Obesity turning into major threat for nation's kids

When Alex was a baby, his round cheeks and chubby legs were admired by all. "You've got yourself a little football player," smiling strangers would tell his mother, Rana Hilderbrand.

As Alex grew up in a split-level home in Bothell, he grew out even more on a diet of KFC, McDonald's and chili dogs. Rana and her husband, Allen, weren't worried. It was how most busy families they knew ate, and everyone in the family, except lanky adopted son Travis, was prone to heaviness.

By the time Alex was in third grade, no one saw him as a future athlete. Too big for Little League uniforms, he had to wear a men's size XL that didn't match his team colors. In Alex's mind, the huge royal-blue pants stood out in a field of navy spandex, advertising his humiliation to all the world. So he quit and spent much of the next two years on the couch exercising control over the TV remote.

Last year, at 305 pounds in fifth grade, Alex was diagnosed with fatty-liver disease similar to what's seen in chronic alcoholics. He'd need to lose a drastic amount, the doctor warned, or face a liver transplant by age 20.

This generation is heavier

How did nearly 9 million U.S. children get this way, so overweight that their health is at risk? Nine million more are almost there. That's triple the rates of a generation ago, according to the U.S. Centers for Disease Control and Prevention.

There's a lot of finger pointing going on. Soft drinks in schools, TVs as baby-sitters, fast-food marketing, harried parents and cutbacks in physical education have all been singled out. But it's more complicated than that. These and other powerful forces have converged to form a current of empty calories and sedentary pleasures.

If families and communities don't start swimming against the tide, our overweight kids will grow to be fatter — and sicker — than today's adult population, where obesity already is epidemic. More than 60 percent of American adults are overweight or obese, and the resulting illnesses kill about 300,000 a year. The government estimates the problem costs the U.S. $117 billion annually.

Heavy kids today are already showing up with adult diseases.

"It's a horrible thing to diagnose an adolescent with a chronic disease like type 2 diabetes, put them on lifelong medications and talk to them about long-term complications like organ damage, degeneration of the retina and heart disease," says Dr. Ben Danielson, head of the Odessa Brown Children's Clinic in Seattle's Central District.

Our kids? Fat?

Washington officials await this pig in the python with dread, but the issue hasn't penetrated the public consciousness yet.

"We see and hear about all the people really into hiking and biking and think obesity doesn't apply to us," says Kyle Unland, state nutrition and activity coordinator. "But just walk around ... more than half of the people in Washington are overweight or obese."

There are no good numbers on how many Washington kids are overweight. The state mostly uses national data showing 15 percent of children and teens are overweight and 15 percent are at risk.

In its Healthy Youth Survey, last done in 2002, the state collected self-reports of heights and weights from a sampling of eighth-, 10th- and 12th-graders. Among 10th-graders, 9.5 percent were overweight, slightly less than the 10.8 percent nationwide. Too few kids in King County took the survey for public-health officials to be able to make estimates about local trends — a data gap Public Health — Seattle & King County promises to close this year.

"When a person, even a child, becomes obese, chances are they are going to stay obese," Unland says. That's why prevention is Washington's battle plan.

There's no magic pill; obesity prevention is inevitably low-tech. There's a long list of local efforts: creating trails in Moses Lake, offering incentives for school districts that improve nutrition policies, and training King County day-care providers in a fitness program.

Washington students are a bit more active than the national average and watch less TV, points out Juliet VanEenwyk, the state epidemiologist who tracks noninfectious diseases. But more 10th-graders here spend upward of two hours a day watching TV (28 percent) or drink two or more sodas a day (26 percent) than get 30 minutes of moderate exercise a day (19.5 percent), the Healthy Youth Survey showed.

Blanket advice to eat better and move more is not necessarily productive, says Adam Drewnowski, director of the nutritional-sciences program at the University of Washington and head of the UW's Center for Public Health Nutrition.

The center funds five community efforts to prevent obesity, including a summer program called Kids on the Move! that had low-income kids tend a garden, prepare recipes with the vegetables and run errands wearing pedometers.

"Preventing obesity has to be a grassroots effort," Drewnowski says. That can mean anything from parents complaining to the school board about what's in school vending machines to agreeing to stop bringing Krispy Kremes to Cub Scouts.

Parent Brenda Krusemark saw so few kids walking to school at Sacajawea Elementary in Northeast Seattle that she organized a Walk-to-School Day the past two Octobers. "Walking school buses" picked up kids in a parade with pinwheels and balloons.

Too late for prevention?

An ounce of prevention may be the preferred public-health tactic, but what about kids who already need their pound of cure?

"There's not much out there to help a child who's already obese," says Bellevue pediatrician Don Shifrin. Despite the surgeon general's call for pediatricians to be in the frontline against child obesity, many can do little but rule out metabolic disorders and provide general nutrition and exercise advice.

Most insurers won't pay for visits to a pediatrician or nutritionist if obesity is the complaint. Even Weight Watchers discourages kids from joining, because research suggests diets backfire in kids.

At the Odessa Brown clinic, Danielson often fears he's identifying a problem with no viable solution. A survey of the clinic's adolescent patients revealed about half were significantly overweight. Counseling on nutrition and recommending 60 minutes of exercise a day may be fruitless when parents don't feel safe sending kids out to play or when there's no affordable fresh produce nearby but fast food on every corner.

That's why former UW football player and fitness evangelist Willie Austin chose the Central District for his ministry.

"Most inner-city kids never get a chance to fully understand a healthy, fit lifestyle," says Austin, whose nonprofit Austin Foundation seeks to turn that around.

He teaches a free Youth & Fitness program three times a year — the next six-week session is set to start Feb. 14 — for kids referred by the Odessa Brown clinic. He teaches a variety of fitness regimens — martial arts, swimming, yoga and taekwondo — and offers nutrition advice to families.

Austin and his volunteer trainers also host daily workout sessions in the Garfield Teen Life Center?s weight room.

De'Ahja Johnson, 10, is there because, "My weight — it just offends me."

The fourth-grader, who weighs 200 pounds but is so cute you just want to pick her up anyway, has been working out after school with Austin since December, when her doctor said she needed to lose at least 20 pounds by the summer because she's at risk for diabetes.

Her mom, Analisa Mitchell, says De'Ahja has always been active; her appetite's the problem. McDonald's meals were just a snack since she was 5. And with two doting grandmas helping to care for her, treats were abundant.

Family approach

"If someone has an overweight child, they can't wait for the world to change," says Dr. Laura Richardson, an adolescent-medicine specialist at Children's Hospital & Regional Medical Center. "They need to draw on what resources they can find in the community, but the solution has to be family-based."

Since Alex Hilderbrand's diagnosis with liver disease, his family members have formed a united front to help him, and themselves, turn the tide.

His mother, Rana, swept junk food out of the pantry. She hurries home from work to serve baked orange roughy instead of fast food for dinner. Andrea, 14, gave up soda. Travis, 16, plays hoops with Alex instead of watching TV.

And Alex's dad, Allen, is working overtime so the family can afford to send Alex to the Committed to Kids weight-loss program, which has cost them $8,600 for three 12-week sessions.

After school, Alex goes to the swank Bellevue Pro Sports Club, where the program is based, for workouts, from weight-lifting to games like speedball, a hybrid of basketball, soccer and rugby that leaves Alex winded but smiling. The whole family gets nutritional and behavioral counseling and access to the gym. So far, the family has lost a total of 200 pounds.

At 5-foot-10 and 245 pounds, Alex is still a ways from a healthy weight for a 12-year-old, but for the first time in years he's back in action and in an athletic uniform — as No. 34 on the sixth-grade basketball team, the Rockets.

Julia Sommerfeld: 206-464-2708 or jsommerfeld@seattletimes.com