What's a kid to do?
Those TV commercials continually tell him he deserves a treat today at his neighborhood fast-food restaurant, and high-calorie, low-nutrient foods--commonly called junk foods--are the most heavily advertised products on Saturday morning children's TV.
But at the same time, billboard models and movie and TV stars present the slim and trim body as the symbol of attractiveness.
How can kids have both?
Some cannot, and that is the dilemma of the obese adolescent--a population numbering more than 5 million nationwide, according to Dr. David Sternfeld, a Torrance pediatrician who also is medical director of the South Bay's only weight-loss program geared specifically for youngsters ages 8 to 18, the Body Shop at Torrance Memorial Hospital.
And medical experts say the South Bay is a ripe area for overeating because it has many affluent communities where people have free time, money for rich foods and the psychological stresses that accompany high-achieving people.
"It's the land of milk and honey," said Dr. James Tamkin, an internal medicine specialist in Redondo Beach and medical director of the AMI South Bay Hospital eating disorders unit, where the patients usually are adults but also include older teen-agers.
Dr. John Tsau, a Torrance endocrinologist who has treated many overweight teen-agers, said children with weight problems are under pressure. They feel compelled to eat the way their friends do. "They're out of the mainstream if they don't keep up with the snacks," he said, adding that because of genetic factors, some put on weight eating such foods while others do not.
At the same time, these teen-agers are under the gun at home to maintain trim bodies, and Tsau said he has seen youngsters use food as a means of rebellion.
"They eat because parents are really trying so hard to get them to the right weight," he said. "They are trying not to conform to the ideas and wishes of their parents."
Medical experts say the causes of adolescent obesity range far beyond America's preoccupation with food and eating. Some youngsters use food to deal with loneliness and emotional pain, others have poor nutrition and just eat the wrong foods, and others emulate fat parents. Metabolism plays a role, and one of the newer areas of research into obesity is concluding that genetics is a key factor.
"Fat cells in some children are different than in others in terms of number and size," said Tsau. "That makes it much more difficult for them to manage weight."
Last year, researchers at the New England Medical Center in Boston put the blame on TV, concluding that hours of sedentary tube watching may cause obesity in some children and adolescents. The conclusion was based on surveys of several thousand youngsters between ages 6 and 17.
Sternfeld said that obesity has signals: "If children are fat at 3 or 4, they remain heavy all their lives. Activity is the greatest thing. If children are not as active as they should be, many times they may be pre-obese."
And children apparently are becoming preoccupied about weight and looks at earlier and earlier ages. A study at the University of California, San Francisco, reported in February, showed that about 80% of fourth-graders in the Bay City are dieting.
Medical experts say there is no precise way of knowing how many obese adolescents simply eat too much and how many are developing pathological eating disorders--the most prevalent being anorexia nervosa, which is self-starvation resulting from an intense fear of becoming obese, and bulimia, which is characterized by episodic binge eating. Both largely afflict females.
Tsau said that well over 50% of adolescent obesity stems from poor eating habits, which is aggravated by teasing from other youngsters. "This discourages them from exercising because they look awkward" when they do, he said.
Tamkin said he is "appalled" when he takes teen dietary histories: Breakfast consists of cereal "in which the only nutrient is the milk you use," and lunch is a candy bar and a piece of fruit. "If there's not a good supper waiting at home, they take the easy way out and have fast foods: a hamburger, fries and a milkshake."
Tsau said children often eat the most of what they need least: fat and sugar.
"There is a thin line between problem eating and just plain overeating," said Susan Owen, program director of the eating disorders treatment program at San Pedro Peninsula Hospital. "If the whole person isn't treated, it can become a lifelong problem. Ninety-five percent of diets don't work because they do not hit the psychological problems for eating."
Some Seek Treatment
Some teen-agers do become patients in the eating disorder units at South Bay and San Pedro Peninsula hospitals, according to staff members, but they typically are 16 or older and have developed their problem over a long period of time.