Up to 25 percent of children ages four to 18 have excess body fat but are not identified when the body mass index (BMI) scale is used, according to a new study that included 37 separate studies."BMI is not capturing everybody who needs to be labeled as obese," summed up study leader Francisco Lopez-Jimenez, director of preventive cardiology at the Mayo Clinic in Rochester.
Thus the latest statistics on childhood obesity may not reveal the full extent of the problem. During the past three decades, childhood obesity has doubled. Currently, almost 20 percent of children and teens ages six to 19 are obese - but that statistic is based on BMI.
And it's not just children who are affected. Many obese adults appear to have given up on attempts to lose weight, reported the Clinical Endocrinology News on Tuesday.
In a national survey, about 60 percent of obese adults admitted that they weren't trying to lose weight. And that statistic shocked even researchers.
"That’s a surprisingly high figure. It suggests a dire need to better educate the public about the health consequences of obesity and the importance of addressing the problem with their doctors," said Z. Jason Wang, Ph.D., at a joint meeting of the International Society of Endocrinology and the Endocrine Society.
In addition, Wang expressed concern about the methodology most of these individuals used. Only one in 20 of them chose bariatric surgery or prescription weight loss medication. The rest were experimented with options ranging from over-the-counter supplements or their own diet.
However, those who took the more aggressive approach reported that they were more satisfied with the results. "This finding may mean that diet and exercise alone just don’t work for a lot of people," said Wang.
Looking at the bigger picture, what is causing this epidemic of obesity and corresponding conditions such as diabetes and heart disease? In an exclusive interview, Dr. Robert Lustig noted that sugar is part of the problem.
Author of "Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease," Dr. Lustig noted that "many foods can promote obesity." And although sugar is part of the problem, he lists potato chips and French fries as the top two culprits.
However, "the sugar-diabetes and sugar-heart disease connections are much stronger. Sugar is integral for the development of chronic metabolic disease, because it overwhelms the liver and drives insulin resistance," he explained.
Dr. Lustig recently participated in the creation of a documentary entitled "Fed Up." He emphasizes that it has several key points to make.
It's not about obesity or personal responsibility. Instead, it's about the food environment - and Dr. Lustig blames the government for being "complacent and complicit with the food industry in altering the food environment to our detriment."
And a key message that he makes echoes that of Robb Wolf, author of "The Paleo Solution: The Original Human Diet." All calories are not created equal. Or, as Dr. Lustig says: "A calorie is not a calorie."
In an exclusive interview, Robb told me that he often hears from dietitians who feel that the Paleo diet is too "restrictive" for removing or limiting certain food groups. They urge moderation.
However, said Robb, "I find this position interesting also in that the implication here is that 'all food is equal.' A cupcake is apparently equal to an apple. Can that possibly be correct?"
And in line with Dr. Lustig, Robb emphasizes, "some food is in fact better than other food." He declines to "spin this yarn that all foodsare created equal" and a calorie is a calorie whether it comes from cupcakes or cucumbers.
Just as with the Paleo diet, the response to the "Fed Up" film has been 80 percent positive and 20 percent negative, Dr. Lustig revealed. "The 'hatefuls' are people who are entrenched in their "calorie is a calorie" mantra (e.g. many dietitians), professional detractors who like to stir up animus for their own gain, people covering for the food industry, and people who are so hooked on sugar and processed food that they can't see their way clear."
The question: What will it take to halt the onslaught of processed foods loaded with sugar, salt and trans fats? "The food corporations don't care what they sell," said Dr. Lustig. He's a believer in cooking up your own meals rather than buying processed foods, and recently concocted a cookbook "The Fat Chance Cookbook: More Than 100 Recipes Ready in Under 30 Minutes to Help You Lose the Sugar and the Weight."
"And right now they're selling a lot, so they won't change without pressure. Public health doesn't have the clout, so nothing is happening yet. That pressure will have to come from business, insurers, government, or the people," he added.
Slowly but surely, he has noted changes. "We're seeing small efforts in each of these stakeholders to change the paradigm. Hopefully over the next couple of years, those outcries will grow louder," he added.
For parents with obese children, Dr. Lustig feels that dessert once a week is fine. "But if every meal is dessert, then it's not dessert, is it?"
And for adults who want to shun sugar and boost weight loss, Dr. Lustig offers this advice: "Any diet that gets insulin down will promote weight loss. The things that make insulin go up are high sugar and low fiber."
Conversely, foods low in sugar and high in fiber make insulin go down. "A low-sugar high-fiber diet is called 'real food.' Any diet that promotes real food works," he declared.