FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

FAT ADOLESCENTS BECOME LONELY POOR ADULTS

Question: I'm concerned because my grandchildren are over weight. My daughter, the childrens' mother, is a little over weight, but her children are very large. I think they are at increased risk for serious problems when they become adults because they are overweight now. My daughter doesn't think so. She says they will slim down later and be fine. What is your opinion?

Answer: Obesity is a serious condition that increases the risk of developing many unwanted problems. High blood pressure, heart disease, respiratory problems, arthritis and other orthopedic problems, and diabetes all occur more commonly in obese individuals. These also occur more frequently in individuals that were obese as adolescence, but this is probably true because 77 percent of those that were obese as adolescence continue to be obese when they are adults. (There goes your daughter's "slimming down later" theory.) A recent study done at the Harvard School of Public Health has shown another complication of obesity reduced income and loneliness. This is surprising and contrary to common belief. Most demographic studies have shown that low socieo-economic status increases the risk of being single and obese. This study suggests that it is the condition obesity that increases the chances of becoming poor and unmarried.

The researchers followed more than 10,000 adolescence for seven years as they matured to young adulthood. These individuals were selected to represent the cultural, ethnic and economic mixture of U.S. society. From this group, 3.4 percent of men and 3.0 percent of women were found to be obese by the definition of being above the 95th percentile in body mass index. (Note: body mass index is obtained by dividing the weight measured in kilograms by the square of the height measured in meters.)

Family income, paternal education, and chronic health conditions such as asthma and musculoskeletal abnormalities were considered because of their potential impact on eventual income, self-esteem and marital status. This study showed the most consistent predictor of lower income and unmarried as a young adult was the presence of obesity as an adolescent.

Overweight individuals completed less education, were 2.5 times less likely to be married and had a $6,710.00 lower yearly income than their normal weight peers. There was no difference in self-esteem between the groups. Obese women had slightly less education and a slightly greater chance of being single than did obese men.

So, I think you are correct. Be worried about your grandchildren. Obesity is related to many objectionable social conditions and undesirable health problems. However, knowing this is the easy part. Changing a behavior like over eating is much more difficult since individuals become overweight for a large number of emotional reasons. And, changing a habit or behavior is as difficult a task as any of us face.

As I'm sure you know, obesity occurs as the consequence of a "medical" problem like low thyroid hormone levels very rarely. Most obese individuals just eat more today than they burn up doing today's activities. The body simply saves that extra food as fat. All of the days with a little extra add up to obesity. The only way to reduce the trend is to eat less food than the body actually needs. The body will draw upon that stored fat to meet the energy requirements for that day, and this brings down the weight.

You are also faced with the formidable task of convincing your daughter and then convincing you grand children that a change is in their best interest. It will take much skill, diplomacy and love to accomplish this without making some or all of them unhappy. But don't be discouraged by this formidable task. It's just is part of being a caring Grandmother.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.