Diet Alone, or Live It Together?

David L. Katz

I was delighted to join an episode of Katie Couric's show, to air on Wednesday, devoted entirely to the issue of childhood obesity. I was also delighted to learn that People Magazine was a sponsor of the episode and would be devoting next week's issue to the same topic.

But in some ways, a dedicated focus on childhood obesity is problematic, in just the same ways that an isolated focus on obesity among adults is. Children live with adults, not in some parallel universe. We are all in this together. The basic functional unit of our society is only very rarely a lone individual, and almost always a family.

I am grateful that People Magazine will address this important topic. But I certainly don't expect this to represent any kind of fundamental change in the brand. People Magazine will continue to highlight, week after week, every variety of cockamamy diet used by some celebrity to lose an eyebrow-raising amount of weight stunningly fast. It's hard to find any fault with People Magazine for doing this, when most of the magazines putatively devoted to health and well-being tend to do the same.

The dieting that is perennially featured in our popular culture is almost invariably a solitary act. Each diet of the week is something you try on your own to lose weight quickly. But this of course is wrong, in almost every way, for a whole batch of common-sense reasons.

We can start with the epidemic of childhood obesity--a clear, compelling and all but omnipresent peril. I doubt there are many of us unaware of this menace, but for those who don't know, it is the reason why what used to be "adult onset" diabetes is now routinely diagnosed in children. It is the reason for a 35 percent increase in the rate of stroke among 5- to 14-year-olds! It is the reason why our children may be looking ahead to both fewer years of life, and less life in years.

[See Swap This for That: Tips for Feeding Healthy Kids.]

So in light of these stark and increasingly widely known realities of modern epidemiology--how can we even pretend that an adult can go on a solitary diet and leave the family behind and still be a responsible parent?

Our culture routinely establishes the bounds of responsible behavior. Adults who drink alcohol are not at liberty to share it with their 3-year-old, and no responsible adult would do so. Smokers cannot offer a drag to preschoolers.

Despite the fact that poor diets are imposing far greater harm on the nation's children than alcohol, tobacco and drugs combined, we seem disinclined to establish any relevant parameters. And they are past due.

Through the medium of pop culture, we routinely encourage one another to try the latest diet. Almost never does the word "family" appear. It can, and should. We should be asking routinely: "It's 6 p.m., and you are on the '_____' diet; What the heck are your kids eating?"

One of the salient themes that Katie Couric's show will convey is that treating childhood obesity effectively is all about family. An isolated emphasis on the weight of a child is demeaning, and demoralizing. It is an assault on self-esteem.

[See Vogue's 'Diet Mom:' How I Enforced My Kid's Diet.]

A focus on families pursuing health together--something which every guest expert on the show stressed--is the very opposite. It's about solidarity. It's about love. Love and togetherness make otherwise awkward discussions about weight control easy. The discussion is not: "You need to lose weight." But rather: "I love you and want you to be healthy and vital. Let's work on that together and help one another."

Food is the centerpiece of almost all of our social interactions and always has been since the dawn of civilization. It makes no sense for efforts to eat better, or less, to occur in isolation, and in shadow.

In unity there is strength. Strength is needed by both children and adults to eat well in a culture that conspires mightily against doing so. Strength is needed by both children and adults to keep weight in a healthy range in a society where a sizable majority is overweight or obese.

In an age of epidemic childhood obesity and its grave consequences, the very concept of adults going on diets by themselves to lose weight fast should be obsolete. Everyone with a modicum of common sense already knows that quick-fix diets are the new-age equivalent of the kind of get-rich-quick schemes ridiculed for decades on sitcoms (Ralph Kramden comes to mind). They don't work and are designed to exploit the gullible. But even if they could work, go-it-alone diets that leave our kids behind to fend for themselves are, in a word, irresponsible.

But there is, as well, a purely selfish case to make for family-based approaches to losing weight, and more importantly, finding health. The origins of epidemic obesity reside in culture--and a family can establish a culture. That's really what "family values" are. An individual does not make culture. So only by engaging with our family can we shift our personal culture toward an emphasis on health that supports our efforts and facilitates our progress. You can try, for example, to eat well in a house stocked with junk food; but good luck! When everyone in your home is pursuing health together, and you only have wholesome foods on hand, eating well is the prevailing default--and you are far more likely to succeed.

Adults and kids will get to health together, in other words, or probably not at all.

As editor-in-chief of the peer-reviewed journal, Childhood Obesity, I can certainly sanction giving this urgent matter the dedicated attention it deserves. But parents and children have long broken bread together--and that is probably the only way to break the chain of adverse effects of poor diet, physical inactivity and weight gain as well. The solution here resides with lifestyle that emphasizes health as a constant priority--and the pursuit of health as an expression of modern love. Childhood obesity is not about them; it's about us.

We can diet alone. But we can only live it together. Together is better.

[See 8 Ways to Eat Well and Save Money at Home.]

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David L. Katz, MD, MPH, FACPM, FACP, is a specialist in internal medicine and preventive medicine, with particular expertise in nutrition, weight management, and chronic-disease prevention. He is the founding director of Yale University's Prevention Research Center, and principal inventor of the NuVal nutrition guidance system. Katz was named editor-in-chief of Childhood Obesity in 2011, and is president-elect of the American College of Lifestyle Medicine.