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Even if 'obese' fits, it isn't said to kids

By ASSOCIATED PRESS
Published July 3, 2006


CHICAGO - Is it okay for doctors and parents to tell children and teens they're fat?

That seems to be at the heart of a debate over whether to replace the fuzzy language favored by the U.S. government with the painful truth - telling kids if they're obese or overweight.

Labeling a child as obese might "run the risk of making them angry, making the family angry," but it addresses a serious issue head-on, said Dr. Reginald Washington, a Denver pediatrician and co-chair of an American Academy of Pediatrics obesity task force.

"There are a thousand reasons why this obesity epidemic is so out of control, and one of them is no one wants to talk about it."

The diplomatic approach adopted by the federal Centers for Disease Control and Prevention in 1998 avoids the word "obese" because of the stigma. But a proposal studied by a committee of the American Medical Association, the CDC and others would give fat children the same labels as adults: overweight or obese. Final recommendations are expected in September.

The debate illustrates how touchy the nation is about its weight problem.

Obese "sounds mean," said Trisha Leu, 17, who thinks the proposed change is a bad idea. The Wheeling, Ill., teen has lost 60 pounds since March as part of an adolescent obesity surgery study at the University of Illinois at Chicago.

"When you're young, you don't understand what obese means," Leu said. "I still don't understand it."

The CDC labels children "overweight" if their body-mass index is in the 95th percentile or higher - or greater than at least 95 percent of youngsters the same age and gender. They're "at risk for overweight" if their body-mass index is between the 85th and 94th percentiles.

But many pediatricians understand the first category to mean "obese" and the second one to mean "overweight," said Dr. William Dietz of the CDC.

About 17 percent of U.S. children are in the highest category, and almost 34 percent are in the second-highest category. That sounds impossible, but it's because the percentiles are based on growth charts from the 1960s and 1970s, when far fewer kids were too fat.

But determining excess weight in children is also tricky, partly because of rapid growth that can sometimes temporarily result in a high body-mass index.

Maria Bailey of Pompano Beach, whose 12-year-old daughter is self-consciously overweight, opposes the change: "We're already raising a generation of teenagers who have eating disorders," Bailey said. "I think it would just perpetuate that."

But Paola Fernandez Rana of Fort Lauderdale said the word "obese" should be used at some point with her 9-year-old daughter, who is 40 pounds overweight.

"In order to change the situation, she is ultimately going to need to hear it," Rana said.

[Last modified July 3, 2006, 00:01:57]


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