The Root Causes Of Childhood Obesity

Most kids are not sleeping enough in this country, and that has a huge impact on their metabolism. We know that when we're sleep deprived, we're more likely to gain weight. We have higher levels of insulin. We have higher levels of insulin resistance and metabolic syndrome. Welcome to Doctor's Pharmacy.

I'm Dr. Mark Hyman. That's Pharmacy with an F-A-R-M-A-C-Y, a place for conversations that matter. and this conversation is gonna matter because we are facing an epidemic of childhood obesity. We're gonna talk deeply about what this is, how it's happening and how to fix it. And we've got none other than Dr. Elizabeth Boham, who's my colleague here at the Ultra Wellness Center on this special episode of House Call of the Doctor's Pharmacy. Liz is an incredible doc. She's a RD first, a nutritionist, exercise physiologist, and MD with a fellowship in nutrition. She is the doctor's doctor and I'm just so glad to have her as our medical director here at the UltraWellness Center. Welcome back to the Doctor's Pharmacy.

Thank you, Mark. It's great to be here.

Okay, so this is not a fun topic, but we got to discuss it, which is the fact that we have a problem of childhood obesity. We have had to rename diabetes from adult onset diabetes and juvenile diabetes to type 2 diabetes in type 1. Why? Because little kids were getting adult-onset diabetes. Kids as young as two or three are getting type two diabetes or adult-onset diabetes. One in four teenage boys, one in four teenage boys has pre-diabetes or type two diabetes. We're seeing 30 plus percent of kids in America overweight or obese. One out of three kids. Is this their fault? Because we have a view that obesity is really a personal issue. It's an issue of personal responsibility. It's either because you eat too much and you're a glutton or you're lazy, you don't exercise enough or both. But when a two-year-old has diabetes, is it really their fault?

No, I mean we know that it has so much to do with their mother's and their mother's pregnancy and how much weight she gained during pregnancy and what she ate during pregnancy. But we also know it's probably going back even more generations because of, you know, we're learning so much about epigenetics and how that influences our metabolism. So what your mom ate and her mom ate during pregnancy is influencing how your metabolism is going to work. We know that babies that are born underweight are at increased risk for obesity and insulin resistance when they're children and adults. We also know that babies that are born overweight are at increased risk for insulin resistance and obesity when they're children and then when they grow up. So there really is the optimal weight for a child to be born at and what that mother eats, and how much weight she gains and how active she is. Or I'm sure there's a lot more to it. We know there's a lot more to it, right, in terms of toxins in the environment and the microbiome. But there's just so many different angles to this that are important to be paying attention to.

The gut microbiome section, and you're talking about is very important, is that the environment in which the fetus grows, the term is a lot about programming its future risk of disease. Yes. It's risk of cancer, it's risk of heart disease, it's risk of diabetes, it's risk of obesity. And it's a lot of pressure on the mother, to be honest with you. And that's not to make people feel guilty, but it's to double down on your healthy habits when you're pregnant and your healthy diet. But it's far more than that, right? These kids are often born into a toxic nutritional landscape and they're fed foods that aren't even foods. I mean, baby food. What the heck is baby food? I mean, there's all this baby food. You think our hunter-gatherer ancestors had Gerber? I mean, what a bunch of nonsense. They had breast milk and then they ate regular food.

Oh, that just drives me crazy. When you go to a restaurant and there's a children's menu, and I remember when my kids were little and they'd be like, can I bring the children's menu? I'm like, what? Because you know, you see what's on the children's menu.

Chicken fingers. It's just crap. Fries, burgers, hot dogs, pizza. pasta, right? It's true. And you know, like, what did kids eat in Japan? They eat raw fish and seaweed. They don't have happy meals or Lunchables or Gogurts. They don't have all this junky cereals, Froot Loops and Captain Crunch and Cocoa Puffs. I mean, it's staggering what we feed our kids. I mean, we feed our kids stuff we wouldn't feed to our dog.

Right.

Think about that. Would you get your Gog cocoa puffs?

No, and it's kind of, it's crazy that people think, oh, well this is all they'll eat. This is all my child will eat. They're just, you know, or they really are picky eaters. So I wanna make sure that they're getting what they will eat. And so I get very concerned about these children's menus. It drives me crazy.

Well, you know, it's true. There were two things on the menu at my house when my kids were growing up. Take it or leave it. This was not a restaurant. There was no menu. You didn't get to, have different foods, you ate it or you didn't eat it. You know, my mother, so she didn't make her eat them, but she gave her the same exact eggs for lunch and the same exact eggs for dinner. And by dinnertime, she was hungry and she ate them. And she never think that it's important that we understand that the food environment we create for our children determines their whole life. If you're obese as a kid, your life expectancy is 13 years less than if you're not.

If you're obese at age five, if you have severe obesity at age five, you're 90% likely to have obesity when you're older and an adult. And so, you know, it's so hard, we know for so many people it's so hard to lose weight, right? I mean, I have some patients that they can't gain weight, but most people, they're struggling with gaining too much weight and trying to keep the weight off. When a child gets obese or overweight as a child, it makes it so much harder for them when they're an adult.

It kind of programs them.

It programs them, it gives them extra fat cells, it makes it very hard for them to maintain a normal weight. as an adult. Prevention is really key here. It's very important that we deal with prevention because it makes it easier for that child for their whole life if we prevent that weight gain in the first place. And it's not just the health consequences, which are staggering, right?

Increased heart disease, gallstones, fatty liver, sleep apnea, high blood pressure, asthma, sleep apnea, all kinds of orthopedic problems. Those are bad enough. But it is the worst stigma for a kid to be overweight. I mean, they've studied kids and they'd rather hang out with a kid in a wheelchair who's a quadriplegic than a kid who's overweight. That's how bad the stigma is. And we often stigmatize each other and the kids because we have this view that it's personal choice. But when you're dumped into an environment with foods that are highly addictive, that are designed to hijack your brain chemistry, hijack your hormones, hijack your metabolism, deliberately designed by food companies in taste institutes who hire craving experts to create the bliss point of food. I'm not making this up. Literally the terms they use in their internal corporate documents to create heavy users. I mean, this is just criminal in my view. It's criminal. And the food marketing to kids, I mean, the average two-year-old barely talk, but they can recognize junk food and call for it by name when they go to the grocery store and they can't even walk. that is terrifying to me. And kids can't distinguish on television or an ad between reality and fiction until they're eight years old. And there's now stealth marketing, which is terrifying because, you know, kids see thousands and thousands, maybe 10,000 commercials a year on television. But Facebook, for example, had five billion with a B, billion ads for junk food targeted at kids in one year. How do you fight that?

It's so hard. It's so hard to fight it. But it's important. I mean, when you go, when you bring your child to the doctors, what you're looking at, they look at the growth chart and they look at the BMI. And if, you know, the BMI or body mass index is not a perfect marker. I mean, there's problems with it, but it is something we use as a guide and it can give you some indication of where your child is at. So if you're greater than the 85th percentile for your child's age and sex, they're considered overweight. And greater than 95th percentile on that growth chart, you're considered obese. And now we have a category for the severe obesity, which is super obese, which is 20% over that 95th percentile. And- It's talking about BMI.

It could be more than 100%.

I know.

It's like you're 120%.

Right. And so if your BMI is greater than 35 for a child- Just to.

Put that in perspective. You know, these percentile graphs are made on population data where they look at the entire population and the whole population has to fit into 100%. Right? Zero to 100. Now they had to create a new category of 120% or more.

Yep.

Well, how does that happen? It happens because the entire population shifts into a category that never existed before. There were no kids who were that overweight unless they had some weird genetic disorder. Picky-Kate syndrome or something. I think we are really in this crisis now because we're threatening the next generation of our entire human race. And it's happening globally. It's not just here.

Absolutely. We see it's 5% of children are adolescents in the US. And for those teenage years, 7% of girls and 9% of boys are in that severe obesity category. and as you mentioned earlier, a third of children are either overweight or obese. And as we have just talked about, prevention is key here. That's just making it so much harder for them throughout their whole lives. And whatever we can do at this stage of the game with your young children, whatever you can do at this stage of the game is really critical for setting them up for success.

And it's often a lack of education, awareness, understanding. It's generational. It's food apartheid. which is this term that's been used over the last few years by people in these communities to talk about what's really going on. Because a food desert sounds like a natural phenomenon. Oh, it's a desert. It's a forest. You know, it's a river. No, it's, it's, this is much more serious. This is segregation and division of our culture in ways that lead and perpetuate to racial injustice, to structural racism and structural violence. drives these communities to continue to suffer from chronic disease and health disparities and obesity. I mean, the average African American kid drinks twice as much soda as a white kid. Not because they like it more, it's because there's just a lack of education, awareness, and there's also increased pressure of marketing in these communities. I mean, every time there's a food stamp coming out every month, then you get your food stamps for the month, the local bodegas, will actually put giant ads up for, you know, get your two-liter bottle of soda. We take EFB, electronic funds, whatever they call EFTs. And it's like, it's just unconscionable to me. And it's terrifying to me because we're really threatening the next generation of our population. And if we don't stop and take care of this now, it's terrifying. Harvey Karp, who's a friend, a physician, who was a pediatrician, said, you know, if a foreign nation we're doing to our children, we are doing, we would go to war to protect them. We would go to war. We are not doing anything to protect our kids. Nothing. We're not limiting food marketing. We're not getting rid of all these junk crap foods that they're targeted at kids. We're not fixing the school lunch program.

We're fixing the school lunch.

The school lunches are better because of Obama's Healthy Hunger Free Kids Act, but it's still not where it needs to be.

A pizza is still a vegetable. Yep. And I mean, that's a great place to start is just with the added sugar. You know, I mean, they say that the average child is consuming 270 calories a day, which is 10 to 15% of their total caloric intake on sugar-sweetened beverages. So that's 10 to 15% of calories that are nutrient devoid, no nutritional value, and are only leading to this whole problem of weight gain, insulin resistance, type two diabetes and metabolic issues throughout their whole life. You know, as we've talked in the past all about how that shifts your fertility and, I mean, there's so many aspects to it. So, I mean, that's a great place to start. And no, really, most of our kids, all our kids, very few of our kids need any sort of sports drinks at all.

Energy drinks, sports drinks, juice boxes.

Yeah.

I mean, it's terrible. One soda. increases a kid's risk of being obese by 60% one soda a day. It's crazy.

It's pretty crazy.

And it's a huge part of their caloric intake. It's up to 15% of the average kid's intake and it's something that's just so unnecessary. Hey everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. and I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter, and in it I share my favorite stuff, from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to Dr. Hyman.com/picks to sign up. That's Dr. Hyman.com/picks, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Now back to this week's episode. I was at a conference on childhood obesity and it was in Atlanta and Bernice King was there, it was really fascinating with was with, you know, one of the major universities there, Emory, I think.

And.

There was a guy, a doctor there who was a liver specialist. And I'm like, what are you doing here? He's a pediatric liver. I'm like, he said, well, you know, we're seeing enormous rates of fatty liver in kids, and we're seeing teenagers on the transplant list for livers.

All because of insulin resistance and mostly from sugar-sweetened beverages, right?

From high fructose corn syrup, which specifically targets the liver in terms of creating a fatty liver. And for those of you who really want to understand a lot about these issues, there was a movie a few years ago came out in 2014 that I starred in, well not really started, but I was in it. And it's called Fed Up. It's on Netflix and I encourage you to watch it because it really highlights the ways in which our children are so affected by this. Here's a kid who's 16 years old.

Who needs a gastric bypass. Right, right.

How does that make sense?

It doesn't make any sense. So we wanna talk about what can we do, what can you do when, you know, how can you feed your child right from the start, right? And so the first thing we always talk about is the importance of breastfeeding. You know, we know that whenever possible you wanna breastfeed your child because it decreases their risk of obesity lifelong. So, you know, that is an important thing.

There's, you really- How does that work?

So, you know, that's a great question.

I have some ideas, but I want.

To hear what your idea is. You know, there's, you're shifting, it's the composition of the breast milk, you're shifting, there's better limitations on what the baby will consume. So when they're breastfeeding, they don't consume as much as when they're bottle fed. You know, the bottle feeding, you get more milk faster through a bottle than you do through a breast. And so that actually impacts the amount of calories that the baby consumes, there's probably issues, sure, there's issues with the microbiome that gets shifted through breastfeeding that is not happening when babies are bottle-fed. There could be even what's in the bottle itself, right? So if the bottle is a hard plastic, we know, for example, BPA is impacting our metabolism and our weight.

Dr. Yeah, pre-diabetes, insulin resistance.

Dr. Yes, so there's probably so many issues with with the, with breast milk.

Yeah, and what's fascinating is when you drink formula, it actually changes the microbiome and feeds bugs that are pretty toxic and create inflammation in the body. And what's really fascinating about breast milk is that there's all these undigestible fibers and starches in there called these oligosaccharides that, you know, have no nutritional value for the baby, but they're designed completely to feed the microbiome, which is just this beautiful sort of virtuous cycle that is allowing these kids to thrive and get healthy and reduce inflammation and really get them healthy. So, not everybody can breastfeed, but it is really important. I think that's really key. What else can parents do?

You know, and avoiding those sugar-sweetened beverages, as we've mentioned, that's, you know- no.

Liquid sugar calories, period.

Period.

No juice.

No juice, no sports drinks, no soda, you know, no, I don't know, Kool-Aid or any of those. There's just no need for any of it. It's empty calories and there's no need. Every once in a while, you know, you can give a child some diluted 100% juice if you want to, but it's not necessary. It's not something they should have every day.

It's not part of their fruit and vegetable consumption.

No, it's not part of their fruit and vegetable consumption. So that's key. You know, getting your kids moving, getting them outside every day, you know, that's really important. It gets them, you know, unfortunately, it's harder to move these days unless you put it into your schedule and we need to put it into our kids' schedule. We need to make it part of their day that they get out and they move and they either they're playing a sport or they're just having fun and they, you know, they're doing lots of things. They're doing lots of finger exercises on their phone. Oh, my goodness, the phone. It's, you know, it's scrolling. It's making it so much harder for parents. It's making it so much harder for parents to help their kids grow and develop. So screen time, really the recommendations are none for kids under the age of two. And then less than two hours after that, you want to limit screens in the bedroom. There's no need for a TV, a phone, or a computer in the bedroom. So you just have the kids not have it in there. It helps with their sleep, which is another thing that's critical. most kids are not sleeping enough in this country, and that has a huge impact on their metabolism. We know that when we're sleep deprived, we're more likely to gain weight. We have higher levels of insulin, we have higher levels of insulin resistance and metabolic syndrome. So it's really important that you put restrictions on your children's sleep and wake cycle. That really is helpful. You know, our teenagers still need eight to 10 hours a night. Those six to 12 year olds need nine to 12 hours of sleep a night. And of course, you know, the one to two year olds are needing 11 to 14 hours. So, you know, as you get younger, you're needing more sleep. But even though teenagers need eight to 10 hours of night of sleep, and that's, you know, it gets harder when they get older. They wanna stay up late, they wanna be on their phone, they wanna talk to somebody, and, you know, it's really important. We know that children in the children years, if they get to sleep before 8:00 PM, they have a lower rate of obesity, they have a lower rate of weight gain, they have less, of course, sleep deprivation, they get better sleep. We know that sleep deprivation, as I mentioned, increases insulin, it increases ghrelin, which makes them hungry. Yeah, if you don't sleep enough, you're.

Hungrier and you crave more sugar and carbs.

Absolutely, and then you create- It's true for adults as well. It creates this inflammatory process in the body that even if you're eating the right right foods, you're more likely to gain weight, which I think is important to remember that even if you're eating the right foods, if you're not sleeping enough, your metabolism can be messed up. I talk to my daughter about this one all the time.

I bet. You know, the other thing I often talk about is how do you make your home a safe zone? Yes. I mean, the kid who's three years old who's gaining weight or five years old isn't saying, Hey, Dad, can I have the keys? Go to the car. I'm going to go to McDonald's or I'm going to 7-Eleven to get big gulp, but they're not doing that. How do you make your home a safe zone? I think this is so important. Yes, it's okay to have treats. If you're making cookies yourself, like make it from real ingredients. Don't, you know, eat a ton of them. You can have stuff, but if you want french fries, make them yourself. You know, like, I think there's a level of responsibility the parents have, which was also important for themselves to actually create a safe home environment for their children. People put little things in the plugs. I mean, a kid is less likely to die from electrocution than they are from the bad food that you have in your cupboard than the Froot Loops you're serving them for breakfast or the French toast or the, you know, the, the, the sweetened yogurt, which has more sugar per ounce than a can of soda.

Yeah.

So we really have to take that seriously. And in my house, you know, my My son once said, Dad, I want to invite my friends over, but there's nothing to eat in the house. And of course there was a lot to eat. It just was stuff you had to cook and make, and it was real food. I said, okay, let's go to the grocery store. I said, you can get whatever you want. Buy whatever you want. There's one condition. You have to read the label, and it can't have any trans fats or high fructose corn syrup. He's like, Dad, there's nothing to buy, nothing. And I'm like, Exactly. Like, there are grocery stores where you can buy healthier forms of snacks. There are a place like Thrive Market, you can go to thrivemarket.com and find delicious snacks that are lower in sugar, that are higher in protein, that have good fats, that don't have all the refined starches and sugars. So, you can do it, but it takes a little work and it takes a little education. And I think that's the problem is.

We really aren't taking this seriously as a society. And now your son is an amazing cook and he loves to cook and make delicious food that I've gotten the great opportunity to consume. So, I mean, I think it's, I think we have to be getting our kids into the kitchen at a young age, as, you know, even when they're, when they're two, you know, having that high chair or, you know, their bouncy seat right in the kitchen, getting them used to and around your cooking, getting them involved, having them have input, you know, really is helpful. You know, we don't wanna be just like, oh, you can't have this and you wanna have this. You want them involved in the process. It makes it a lot better. Absolutely. You know, you want them having suggestions like, Let's come up together with some healthy food that you want to have tonight. What would you like to help me cook? Can you help with preparation, peeling or cutting or mixing? That really gets them involved and they become part of the recipe and the preparation and then they love it more and then they want to eat it more.

Yeah, and you can make cool stuff that's delicious. Instead of making waffles from white flour, you can make waffles from cashews, for example. So I make cashew waffles or you make almond flour pancakes. There's substitutes and swaps that kids can still have fun and you don't have to put a ton of maple syrup, you can use fruit, you can use fruit spreads. So there's a lot of hacks. When my kids were young, we had a book called Pretend Soup, which was like 50 recipes that are fun to make with your kids, that have fun names, that are delicious to eat, that are made from real ingredients. And so I think we all have to get back in the kitchen. I think the average person in America spends more time watching cooking on television than actually cooking themselves. So, I think we have to get back into the cooking situation. It doesn't have to be that hard. We had a doctor dinner at our house the other night and you came a little bit late, but George was there and Todd was there early. And literally, nothing was ready and it was 5:15 and everybody was coming over at 5:30. And literally, dinner was ready on the table at 5:45 and we made this incredible meal. I just stuck some you know, lion's mane mushrooms in the oven. We sauteed some Chinese cabbage and garlic, which took three minutes. We put a roasted salmon in the oven for 20 minutes and roasted squash, butternut and kabocha squash and tossed some cinnamon on there.

And we just threw it all in the oven.

It was delicious. It was delicious. My favorite warm meal. But it doesn't have to be so.

Hard and it can be incredibly yummy and delicious. And I think, you know, that was delicious. Thank you. And I think what's really critical is just recognizing how important it is to.

Be.

Working right from the beginning, right when your kids are when they're born and early in life and not just sort of putting it off because it really makes a huge difference for them later on. The first case I have is this 10 year old. And, you know, for boys, it's actually a common age where they do start to gain some weight because it's before they start to grow. And so sometimes you know, a little bit of extra weight around that age may be okay, but this mom was getting concerned and he was gaining a little too much weight around his belly. And, you know, he was starting to play more on his phone and playing more games on his phone, so he was becoming less active outside. And when we got his detailed food intake, you know, we realized, and mom actually realized how much some of these processed refined carbohydrates were sneaking into his diet. Not that he had a bad diet, but they sneak in, right? He was having some pancakes for breakfast and he'd come home from school and snack on crackers and pretzels and with some juice. And he was kind of picky, he wasn't a big vegetable eater. So what was really critical and what we really focused on with him and as you know, we have a nutritionist with every patient who comes in, they see a nutritionist as well. So our nutritionist really focused on getting him cooking and getting him excited about all the different things that he could prepare and cook. And that was great for him. He started to experiment with different vegetables in the kitchen and went shopping with mom. And we encourage mom to really and dad to pull out some of the refined and processed foods at home. So they weren't even around, like you said, make it a safe zone. So he's not like, he doesn't have to, oh, okay, I'm going to not want to eat those extra cookies or the extra crackers. You don't even have to make the decision.

The food's just not there at that level. I mean, yeah, I think you can go out and stuff if you want a treat or whatever, but it's an effort. If you have to drive five miles to go get ice cream, you might not do it, right? And listen, there are many nights when I would be home, if there was a Häagen-Dazs vanilla Swiss almond or Ben & Jerry's Chunky Monkey, in the fridge, I would eat it. I would eat it. Even me who knows more than most people about nutrition and has written many, many books about it, I would eat it. So I just don't have it in the house. And my daughter, we were on vacation in Martha's Vineyard, she's like, Dad, let's go get ice cream. I'm like, okay, it's like a 20 minute drive. Do we really want to go? Okay, we'll go once and it'll be a treat and I'll do it like once or twice a summer. you know, it's fine, but it's, it's the daily inundation with the ultra processed foods, which is 60 of our calories, is killing our kids. And I, I think, you know, we really have to understand the role of the, the family. And even if you have a, you know, a weird family, you know, like a single parent or I was a single parent, you know, you can do it. And, and I, I made it a huge point to have family dinners, and I'm just amazed at how many families Don't eat together. And I was interviewing Shawn Stevenson, who grew up in a very underserved area, very food insecure, lived on food stamps. He said he can count on the fingers of one hand the number of times he sat down with his entire family for a family dinner. And it was something that I insisted on. Even when I was working hard, even when I was a single parent, had a job, just trying to do it all, it was so important to me to come home to cook with the kids, bring them in the kitchen, have them help, teach them about food. And now they're both amazing cooks. They love to make food. I didn't teach them to cook, we just did it as part of life. And it's sort of how we all grew up, learning the traditions. And now we have generations who don't know how to cook, who've never cooked a meal. We don't know how to stir fry a vegetable, who don't know how to cook an egg, who don't know how to just do the most simple things.

Other than open a package and stick it in a microwave. Yeah, and I think that's what really was great with this first case here of the 10 year old boy is that he learned a lot more about nutrition and he got involved in it. And then he was the one leading the way in terms of let's make this mom and let's add in this vegetable. And we really also focused on his sleep. At age 10, you need you know, that 10 to 12 hours of sleep a night. And a lot of times parents forget that, you know, and they don't realize they still need a lot, a lot of sleep, those kids. So that was really important. And, you know, he's doing great. He grew, he's grow, he grew, he grew. And so his, his weight is now in the normal range and he's just.

Really thriving and doing really well. That's wonderful. You know, it's not, it's not always easy and it is a struggle. I mean, I mean, I used to make my kids lunch every day and healthy lunches and bring them to school. and they would like trade with other kids. So you can only go so far, but there's a lot we can do as parents to make a difference. And there's also a lot we need to do as a society to address this at a bigger scale. In some countries like Chile, they've eliminated all food marketing to kids between 6 in the morning and 10 at night. They've put warning labels on boxes. They've taken off Tony the Tiger and all cartoon characters from any kids foods. They've not allowed any junk in schools. You know, now in our schools, they have what we call competitive foods, right?

Yep.

So competitive foods. So let's see, do you want an apple or do you want a cookie? Like, well, the kid's gonna eat a cookie, of course, right? So the whole system is terrible in our schools. The school lunches need a long way to go. You know, 50% of schools have brand name fast food companies serving food in their school cafeteria. It's Taco Bell Tuesday, it's McDonald's Monday, it's Wendy's Wednesday. I mean, it's terrible out there. And pizza hut and this and that. And 80% get funding from soda companies and their soda machines and it's really criminal. And even if the school lunch is okay, and then of course they circle the kids schools in the school districts, especially in underserved areas, with bodegas, with all kinds of crap, with fast food restaurants. I mean, think about it, you wouldn't let crack dealers stand outside the playground and be ready for when your kids come off the playground to give them some crack.

And that's exactly what we're doing with our kids. And then sports drinks, you know, a lot of times parents think, oh, my kid just played four hours of soccer today and they need a Gatorade or two. You just don't need to do that, you know. You can just give orange slices at halftime and give them water, you know. And there's electrolyte replacements if you want to use that that are, that don't have added sugar and you can just use coconut water too. There's lots of ways to avoid all that extra sugar. It's true.

We have to as parents stand, take a stand. We have to go into our schools and take a stand. But also we need bigger systemic change. And I think that's one of the things I've really focused on and with Food Fix book I wrote last, I really talked about the bigger systemic issues because we can do all we want as parents. But if their kids are seeing 5 billion ads on Facebook, if they're getting 10,000 commercials if they're targeting poor minorities, if they're using basically mind manipulation techniques to get these kids to become addicted to these foods if they're using all these cartoon characters. I mean, Disney went so far as to say, we're going to take out all this stuff from McDonald's and the food, we're not allowing that to happen anymore. There are companies that are doing it, but we need real serious policy change because 'cause our children are so threatened. And I do think we need to go to war to solve this because we are heading towards this horrible crisis. It's like COVID, right? You say, oh, there's 180,000 new cases. Okay, great. And then the hospitalizations aren't so bad. But three weeks later, the hospitals are full. It's not three weeks with obesity, but it's 10 years, 20 years later. And what's really frightening to me, Liz, is when you look at the data on how these kids do, not only are they stigmatized as kids, not only are there these social ramifications, but these kids are less likely to graduate high school. They're less likely to get a job. They're less likely to have a good career. They're less likely to earn a significant income. They're less likely to have successful relationships and marriages. And it's like, Wow, like this is unconscionable. Yeah. Like it's unconscionable.

And, you know, as we mentioned, what, you know, if you're overweight at a young age, it's just much, much, much harder to maintain a healthy weight as an adult. And so it's really important for us to deal with prevention and not just then, you know, working on, oh, we've got to get the weight down, weight down, weight down as an adult. You want to prevent it from the big start.

Yeah, I agree. I mean, I think we are in a crisis moment. And, you know, when I read that stat that one in four teenage boys has diabetes or type 2 diabetes or prediabetes, yeah. I mean, how do we live with ourselves as a nation if we let this happen to our children? Right?

Yeah.

So, I think, you know, at the ultra wellness center, we deal with all sorts of issues and I think we deal really well with obesity, really well with childhood obesity using A very comprehensive approach of medical evaluations, nutrition consultations, coaching, support. But this is a big problem and I think we all have to take this on seriously as a nation.

I agree, Mark.

Well, thanks Liz for again being a guest on the Doctor's Pharmacy. I know this has been not the most uplifting conversation, but we got to have it. We got to talk about it. We got to think about how to solve it. And I encourage people to share about this and their struggles and issues. Leave a comment, share with your friends and family. We'll see you next time on the Doctor's Pharmacy.

Thank you, Mark.