosis nigicans – a sign of insulin resistance, a stop on the road to diabetes. Most of his teeth were more fillings than native tooth, and new festering cavities gave his exhalations a sour punch. He sounded like he was out of breath from just hopping on and off the exam table. He was marinating in a thin layer of sweat that made him feel clammy all over, and look greasy as if he’d been manning the fry station and absorbing the oil splatter at McDonald’s all day. He smelled subtly of old world cheese.
“Well, Kate, I’m not going to say anything new…”
Sighing, “Yeah, we know, Xander has to lose weight.”
“And I’m going to send Xander for some blood work today: fasting blood sugar, lipid panel, insulin and liver enzymes. And thyroid function, too.”
Kate brightened a bit. “You think that could be it? Hypothyroidism?”
The dream is that all Xander needs is a pill once a day to fix all of his ills. Just like most parents, she is holding on to hope that her child’s abnormality is due to some disease outside of her or the child’s control. It’s much better than acknowledging that he’s just fat because he’s fat. How convenient would it be to shift personal responsibility to some tangible condition beyond a person’s control? The next stop will be to say Xander has an addiction to food, that he has the “disease” of addiction, to compare him to a hypothetical heroin addict that has to use a little bit of heroin three times a day to get nutrients. Total crap. A person can get all their needed nutrients eating flavorless greens and meats if they wanted to do so. I have yet to meet the obese person claiming a food addiction that got fat eating dry salad and boiled skinless chicken. Xander is not addicted to food. He just enjoys the feeling of food that tastes good to him, just like everybody else, but he has chosen to forgo common sense and eat ridiculously high amounts of processed and instant gratification calorie dense foods because they taste the best to him and are more easily consumed, consequences be damned. He made a series of poor decisions that morphed into a bad habit consisting of nothing but continued poor food decisions. Obviously habits can be hard to break, but habits are just habits and are not ingrained into his DNA like his sex, so they can be eliminated with a convicted decision to modify behavior. If Kate was really serious about helping to rid his problem with food, she could just eliminate the overvalued highs that Xander has placed on tastiness. If certain foods cause problems, make the decision to eliminate them. Keep them out of the house. Make it harder to find those foods. Don’t let him have a taste, then decide to limit the problem food; the decision for control has to be made beforehand. Just have him eat home prepared meals only. Just have him eat raw vegetables and legumes every meal – not as delicious as bacon cheeseburgers, but it will stave off overeating, provide daily nutrients, and begin the journey of weight loss. But that would mean difficult sacrifice with only an abstract promise of a future healthier life – too much work for an unseen reward. So he will never give up his diet of deep fried fats. Kate would rather look for medical conditions that could be blamed for his weight and continue to allow him to wallow in his woe-is-me obesity.
This hope for a medical disease diagnosis is the same as when Xander started doing a bit worse in school earlier this year. Kate cried it was ADHD. Again, total crap. No kid develops
Obviously, Xander’s physical exam was not good. Belly skin full of stretch marks. His midsection looked like pulled peach play-doh. The back of his neck had dark velvety skin -- acanthosis nigicans – a sign of insulin resistance, a stop on the road to diabetes. Most of his teeth were more fillings than native tooth, and new festering cavities gave his exhalations a sour punch. He sounded like he was out of breath from just hopping on and off the exam table. He was marinating in a thin layer of sweat that made him feel clammy all over, and look greasy as if he’d been manning the fry station and absorbing the oil splatter at McDonald’s all day. He smelled subtly of old world cheese.
“Well, Kate, I’m not going to say anything new…”
Sighing, “Yeah, we know, Xander has to lose weight.”
“And I’m going to send Xander for some blood work today: fasting blood sugar, lipid panel, insulin and liver enzymes. And thyroid function, too.”
Kate brightened a bit. “You think that could be it? Hypothyroidism?”
The dream is that all Xander needs is a pill once a day to fix all of his ills. Just like most parents, she is holding on to hope that her child’s abnormality is due to some disease outside of her or the child’s control. It’s much better than acknowledging that he’s just fat because he’s fat. How convenient would it be to shift personal responsibility to some tangible condition beyond a person’s control? The next stop will be to say Xander has an addiction to food, that he has the “disease” of addiction, to compare him to a hypothetical heroin addict that has to use a little bit of heroin three times a day to get nutrients. Total crap. A person can get all their needed nutrients eating flavorless greens and meats if they wanted to do so. I have yet to meet the obese person claiming a food addiction that got fat eating dry salad and boiled skinless chicken. Xander is not addicted to food. He just enjoys the feeling of food that tastes good to him, just like everybody else, but he has chosen to forgo common sense and eat ridiculously high amounts of processed and instant gratification calorie dense foods because they taste the best to him and are more easily consumed, consequences be damned. He made a series of poor decisions that morphed into a bad habit consisting of nothing but continued poor food decisions. Obviously habits can be hard to break, but habits are just habits and are not ingrained into his DNA like his sex, so they can be eliminated with a convicted decision to modify behavior. If Kate was really serious about helping to rid his problem with food, she could just eliminate the overvalued highs that Xander has placed on tastiness. If certain foods cause problems, make the decision to eliminate them. Keep them out of the house. Make it harder to find those foods. Don’t let him have a taste, then decide to limit the problem food; the decision for control has to be made beforehand. Just have him eat home prepared meals only. Just have him eat raw vegetables and legumes every meal – not as delicious as bacon cheeseburgers, but it will stave off overeating, provide daily nutrients, and begin the journey of weight loss. But that would mean difficult sacrifice with only an abstract promise of a future healthier life – too much work for an unseen reward. So he will never give up his diet of deep fried fats. Kate would rather look for medical conditions that could be blamed for his weight and continue to allow him to wallow in his woe-is-me obesity.
This hope for a medical disease diagnosis is the same as when Xander started doing a bit worse in school earlier this year. Kate cried it was ADHD. Again, total crap. No kid develops
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