<p>You really need to keep that part of it to yourself. My son is gay and we live in a very conservative area. I well understand worry based on societal attitudes but that’s my problem. I simply will not encourage my son to change to fit into someone else’s ideal, that’s just not healthy. </p>
<p>Having said that, I think there is room for an offer of help with the health side of things but only if you can keep it separate from the appearance issue. Tell her what you said here, that she was dealt a bad hand genetics wise and you want to know if she’s interested in seeing a doctor to find out what her risk factors are and, possibly, what can be done to mitigate them as much as possible. Same with seeing a nutritionist.</p>
<p>You must be prepared for her to turn down your offer of help. You also must be prepared to step back if she does accept your help in terms of finding health care professionals. </p>
<p>And I’ll share with you that it is very, very difficult to find doctors who can deal with weight in a positive way. I nearly had back surgery a few months ago because every doctor I saw was convinced that the pain I was in was from my weight and its effect on my back. While reading an MRI, one doctor saw a shadow in the corner and it was only after I pushed him that he ordered another MRI. It turned out I had a grapefruit sized dermoid cyst on one ovary and one about half that size an other other plus I have endometriosis stage IV. I’m doing really well now, having had the correct surgery.</p>
<p>That’s my long winded way of saying that if your daughter says the doctor or nutritionist seemed too focus on her weight and was not listening to her about other concerns, I say find another doctor.</p>
<p>So is the idea that being fat is the same as being gay? My apologies. This is one area where I have not worked hard to erase my prejudices. I’m average slender - but I work at it. I try to stay active. I keep my cake eating to a few bites here and there. Is it really true, medically proven, that different people could have my life and be at a markedly different weight? I’m open to new knowledge.</p>
<p>My feeling is that if the daughter is staying active, and eating well, that’s all that matters. But if she is binge eating, junk eating, over eating, that’s not fine. She is putting her health at risk, and society aside, she should be spoken to as one would speak to any child who is putting themselves at risk. We shouldn’t fall prey to society’s over-emphasis on skinny, especially for women, but nor should we let our distress keep us from parenting.</p>
<p>pugmadkate,
You posts are excellent, informed and sensitive. Thank you for sharing your personal journey.
The story about the dermoid cyst and endometriosis reminded of another possible cause for stubborn weight gain (in females): poly-cystic ovary syndrome or PCOS. It is probably more common than we realize, but not easy to diagnose, and may exist on more of a spectrum than commonly believed. </p>
<p>OP- It might be a good idea to ask that your D’s next blood panel include information about testosterone and her other female hormones. You can google the condition to learn about the range of symptoms and causes and ways to diagnose.</p>
<p>All I can say is that obesity is a far from well understood phenomenon. While overeating, eating too much glycemic food, preferring processed food, consuming too many calories, not moving enough may be responsible for some? many? cases, there is much to be learned about the science of obesity. Metabolic biochemistry, endocrinology and neurochemistry are very fertile research fields doing work on obesity now, but the research is still being done and more needs to be done- it will take time. Meanwhile, practicing MD’s are without tools to deal with this difficult and growing syndrome.
It takes a curious and confident patient to take care of him/herself. </p>
<p>Nevertheless, support your D in starting with the simple: check-up, questions based on a little research, healthy meal plan and lifestyle.
Best of luck and health and happiness, and peace among us!!</p>
Actually it is medically proven and new discoveries are being made every day. </p>
<p>I used to live in the Phoenix/Scottsdale area not too far from the Pima Indian reservation. I noticed that almost all of the Pima Indians I saw were morbidly obese. It’d be easy to draw conclusions from just that observation in the context of my own life and ‘the norm’ - most of which would be directed at their habits, the amount they eat, what they eat, lack of exercise, etc. - the usual.</p>
<p>However, I since found out that there have been fairly exhaustive studies in this area on the Pima Indians in particular (you can google it). They were placed in controlled environments that measure the calories in and calories used - i.e. the ‘efficiency’ of the use of calories. It turns out that their bodies are extremely efficient in the use of calories. This was something that was necessary for generations of these people to survive in the harsh environment they lived in (desert) - something that you and I probably wouldn’t have survived. Fast forward to today when there’s Safeway, McDonalds, restaurants, cars, etc. and they almost don’t have a chance. The bottom line is that they could put you and one of them in the controlled environment and feed you both the exact same thing and have you both perform the same activities and you’d end up ‘normal’ and they’d end up obese.</p>
<p>The Pima Indian example is an extreme example and a study easier to conduct because of the contained genetics but this illustrates that we’re not all the same in this area.</p>
<p>Research is showing it’s not simply the efficiency of the body either. There are other factors such as the gene I mentioned above that triggers the brain to ‘stop eating I’m full’. Whereas you or I may be able to fairly easily stop eating after eating a reasonable portion some people don’t get that feeling. It’s hard for those of us who don’t have the issue to understand or comprehend what it’s like for those who have the issue - anymore than they can comprehend what it must be like to not have the issue.</p>
<p>And then there are other issues that can be part of the equation - emotional issues, poor habits both lifelong and recently acquired (as in access to an unlimited amount of poor quality food - i.e. the college cafeteria), newly developed social aspects such as drinking alcohol, a physical injury preventing normal exercise, lack of time/scheduling/focus to exercise, etc. </p>
<p>It can be a complex issue for a lot of people with no simple answer which is probably why so many people have the weight issue.</p>
<p>Speaking of the Pima,
Daphne Miller is an ethno-nutritional integrative MD who works at UCSF and got her MD at Harvard.
She has a new book about the Jungle Diet, and other books. She has a free video lecture (1.5 hours) available on UCSF’s mini-medical school web page. (Lots of interesting other free lectures there, as well!)</p>
<p>Anyway, among several isolated cultures, all with good health, no obesity, and longevity, she visited (with very very different diets and life-styles and gene-pools, she found a tribe of Pima in Mexico who do not have the health problems showing up in the US Pima.</p>
<p>Her theory is that we need to eat less processed/ closer to the earth foods to maintain our correct gut health. “It would be healthier to eat good soil than to eat a McDonald’s meal!” And that all aboriginal diets are composed of minimally-processed foods, pastured meats and fish, highly nutritious plants, and are filled with spices and plants with very healing properties, served in moderate portions and consumed in groups. She also says proper food-combining minimizes glycemic index of a given dish or meal. And that meats are used more sparingly, like spices, in keeping with the higher cost of grass-fed range stock. The general observations applied across the board to these healthy isolated cultures with very different cuisines from all over the globe.</p>
<p>That said, American diet is basically the OPPOSITE of all this. It would be very hard for the average college-student to try to live on an aboriginal diet! And to find, afford and take the time to prepare local farm-raised foods, even if he/she were consuming less processed foods.</p>
<p>I have to say that living on a campus with access to primarily dining hall and fast food can really be tough for those who do want to try to eat more healthfully. I only hope that there will be progress for all, including colleges, “soooon LOL”. These types of food are expensive to raise and then to purchase, and are quite inconvenient/require cooking, and might not be palatable to many Americans. But she insists that her “Jungle” recipes are simple and delicious!</p>
<p>And I will be the first to admit, that as an upper middle class American living in Northern California, shopping almost exclusively at Whole Foods, and cooking for myself breakfast, lunch, and dinner, I much more control over what goes into my body than much of America, and that I make a conscious effort to eat as much food made from 1st level ingredients, i.e. as they come from the ground, as I can stand to. Bread, pasta, chocolate, are all 2nd level, so I am in no way perfect. But McDonald’s, “meals” from big supermarkets, they are all 3rd level, and to be avoided.</p>
<p>The worst part of all this, to me, is food injustice. That with privilege comes access to real food.</p>
<p>Personally, I believe that future generations (long after we are gone) will look back and say, “What the $%# were they thinking…serving all those processed foods?” Just like we now look back and laugh at the notion that cigarettes aren’t addictive. And yet, there was a time when many adults in this country smoked (42% of the US population in 1965) and were told it was safe and even good for you (by the tobacco companies, of course). It was until the government started forcing cigarette makers to slap warnings on cigarette packs that people started to understand how harmful it was for you. The interesting thing is not everyone who smoked became addicted to nicotine and of course, some people just didn’t like the taste of it. Some people are able to quit the first time out, many people battle that addiction all their lives. </p>
<p>I believe that the food manufacturers have figured out how to make many consumers addicted to their foods. Read former FDA commissioner David Kessler’s * The End of Overeating * for an eye opener on how the food industry has managed to come up with the perfect combination of fat, sugar and salt that leads some people to overeat in an addictive manner. Researchers are starting to discover that there are chemical changes in the brains of many overweight people. Changes that were probably triggered by the foods many of us eat on a regular basis. Some people can eat those foods and put them down without an issue - just like alcohol or recreational drugs. Other people eat the same foods and find themselves in the midst of a severe addiction.</p>
<p>It’s a very complex issue. It will be interesting to see how this is addressed by our society. We’ve hit upon a perfect storm - cheap processed foods, sedentary lifestyles due to being a mostly service industry nation, many people live in suburbs where they have to drive to get anywhere, overprotective parents who don’t want their kids playing outside all day where they might kidnapped, both parents working so that no one has time to cook from scratch. The list of factors that contribute to this issue is very long and very complex.</p>
<p>I think I am quite lucky having spent a large part of my childhood living in Africa where access to processed food was pretty limited. I’ve slipped into the overweight category from time to time, but have never had a serious problem. I feel sorry for my sister-in-law who at barely 5’-0" has to eat 1300 calories a day or less to maintain her weight.</p>
<p>Wait till you get older, Mathmom, heh heh. For the first time in my life, I am having to watch my calorie count as my clothes are getting tighter if I eat more than usual for a few days, not a problem I ever had. Apparently the old metabolism slows down. I have no desire to buy a new wardrobe and hate tight things, so I am watching what I eat now.</p>
<p>The OP should try to initiate a conversation with her daughter so that her daughter opens up about the topic. I never bring up my daughter’s weight, but if I ever mention diet, exercise or weight, she’ll often comment about herself, which then gives me license to say something. I’m always very non-judgemental and helpful, and I keep the discussion very, very light. My daughter is a bit underweight, and she really watches her weight, so I’ve always been careful to present a neutral, non-weight obsessed attitude.</p>
<p>My 25 year old niece has gained about 50 pounds since she graduated from college three years ago - she’s now about 80 pounds overweight, according to her physician. She repeatedly asks me for weight loss advice (I’m at a normal weight), and expresses an interest in eating healthy and getting more exercise, but she’s actually continuing to gain weight. Her mother is Mexican, and she was raised partially in Mexico. Most of her mom’s relatives are very overweight. She’s accustomed to traditional Mexican food - beans, white rice, cheese - everything made with lard. This is her comfort food and my impression is that it is the only food she likes. My suggestions of simply prepared vegetables, whole grains and lean protein sound like deprivation to her. I’ve tried to tell her that after a while, she’ll actually prefer the taste of fresh and healthy - Alumother’s level I foods, but I don’t think that she believes me. I worry that she’s at risk for diabetes, which runs in her family. The funny think is, she’s not beating herself up about the weight at all. She’s quite confident about her appearance and she seems to see this as strictly a health issue. I just wonder if she’ll ever be able to remove or limit this type of food in her diet.</p>
<p>OP - beyond discussions of food - both quality and portion control - I think exercise also has to be a big part of the solution. You wrote:</p>
<p>
</p>
<p>What does she do for exercise? You wrote that she will be living away from home this summer - will she have a gym membership? Would she appreciate it if you were able to arrange one for her as a gift? Or would that be offensive? Is there any physical activity that she might like to try? I’m thinking along the lines of cardio-boxing or something of that sort where maybe it would be possible for you to buy her a package of 10 classes as a gift and see if she likes it.</p>
<p>cpt, I watch what I eat very carefully and I try to exercise a minimum of three times a week. I’m well aware of the effect of aging! It helps that dh won’t eat bread, rice,pasta or potatoes so I rarely serve them. Nevertheless, I am not, and have never been worried about obesity. Even when my Dad was drinking heavily and not exercising at all, he didn’t get really obese, though he was certainly overweight. As long as I keep cookies out of my house I am fine!</p>
<p>I’ve been puzzled about what the OP should say, because I do feel that it’s okay for a mother to address it, but realize that almost anything she says may end up being unintentionally hurtful. I’d probably try to make it lighthearted and call it “the freshman 15” and offer to pay for nutritionist/programs or whatever if the daughter is interested. Make the offer once then drop it.</p>
<p>I think offering a joint exercise program might work. I know when I was young, all I had to do was start exercising and I lost the 20 pounds I’d gained at college/grad school without even trying. (Once by running 3x a week, the other time by getting a job which required biking to work.)</p>
<p>I’m just going to throw this into the mix, but is she on birth control pills? My d tried the pill a couple of years ago, and her weight just shot up. She went off it after 3 months, because the weight gain was just one of many side effects for her, and it took many months for her body to get back to normal. She then tried a lower dose pill, and immediately started gaining weight again, I’m talking 15 lbs in less than 3 weeks. She stopped taking them and is now back to normal. We joke that she is allergic to the damn things.</p>
<p>There is just so much we don’t know about obesity. This is a young woman whose father is morbidly obese and who has many relatives on the father’s side who are large people.</p>
<p>My guess is that the OP’s daughter is going to be an overweight adult no matter what she does now. I would like to harken back to one of the posts by pugmadkate about the possible damage which was done by years of yo-yo dieting. It may be that the best thing this young woman can do is try to find a natural plateau and try to stay there. Yes, eat healthy food. Yes, get physical exercise and be healthy. And try not to gain more. Ironically, repeated weight loss in genetically overweight people causes net rebound weight gain–this is a real phenomenon.</p>
<p>For people who are strongly predisposed to overweight, there is a different battle going on. There is a point where not only your quality of life, but also your health can be harmed by trying to constantly diet back down to some pre-established goal weight.</p>
<p>And yes, fat people know exactly what other people think of them.</p>
Sometimes families predisposed to overweight are also predisposed to other things, like thyroid disease in my family. I’ve already mentioned my struggles, but after all of that, my much older sister found after her own odyssey through multiple miscarriage hell that she also had thyroid disease and could have been spared much misery with appropriate medical intervention. We found out later that every person in our extended family has thyroid disease because both of my parents do (did). There seemed at the time and, to a lesser degree now, a sort of sneering thing about thyroid disease where people assumed it was a fake excuse, despite the serious complications that can arise from untreated thyroid disease. I’m glad we’re moving away from that, but I still don’t think overweight should be painted over with shame. It’s fine to be heavy and healthy, but a simple blood test can be a beneficial thing and if there are other symptoms (such as menstrual symptoms), then serious consideration should be given to making sure weight isn’t part of a larger problem. My husband is very overweight and has some health problems as a result, which he is working on with his doctor, but I have to wonder if I have unwittingly hindered his progress because I find him much more attractive heavier. Not miserable, just big and cozy. It’s a complicated matter all around. No easy answers, just love and support for our kids.</p>
<p>Do you have any of the “Eat This Not That” books? You might want to buy one and be looking at it when she is home…the books are fun and glossy and great for starting converstations about portion control and calories. The author picks outrageous examples. It’s easy to start a converstation on calories and nutrition by saying “It says here that the Bloomin’ Onion at Outback has almost as many calories as a person needs in an entire day!” You can be horrified together by how bad some of this food is.</p>
<p>Lots of people really do think that a salad at Wendy’s has fewer calories than a burger. (Chicken ceasar: 750; burger 550.) If you eat at Macaroni Grill, wouldn’t you think that you were being “good” by having the crusted sole instead of the fetucinni alfredo? (sole: 1120; alfredo: 770.)</p>
<p>My D saw the Eat This Not That guy on TV and became interested. We now have a few of his books. It’s almost a game. She has started label reading. She now knows that a flour tortilla has quite a few more calories than a corn tortilla. She knows that the low fat sour cream tastes just as good to her as the regular.</p>
<p>I’m not saying that any of this will make your D slimmer. But it may encourage her to make healthier choices, which is what is important, after all.</p>
<p>She obviously knows she is overweight, and that diet, lifestyle changes and exercise are needed.</p>
<p>How about offering to have a complete blood work-up and physical so she can see if there are any emerging concerns such as a thyroid condition or diabetes? How’s her menstrual cycle - any facial hair-- this could also be PCOS. Knowing if she has a health issue or just bad lifestyle choices can help her make a choice on whether to do something or not. Weight loss is tough when you are a sleep deprived person with little time to engage in healthy cooking.
The least she could do is portion control and aim for some amount of regular sleep.</p>
<p>Unfortunately, I concur with nearly everyone- you cannot have a conversation about her weight. But you can discuss whether she might have any health issues and offer to get her a solid physical evaluation (say goodbye to the pediatrician if you haven’t already done so-- get an adult internal medicine specialist).</p>
<p>Haven’t read all the responses, but if she is coming home for the summer how about you suggest she join you walking, biking, taking a zumba class or something like that. Get her into the exercise routine (assuming she isn’t). You don’t have to present it as something to do so she loses weight but perhaps as something your doc suggested you do and you would like company.</p>