What Works For Overweight And Obese Children

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Guests

Dr. Antronette Yancey, professor, Department of Health Services, UCLA School of Public Health
Dr. Thomas Robinson, pediatrician and director of the Center for Healthy Weight at the Lucille Packard Children's Hospital

Since 1980, obesity rates have nearly tripled among teens and children in the U.S. An article in the Journal of the American Medical Association suggests that the best place for super obese children may be foster care. Many parents just don't know how to help their severely overweight children.

NEAL CONAN, host: This is TALK OF THE NATION. I'm Neal Conan in Washington. We continue to get bigger and bigger. Even worse, our children are too, with almost one in three classified as overweight or obese, according to the Centers for Disease Control and Prevention.

A provocative article in the Journal of the American Medical Association suggested that maybe in severe cases, where the child's health is at immediate risk, states may need to use laws that govern child abuse and, as a last resort, remove children to foster care.

Taking children away from their parents, of course, is an extreme and controversial solution. But too many parents don't even know how to identify whether a problem exists, let alone how to solve it.

Today we'll talk with experts about childhood obesity and what parents can do to recognize and resolve weight problems. If obesity's an issue in your family, we want to hear your story. Give us a call, 800-989-8255. Email us, talk@npr.org. You can also join the conversation on our website. Go to npr.org. Click on TALK OF THE NATION.

Later in the hour, apologies, accusations and a little shaving cream today when Rupert Murdoch appeared before a parliamentary hearing. We'll hear some of his answers to tough questions.

But first, children and obesity. We're joined by Dr. Antronette Yancey, professor in the Department of Health Services at the UCLA School of Public Health, joins us from our studios at NPR West in Culver City, California. Nice to have you with us today.

Dr. ANTRONETTE YANCEY: Great to be with you.

CONAN: Also with us, Dr. Thomas Robinson, a pediatrician and the director of the Center for Healthy Weight at the Lucile Packard Children's Hospital, with us from his office at Stanford. Nice to have you as well.

Dr. THOMAS ROBINSON: It's nice to be here, thanks.

CONAN: And Dr. Robinson, why don't we start by asking about that controversial proposal. What do you think about the suggestion that in extreme cases child abuse laws should be invoked and, as a last resort, children removed to foster care?

ROBINSON: Well, I think the key comment you made was as a last resort. As health professionals, we actually don't make those decisions. We refer families where, or situations where we believe that a child is in immediate danger of a life-threatening problem. And we refer those to child protective services. And it's really child protective services who do the investigation or the full investigation and make those decisions, along with the legal system and the courts.

CONAN: And it's actually your obligation to notify them if you think - if you think something's an immediate problem.

ROBINSON: Correct, yeah, we're mandated reporters. So if we see something that we think is life-threatening or puts a child or someone else in the household at risk, then it's our responsibility to report that.

And I think in some cases, as with other medical conditions, serious medical conditions, you could get to that point in a case with obesity, but it's going to be extremely rare.

CONAN: Extremely rare. Antronette Yancey, Dr. Yancey, would you agree?

YANCEY: I definitely agree. It's an extremely rare situation. And I really think that this is a part of the problem we have with our health care system, that prevention kind of is, you know, at the bottom of the list in terms of funding and attention, and instead there's so much of a focus on the treatment issues, especially the extreme ones.

Actually, Tom and I serve on the Institute of Medicine's standing committee on childhood obesity prevention, and there are a lot of us working actively to address exactly this issue of making the healthier choice the easy choice for parents rather than their having to swim upstream as they do now, because the whole deck is stacked against them in terms of lack of supermarkets in certain neighborhoods, inadequate play facilities, unsafe and, you know, poorly kept.

I mean, really, most families don't have the healthy choice as the easy choice, and even those living in very affluent neighborhoods are still subjected to advertising and marketing on television.

CONAN: And as you suggest, these are extremely rare cases where the state would be - might believe it needs to intervene. So let's talk about the vast majority of cases where you're trying to work with parents and changing the culture of the family. Is that a fair thing to say?

YANCEY: Well, that's fair, but I also think it's the culture of our society, because we tend to sort of point at individuals and families and say these parents should be making better decisions, but really, our society has conspired to make it difficult for parents to make those very decisions and choices.

So I think turning the lens on us as a society and saying, why have we abdicated the responsibility for our children to corporate interests that, you know, are really making money on helping kids become more obese?

CONAN: Dr. Robinson, as you look at the situation, though, as somebody who deals with this clinically, you have to be treating individuals and not going, as Dr. Yancey might, to address the broader issues of society.

ROBINSON: Yeah, although I totally agree with what Dr. Yancey is saying, what Toni is saying (technical difficulties). And a lot of our approach to (technical difficulties)...

CONAN: And we're talking with Dr. Robinson on a phone line that's clearly acting up, and we're going to try to reconnect and see if we can establish a more stable connection. You heard those digital artifacts, I think they're called. But anyway, Dr. Yancey is still with us, and let's see if we can get a caller in on the conversation, and we'll start with Nikki(ph). Nikki's on the line from Dexter in Michigan.

NIKKI (Caller): Hello.

CONAN: Hi, Nikki.

NIKKI: Hi. First off, thank you for taking my call. And I guess I kind of want to speak to what both doctors are saying, one about treating the individual. I'm almost 34 years old. I'm 5'3" and I weigh 330 pounds. So I am classified as morbidly obese.

And my eating comes from an emotional place, and if I could go back and fix the issues emotionally within my family that cause me to go for pleasure through food, which causes, you know, extreme dopamine receptor issues, and so that was where I felt good was eating food, if that emotional state could have been dealt with, I might not be in the situation I was in.

And then also to speak about the corporate issue, I've got to really give a sort of tip of the hat to Morgan Spurlock and the work he did in "Supersize Me" and bringing to light the issues with the fast food industry.

And I'm - you know, like I said, I'm born in the late '70s, and I've come from an era, and I see my contemporaries raising their children by, oh, we don't have time for dinner, let's run to McDonald's, let's run to Burger King, let's run to - and those places are so quick and easy.

And so it's difficult to make a good choice when you have a really busy family.

CONAN: I wonder, growing up in your family, did your parents try to work with you to see if...

NIKKI: Yeah, they did. I mean, I wouldn't say that I really got to an obese state until I was mid-college. So I was in my mid-20s. I mean, I was always a heavy kid, but that's just sort of my build. And my mom worked with me a lot, trying to make good choices. And we didn't do fast food very often.

If mom and I would take our big, you know, monthly grocery store trip, and I went with her, we would maybe stop at a place on the way home for dinner. But I've noticed that especially through my college years and even post-college, it's really a lot easier for me to just stop in and get some fast food rather than pack a lunch and worry about keeping it cold and taking care of all these other things that I need to do to keep me healthy.

And it's a really, really big battle.

CONAN: Nikki, we wish you luck. It's never over.

NIKKI: Thank you.

CONAN: Thanks very much for the call. And as - I think Dr. Robinson is back with us on the phone?

ROBINSON: Yes, I am, sorry about that.

CONAN: That's okay. Well, we tried to get the better circuit, and we paid for it.

(SOUNDBITE OF LAUGHTER)

CONAN: A little digital hubris there. But as you listen to Nikki's story, it's clear, yes, she put it in the societal context of, you know, corporate culture and "Supersize Me," but a lot of this stems from the emotional situation that we have in our families.

ROBINSON: Yeah, I think - well, it's - you know, we live in a world, as you say, that makes it very difficult. And she said, it makes it very difficult to make healthful choices and make the choices that we may believe are best for us, even if we really want to, even if we have a lot of willpower or motivation to do so.

And so a lot of it is working with families to develop skills to really address these other issues, and certainly the emotional component is a big one, and what you grow up with in your family can have a huge impact on how easy it is to make those changes.

CONAN: And when you're talking about working with the family, you're really talking - one thing I know you do there at the Lucile Packard Children's Hospital is work with families to categorize foods so that there's an easy recognition system, so you know what you can eat anytime, what you can eat from time to time, and things that should be literally off the table.

ROBINSON: That's right, and a lot of it is using really tried and true sort of behavioral approaches that we've known for many, many decades are more effective for changing behavior, the - learning more information about nutrition doesn't necessarily help you choose foods because you can always sort of rationalize your way in or out of eating certain foods.

(SOUNDBITE OF LAUGHTER)

ROBINSON: And so a lot of it is making it very simple for families to identify what the foods are that they should be eating more of and those that they should be eating less of.

CONAN: Let's see if we can get another caller in. Let's go to Mike(ph), and Mike's with us from Cassopolis in Michigan.

MIKE (Caller): Hi, Neal, thanks for taking my call.

CONAN: Sure, go ahead.

MIKE: You know, my son is seven years old, and he is admittedly overweight. And I'm very concerned about what to do about his weight. His diet isn't anything different than I recall. In fact, I think it's better. Most of his snacks consist of fruits. Yet he seems to be gaining weight. And my real concern is: Is it something environmental that he's dealing with?

CONAN: Dr. Antronette Yancey, I think even at seven, I'm not sure parents are aware of when their kids are eating all the time.

YANCEY: Well, I definitely think that's a big issue. I mean I think parents' control over their children's eating, even at that young an age, is a little bit overestimated. And in fact, children are subject to a lot of other influences.

But I think the other piece of this equation that doesn't get talked about as much, and we haven't really emphasized it this morning yet, is the activity side. I think that the physical activity is really foundational in that it influences appetite, it influences the desire for water and fruits and vegetables, and many kids are just not getting sufficient amounts.

Even when a kid goes out and plays for an hour once a day or goes to PE class, still there's so much more sitting that children are doing, and both the sitting and lack of getting the 60-minute-a-day recommendation of moderate to vigorous physical activity are parts of the equation here.

PE has been cut back, and we have a lot of challenges to getting people moving.

CONAN: Mike, does your son get enough exercise?

MIKE: Probably not. I went to school in Illinois, where we had PE every day. And now I'm in Michigan, and he has PE once a week. And that's always been an issue with me.

CONAN: Well, we wish you the best of luck, Mike. But sometimes kids go eat at school or someplace else, and you're not aware of all the time what their intake is. But we wish you the best of luck with the situation.

We're talking about the child obesity problem, stay with us. It's TALK OF THE NATION from NPR News.

This is TALK OF THE NATION from NPR News. I'm Neal Conan. We mentioned earlier the controversial piece in the Journal of the American Medical Association that suggested that in the most extreme cases, as a last resort, states may need to remove children considered super-obese and put them into foster homes. You can find a link to that article on our website, at npr.org. Click on TALK OF THE NATION.

We're talking today about obesity in children, what parents can do to reverse the trend. If obesity is an issue in your family, we want to hear your story. What worked? What didn't? Give us a call, 800-989-8255. Email us, talk@npr.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.

Our guests are Dr. Antronette Yancey, professor in the Department of Health Services at UCLA School of Public Health. She co-directs the UCLA Kaiser Permanente Center for Health Equity; and Dr. Thomas Robinson, pediatrician who directs the Center for Healthy Weight at the Lucille Packard Children's Hospital at Stanford.

We have an email from Amy(ph) on that question about that article: Talking about the obese children and possibly removing them from the home, I would think if the children are obese, then the parents are, too. The issue needs to be tackled with the adults first. Please comment on this. Dr. Robinson:

ROBINSON: Yeah, well, I think we tend to approach families as a whole because that's how they exist, and that's how they live. And so I agree that you address - the issue with the entire family, the parents as well as the kids. However, sometimes working with the kids is the way to get - is the easiest way to get new behaviors instituted into the family.

CONAN: Ah, because the adults will respond to a problem they see with their child but not necessarily with themselves.

ROBINSON: Right, and if your child gets excited about doing something, then it often brings the parents in and has them going. So for example, the physical activity piece is one in which we work a lot with kids directly, and they get their parents more active, as opposed to the parents coming down and saying I have to get my child to be more active.

CONAN: I need to be a model for my child, yeah. Yeah, let's see if we can get another caller in. This is Dan, Dan with us from Clarksville, Tennessee.

DAN (Caller): Hi, how are you?

CONAN: Good, thanks.

DAN: I want to talk about how, you know, it's one of those that obesity, it's - you know, or naivety of the effects of it over time, you know, because the effects of it are so slow to come in comparison to, you know, in retrospect of how, you know, the positive reinforcement of a quick, fulfilling meal from fast food, you know, you can get the effects immediately, you know, feeling good about it as opposed to not knowing the true effects of obesity to your health.

And I always alluded towards my family, when they buy a big bag of chips, and they share a bowl between, like, two people of this big bag of chips, they're so headstrong and adamant about me quitting smoking, and it's I know a weird allusion to allude toward smoking, but it's one of the same things where I won't see immediate side effects, but they know because based on commercials, everything, all the negative outlook on cigarettes in comparison to, you know, eating wrong.

It's the same thing in my eyes, and I can think you bring home, like, five bags of chips, you know, I bring home a pack of cigarettes, we're doing the same thing to each other, and we're just slowly killing ourselves. It's the same exact thing.

CONAN: Dr. Yancey, is the allusion to cigarettes misplaced?

YANCEY: Actually, I don't think it's particularly misplaced. I mean, I certainly would not argue about what is the greater contributor to ill health in our society. But I would say that poor nutrition and lack of physical activity affects many more people than tobacco.

And starting in childhood is really an important piece. One of the things that we've been doing in one of our projects at UCLA is home makeovers. So while those of us that are involved with government efforts are trying our best to do something about the community at large, people can re-think what's in the houses, how easy is it for a kid to open the refrigerator and grab, you know, some cut-up vegetables.

Or are you keeping those chips in the cupboards? I mean, maybe you should either not be buying certain things or be buying them in smaller packages. But there are ways that parents can - you know, parents working with children, maybe children are the impetus - to really try to start making it easier within their own environments that are within their control, to make the healthy choice the easier one.

CONAN: Dan, I understand what you're saying about the immediate gratification, but the obesity, yeah, I guess it can sort of sneak up on you, but once your belt size starts getting bigger, your pants don't fit anymore, you tend to notice that.

DAN: Well, yeah, that's what I'm saying. As far as comparison, you know, you're not going to feel an immediate effect from smoking a cigarette. With a cigarette, you'll actually, as far as instant gratification, you know, it's said that it's relieving stress. Everybody feels good about smoking a cigarette in the same way that, you know, you grab a biggie size from McDonald's, something like that.

But, you know, the cigarette, after, you know, a week, you're like man, running up those steps really hurt my lungs. You know, that was really hard on me. The negative effects are so slow to come, you know, in the same way that eating, they're slow to come.

CONAN: Thanks very much for the call, Dan.

DAN: Yeah.

CONAN: Here's an email from Matthew in Fort Lauderdale: My niece, who is 11, is only 5'8" tall and weighs 190 pounds. She's been overweight her whole life. My sister has just about had it with people telling her she needs to do something. I know she tries, but my niece sneaks food, for example.

Obviously there's a deeper reason for her weight and obsession with food. I've suggested a psychologist, to no avail. I've wanted to go to the school to see if they can let her talk with the school psychologist, but others have told me it's none of my business. So what else can I do?

And Dr. Robinson, the aunt or the uncle is limited in what they can do.

ROBINSON: Yeah, that's a tough dilemma, I think. It's important that they do point that out to peers, to her brother or sister, and that you do comment on it because I think if it's ignored, people tend to think everything's okay.

However, it's something that may require them to realize themselves that it's an issue and that they can achieve - or they can get some help themselves. And it may not be something immediate.

And so even though you don't want to nag a family member to change a behavior, something that they see as their own behavior, something that they're independent on, I think it's - over time I think it can help them see that it's something that's important enough that they need to seek help themselves.

CONAN: And Dr. Yancey, the psychology of this is - can be curious. I've read that sometimes, parents whose child is overweight or even obese can't recognize that or won't recognize that, or conversely some parents who have kids who don't have a weight problem think their kids are fat.

YANCEY: Well, and I think this issue of how people perceive themselves is a very important one, and it's also a very challenging one because people in different cultural groups tend to see weight and size and what's attractive very differently.

In our research in Los Angeles, with a very diverse community, we found that 90 percent of obese people or more actually know that they're obese. And where the slippage really comes in is in a lot of people who are overweight thinking that either they're not overweight or people who are normal weight thinking that they're overweight.

I think the stigma associated with overweight and obesity in our society is very great, and I think that's a part of feeds into this vicious cycle with the emotional eating. But the great thing is that on the physical activity side, that does deliver an immediate return, I mean an immediate feeling of well-being and regulation of mood, you know, de-stressing and that sort of thing.

The problem is that people often don't seek it out because it's so negatively framed, and the gentleman that just called in was talking about, you know, well, walking up those steps was, you know, very hard for him.

So we really have to make the physical activity something that people have to trip over and kind of relearn that it can actually be fun. It can be simple. I mean, we've been doing something called instant recess breaks in the workplace and schools and religious institutions, and, you know, we just try to make it so that the average, sedentary, overweight child or adult can participate and can feel those immediate benefits and then be set on a course toward getting more activity over time.

CONAN: Let's go next to Lance and Lance on the line with us from Columbus.

LANCE (Caller): Yeah, well, you guys were talking about family, and I have a cousin who he's in his mid-30s, and he has a teenage daughter. She just turned 15, and his son just turned 13. And they're both extremely overweight, especially the older daughter.

And it seems like - I don't know. Like I go to our - I don't see them too often, but I go to our family, you know, dinners and things, you know, and birthday parties, and it's always like sloppy Joes, and, like, there's absolutely no regulation over what they eat at all.

Like, I watched my cousin, who's like 13, eat like - and I had a big appetite when I was 13, you know. He ate like four huge, like, gigantic mounds of like macaroni and cheese, and there's like - it's just weird to me. Like, I know he knows that there's a problem and especially like his daughter, she got pulled out of school because she was getting ridiculed so much. So it clearly was is problem, and I think, like, like just, like going back to the, like, American culture thing, I think a lot of Americans just don't know how to handle it at all or even eat different or even like jump onto any kind of, like, everyone is looking for, like, an instant thing, and it's not, like, valued enough in our education how important our health is and how important what goes into our body is, you know?

CONAN: Well, Dr. Robinson, it sounds like this family Lance is talking about clearly know there's a problem, but it's like - I don't want to diagnose from...

(SOUNDBITE OF LAUGHTER)

CONAN: ...on the radio. And certainly I'm not a doctor, but it sounds like they're - given up. I mean there's no point in resisting here.

ROBINSON: I think - and this goes back to what we talked about early on in terms of the - how toxic the environment is and for families, is that often there's a lot of frustration if the people have tried to lose weight or tried to change their diet or increased their physical activity and failed in the past. And so I think it's up to us in a lot of the interventions, a lot of the programs that we develop to really focus on how we can make - help motivate people to see the very positive changes they are making, even if they're very small steps at the beginning, because people do feel like it's a very difficult, and it is a very difficult battle.

What Toni was mentioning about the positives about physical activity you can build those things into eating behaviors as well in which you try and focus on what motivates individuals and families to try and do better. So in some cases we're doing work where I suggest that for some families it's the environment that motivates them. And so maybe that eating a diet that's better for the environment, more focused on fresh fruits and vegetables, and less on meat and packaged and processed foods, and particularly things like fast foods and stuff, is going to be better for the environment, and they can feel very good about that in the immediate term without having to focus only on the long-term health effects.

CONAN: Lance, I'm sorry for your situation. Good luck.

LANCE: Thank you.

CONAN: Here's an email from Rebecca in San Rafael(ph). It's common. I teach cooking classes to children. I found that a child - any child is involved in the cooking process, they'll eat the food they make, and they will almost always love it, time and time again. So please, parents, hear this message: cook with your children. It's a positive experience, quality time and teaches many important skills, dexterity, math, comprehension, food science, reading and most importantly a life skill that helps avoid poor nutrition and improves health. Dr. Yancey, I'm sure that works.

YANCEY: That's definitely one of the strategies that we need to embrace, and I think you've probably heard of the first lady's Let's Move! Chefs, part of her Let's Move! campaign, because we recognize that we need to work with parents. We need to work with schools and communities to make the healthy food choices more appealing, make them cheaper, you know, and address these issues with the food deserts, you know, where people may try to go out and get other foods, but they don't have supermarkets or there's nothing but fast food restaurants in their neighborhoods.

So anything that we can do, especially in going at it from the standpoint of where people already are, so going out into people's homes is very expensive, but gathering, you know, since we have such a problem with childhood obesity and most kids are going to school, making those changes in schools is a really important thing.

CONAN: We're talking about childhood obesity with Dr. Antronette Yancey of UCLA School of Public Health and Dr. Thomas Robinson of the Lucille Packard Children's Hospital at Stanford. You're listening to TALK OF THE NATION from NPR News. And let's go next to Paula. Paula with us from Tucson.

PAULA (Caller): Hi. Thanks for taking my call. I'm a personal trainer, and I deal with issues of weight loss and obesity constantly. And what alarms me about the social program, I suppose, or social dictate that was put forth in The New York Times article, the idea of that, is first of all, I think it would definitely adversely affect the poorest among us who have the least access to healthy foods and education about such things, but also in my profession there are so many theories about weight loss and obesity, some that conflict, that is if we were to put such a social program in place, who's to decide which one we're going to promote?

CONAN: Well, it's got to be...

PAULA: And the third and last...

CONAN: Well...

PAULA: I'm sorry.

CONAN: I just wanted to ask - go ahead. I'm sorry.

PAULA: The third and last point I just wanted to make is that if we're willing to go to that extent, to remove children from a home, the people that show up to enforce that policy had better be walking the walk and talking the talk themselves in terms of their own health and wellness.

CONAN: I suspect you're right about that.

PAULA: Thank you.

CONAN: The article was in the Journal of the American Medical Association...

PAULA: Oh, I'm sorry. OK.

CONAN: ...not The New York Times. But that's...

(SOUNDBITE OF LAUGHTER)

CONAN: ...it's OK. I'm supposed to know that. The - I wonder, is this a personal issue with you?

PAULA: I - well, in terms - I'm an old lefty. So when I see proposals like that put forth that I think would adversely affect a certain population, I do get my dander up, but...

CONAN: Yeah...

PAULA: ...my mother was obese, absolutely, and I'm watching her go through the changes that she went through and the back and forth yo-yoing with diets. I really began to understand at an early age that obesity is not just a matter of calories in and calories out. It isn't that simple. It's very emotional. It's very layered. And I think that that type of social policy really can't even begin to address the complexities. It's too big of an issue.

CONAN: And you say your mother was obese. She figured it out?

PAULA: She is now in a more normal weight. Yeah, she's doing OK, but she's also very elderly.

CONAN: Ah, but I was going to say, what worked for her?

PAULA: Initially Weight Watchers worked for her, but when she lost 80 pounds, I think she got really scared and she gained it all back. And that, I think, points to the emotional underpinnings for a lot of women, especially with weight loss.

CONAN: Dr. Yancey, obviously policy issues are important and need to be addressed, but, as Paula says, this is really complicated.

YANCEY: It is very complicated, and I'm glad she underscored that. But this is - nobody really has a very good solution right now. I mean many of us in research are working towards something like Dr. Robinson, but we really need to grapple with this in a little bit different way than to resort to these kinds of extremes. And I actually was a physician in the foster care system in New York City, and you know, wouldn't wish that on anybody, especially a patient, to you know, be put into that system. I don't necessarily think it would even work. So I think it's a big problem, and foster care I don't think is the main answer that we should be talking about.

CONAN: Paula, thanks very much for the call. We're going to take some more questions about people struggling with issues of childhood obesity when we come back from a short break. We'll also listen to Rupert Murdoch being peppered with questions in parliament about the phone hacking scandal. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

(SOUNDBITE OF MUSIC)

CONAN: Right now we're wrapping up our conversation about reversing the growing trend towards childhood obesity. Our guests are Dr. Antronette Yancey, professor in the Department of Health Services, UCLA School of Public Health, where she co-directs the UCLA Kaiser Permanente Center for Health Equity, and Dr. Thomas Robinson, pediatrician who directs the Center for Healthy Weight at the Lucille Packard Children's Hospital at Stanford. And let's see if we can go next to - this is Gary. Gary calling from Tucson.

GARY (Caller): How are you, Neal and (unintelligible) we love you here in Tucson as you can tell.

CONAN: Oh, thank you.

GARY: You're welcome. Hey, when I was 13 years old, I remember I had always struggled with my weight. When I was in seventh grade, 13 years old, I was just over five foot, had a 38-inch waist, weighed 180 pounds. My family was always heavy. My mother and my father was, got used to a lot of Southern cooking. And a couple of years back when my dad got real sick, I had to look at myself in the mirror and really decide on whether I wanted to follow that path in 30 years and went on a pretty heavy change on my diet, on exercising, got into working out, got into cycling, started reading a lot about sports nutrition and just how bad I was eating.

And it took me a year and a half to drop 40 pounds, and that was a long, really rough 40 pounds and a long year and a half. And I think that the American people have just gotten so lazy, always thinking that there's the miracle drug out there to help you lose as much weight. And I've gained some of the weight back and just really struggled with - if I really want to start going through all that commitment again to do it, knowing that that's what I have to do.

CONAN: I think Northern food can be just as problematic. Lazy is, well, I think people turn towards those, you know, those kinds of drug solutions out of panic. I'm not sure it's laziness, Gary. But I hear your point, and I congratulate you on getting that weight off. I know that wasn't easy.

GARY: Oh, I appreciate it. Yeah, my doctor says I'm in great health. I mean that was really nice to hear, and so, yeah, I just - I really appreciate it. I know that a lot of people just really have to go through what it takes to take that sacrifice.

CONAN: Well, thanks very much for the phone call.

GARY: Thank you, Neal.

CONAN: And there is that - laziness, I think, is part of the stigma that goes along with being overweight and having kids who are overweight. And I wonder, before we let you go, doctors, if you can help us understand what is it that parents don't understand about obesity, and what's something they might be able to do that might help their kids? Dr. Yancey, why don't you go first?

YANCEY: OK. Sure. I think one of the things that parents don't understand is just how sedentary we've become as a culture and how simple it is to begin to reintegrate short bouts of physical activity into the day. I think one of the ways that they can do that, and we've been working on this with the Partnership for a Healthier America, is really start to say, hey, you know, in our workplaces, in our religious institutions, in our schools, wherever we gather together as people, we can adopt these short activity bouts, and that's something that everybody can do.

Everybody can look and see, you know, how am I contributing to this by having, you know, long meetings. I mean, we wouldn't think of cooping up people hours at a time with no water or, you know, other refreshments, but we'll do that with activity.

CONAN: Make 'em sit in a radio studio for hours at a time. Dr. Robinson, if you could give us a quick suggestion, that would be great.

ROBINSON: Sure. I think the most important is to set a good example themselves. So parents are the best models for their children. And the two things that I think in our experience that have had the best effects are, one, is turning off the TV and either putting limits on TV viewing in the home and/or taking TVs out of children's bedrooms. We know that they're in most children's bedrooms now. And that's something that affects both their physical activity and their eating.

CONAN: And the second thing?

ROBINSON: And the second is don't bring the foods you don't want your children eating into the home. If you know that they shouldn't be drinking sodas all the time, and you know that they have an issue with that, then you shouldn't have them in your home. And that's the easiest way to help your family sort of start to eat the foods you want them to eat.

CONAN: Dr. Robinson, thanks very much for your time today. Appreciate it. Dr. Thomas Robinson joined us from Stanford. And Dr. Yancey, thank you very much for your time today.

YANCEY: Thank you. I'm delighted to have been with you.

CONAN: Antronette Yancey was at the studios of NPR West in Culver City, California. Rupert Murdoch testifies in just a moment. Stay with us.

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