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Fat Chance

Aired May 4, 2002 - 20:00   ET



ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): My, oh my, oh my! The fat, the grease, the calories, the downright lard of it all! Every where you look, every where you go, food screaming at us, yelling at us -- "Take me, take me! Eat me, eat me! Now!" Is it any wonder that one in four Americans are obese and another one-third of us are overweight?

DR. JIM HILL, DIRECTOR, CENTER FOR HUMAN NUTRITION, UNIVERSITY OF COLORADO: Age by age, group by group, everybody is gaining weight.

DR. RUDOLPH LEIBEL, COLUMBIA UNIVERSITY: This epidemic has swept the country.

HILL: It's very scary to think about what's going to happen if we don't start changing things quickly.

COHEN: Scary because the fatter you are, the more likely you'll get heart disease, diabetes and a whole host of other diseases.

LEIBEL: Obesity accounts for about 300,000 deaths per year.

COHEN: There is a group of people who have lost lots of weight and kept it off for years.

KAREN BROWN, SUCCESSFUL DIETER: I looked like a completely different person. People treat me so differently.

COHEN (on-camera): So many people have failed. What is your secret?


AARON BROWN, HOST: Welcome to CNN PRESENTS. I'm Aaron Brown. Well, we've all seen the ads, "Lose 10 pounds in 10 days. Burn fat while you sleep." Quick fixes and sure fire remedies for a nation obsessed with losing weight, a nation obsessed with rarely successful. Obesity is now epidemic in the country and many, many people are frustrated, caught up in this endless cycle of diets and failures. But it's not a no win situation. It is possible to lose weight and to keep it off. The methods are proven as CNN's Elizabeth Cohen explains in our documentary, "Fat Chance."


COHEN: The struggle to stay fit is the decades old battle. Driven to find solutions, people have put their bodies through all sorts of strange contortions, trying one new fangled diet after another, most of which ends in failure because we're unable to do the simplest thing of all -- put down the fork.

(on-camera): Well, why can't we put down the fork? We posed that question to an array of experts and they said, "The answer is very simple. Just go ask a caveman." So we found these prehistoric people and indeed the answer became very clear. They never had to worry a single moment of their lives about getting fat. They never thought at all about dieting. In fact, when they found an animal, their instinct said, "Eat up the entire thing" because back then; there weren't restaurants on every corner. They never knew where their next meal was coming from.

HILL: Our problem was -- in obesity; our problem was starving to death.

COHEN: We descended from cavemen. We have the same jeans, the same biological instincts.

HILL: All of our physiology is geared up to eat when food's available. That's work for most of our history. The problem is it's not working now.

COHEN: Biology gives us another kick in the pants when we try to diet. Our caveman jeans say, "Whoa, you might need that fat in case of a famine. Let's hold onto it."

LEIBEL: You're exactly like David against the Goliath of evolution.

COHEN: Dr. Rudolph Leibel at the New York Obesity Research Center at Columbia University.

LEIBEL: The body chronically detects that you were at a lower body weight and tries to make adjustments that cause you to regain the weight.

COHEN: And that helps explain why 95 percent of people who lose weight gain it back again. And here's another reason it's hard for us to lose weight and keep it off -- life is so much easier for us than it was for cavemen.

HILL: You have to go out and kill the wildebeest and prepare it and you know, it was -- it required a lot of physical activity to get through the day.

COHEN (on-camera): But to get through my day requires almost no physical activity at all. I'm a sloth basically. Like most Americans, I go everywhere in my car. In fact, I can do most of my errands without even getting out.

OK, thank you. UNIDENTIFIED FEMALE: Thank you.

COHEN: After I run my errands, I drive to work and then when I get to work, I could take the stairs of the escalator, but I have to admit, I usually take the escalator. And then when I get to my desk, what do I do, well, I just sit here hour after hour, sometimes all day long. I'm embarrassed to admit it, but sometimes when I want to talk to someone just two doors down, I e-mail then rather than get up.

(voice-over): And then on my way home from work, I stop for dinner.

(on-camera): Now, we have here a quarter pounder with cheese, large fries, large Coca-Cola and an ice cream for desert. And this food that you're looking at right here, that's as many calories as I'm supposed to have in an entire day and I'm having it in one meal.

(voice-over): Look at all these modern conveniences that are keeping us lazy and fat, even a contraption that does the walking for you. Is it any wonder that obesity among American adults has nearly doubled since 1980?

HILL: The epidemic of obesity is a byproduct of our success as a society.

COHEN: In fact, modern society has gotten us to the point where even when we want to be active, we can't.

(on-camera): I'd love to walk to the stores near my house, but I can't because between my house and the stores, there's an eight-lane highway and the bridge over it has no sidewalks.

(voice-over): This isn't just a problem where I live in the suburb of Atlanta. Across the country in Denver, Professor James Hill, an obesity expert pointed out the same thing.

HILL: So one of the problems is in a lot of neighborhoods like this one, see, there aren't sidewalks and there's a little thing here beside the road, but would you let your kids walk to school here...

COHEN (on-camera): No! I feel like...

HILL: ... along really...

COHEN: ... I'm taking my life in my hands.

HILL: Two lanes of traffic.

COHEN (voice-over): So now that we've given you all this bad news, our biological tendency to eat, eat, eat, a society that helps keep us lazy, how in the world does anyone ever lose weight?

Successful weight loss in this country is so unusual that Professor Hill keeps a list of people who've managed to do it. We asked two of his success stories, Karen Brown and Robert Romaniello, to tell us how they do it. Considering that six in 10 Americans are overweight or obese, we figured they had some lessons to teach us. Karen Brown used to weigh 194 pounds.

BROWN: I would sit and eat a pound and a forth of Oreos, which is the entire package, and a gallon of chocolate milk in one sitting.

COHEN: Then six years ago, she slimmed down to 124 pounds and she's been there ever since.

ROBERT ROMANIELLO, SUCCESSFUL DIETER: There's enough for another half of me in here.

COHEN: Robert Romaniello used to weigh 218 pounds.

ROMANIELLO: I was a junk food junkie. I was a couch potato. I lived on tacos and at quick food places and did no exercises at all.

COHEN: Then five years ago, he lost 60 pounds.

HILL: What distinguishes the people in the registry is not necessarily how they lost the weight, but how they're maintaining it.

COHEN: There are 3,000 people like Robert and Karen in Professor Hill's group and they tend to have seven things in common, seven things they did to lose weight and keep it off. We'll tell you what they are when "Fat Chance" returns.




BROWN: Want me to get in them? It's really funny.


COHEN (voice-over): It's hard to believe that Karen Brown used to weigh nearly 200 pounds.

(on-camera): Think back to your old eating habits.


COHEN: What would be a typical meal?

BROWN: A chili cheeseburger, a chili hot dog, a chili dog with cheese and onions, Oreos. Those were my downfall.

Hold your head back for me.

COHEN (voice-over): Karen, who's 36, says she wasn't always heavy. The weight crept up on her slowly after she got married, then had four children in seven years. Getting so big, she kept bumping into the walls of her little cubicle at the hair salon where she works.

BROWN: I don't know, bruises. I was like why would I bruise here, but oh, I was working today.

COHEN: But Karen says that having children wasn't the only reason she gained so much weight.

(on-camera): Eating is so emotional, isn't it?

BROWN: It is. We were uprooted several times. We moved 11 times in seven years. When you move, you know, you loose friends and you know, sometimes food is your friend.

COHEN (voice-over): And then, the loneliness got worse. She and her family settled in Denver, but her husband, Randy's, new job kept him away from home for weeks at a time.

BROWN: I just stopped caring, I think. I didn't look in the mirror a lot. I had mirrors that from here up. I didn't realize how heavy that I gotten. And I got on the scale and was like, this thing's broken, you know. And it's like, no, it's not.

COHEN: And so, Karen did well, what so many of us do when we want to loose weight -- she put her faith in fade diets desperately hoping for magic each time.

BROWN: The Atkins diet, the Beverly Hills diet, the waitress diet, the airline stewardess diet, the cabbage soup diet. That was really yucky.

COHEN (on-camera): And you lost weight on these diets.

BROWN: I did. I did, but they didn't stay. It didn't last. I would lose, you know, five, 10 pounds over the course of maybe, you know, six weeks and I put it right back on in 10 days.

COHEN (voice-over): Professor James Hill says almost all dieters succeed at losing weight, but only five percent actually keep it off.

(on-camera): I mean as a country we're pretty good at losing weight.

HILL: Oh, absolutely. If losing weight is the goal, we're great. If maintaining is the goal, we're not so good.

COHEN (voice-over): And the reason for that, experts say, is simple -- fad diets often require you to stop eating your favorite foods. While people can do that for a few weeks or months, eventually they get frustrated, drop their diet and revert to their old ways.

HILL: There are a lot of people who tell you what you to eat. Just follow this diet, it's easy. You just do this. It's easy. I think the answer is that it isn't easy.

COHEN: In 1994, Professor Hill and a colleague started the National Weight Control Registry. It's a list of elite gold-medal dieters. Who's in this registry?

HILL: The requirements are that you must have maintained at least a 30-pound weight loss for at least a year.

COHEN: The average member has done much more than that, maintaining a weight loss of 67 pounds for five-and-a-half years. Some 3,000 people have sent in documentation that they've lost the weight and kept it off.

And after studying Karen and the others in the registry, Hill and his colleagues have come up with a list of seven keys to losing weight and keeping it off, seven tips for the rest of us. Tip number one, expect failure, but keep trying.

HILL: Most of these people, over 90 percent, have told us that they failed many times before they finally succeeded.

COHEN: In fact, Karen tried for about nine years to lose weight. It took all that time for her to be able to walk past the ice cream section without stopping.

BROWN: I think I had tears in my eyes, having putting it back in the refrigerator like, oh, I got to put that back.

COHEN: Eventually, Karen, who's five-foot-three, lost 70 pounds. She doesn't starve herself as we saw one day when we caught up with her having lunch, having her fill of chicken and rice and salsa.

BROWN: No, I don't deprive. I eat a little bit of everything. Everything in moderation.

COHEN: Karen says she lets her body be her guide. At lunch, because she was hungry, she eat plenty. But then, the next morning, Karen had only a no fat muffin, an egg, juice and vitamins. And she didn't even finish the muffin.

(on-camera): You're throwing away half a muffin.

BROWN: I know. I know. But I don't want to eat the whole thing. I don't -- I don't want to get full. I go for satisfaction. I go for being content.

COHEN (voice-over): It's not that she's a saint. And that brings us to tip number two, don't deny yourself.

BROWN: I can't say I don't have cravings because I wouldn't be human if I didn't. But I feed them. I will give myself a ton.

COHEN: Karen and the other members of the registry eat out at restaurants just like everyone else. They indulge in fattening foods from time to time.

(on-camera): I'm going to take a look at your goodie drawer down here.

BROWN: My goodie drawer, yes.

COHEN: Oh, fudge covered ice cream cones, tacos, popcorn with lots of butter. (voice-over): Robert Romaniello is the same way.

ROMANIELLO: And in the secret cupboard here...

COHEN: He's in the Weight Control Registry because he's kept his 60 pounds off for about four years. When Robert weighed 218 pounds, he lived on foods like tacos, steak and chocolate.

ROMANIELLO: One of my favorites here is the fudge dipped chocolate chip. It's very -- it's very high in fat.

COHEN: And believe it or not, he still does eat chocolate and ice cream.

ROMANIELLO: I let my taste buds saturate with ice cream and I'm happy. I'm satisfied. I don't need to feel full of ice cream.

COHEN: So let's take a look at what else is in his frig.

ROMANIELLO: Yogurts, prunes, cantaloupes, cottage cheese, fruits and vegetables and of course, we have the eggs and we have some meat and we have some -- I think in that one is a pasta dish, light mayo, low fat mayo, Miracle Whip Light, skim milk, salad dressings, but most of them are either fat free or low fat. We've got frozen vegetables here and we do have some chicken steaks here, vegetarian burgers, an excellent source of high protein, low fat, very low fat. We have chicken patties, Pinto beans, black eyed peas, Great Northern beans, navy beans, red beans. I'm a bean freak, I think, beanoholic, bean addict.

COHEN: So how is it that some people like Robert and Karen are able to make that switch from junk food junkie to eating healthy? And how did they make the switch last for years? Why can they eat two bites of ice cream and stop while the rest of us would devour the whole bowl? Doctors say there's no simple answer, but when we ask Karen and Robert, they had a few ideas. One, they both said they had a moment where they got really scared about their weight.

(on-camera): If we take you back to that time...


COHEN: You had four children in seven years.


COHEN: You weighed 194 pounds.


COHEN: And what was the moment that you said, "This has to change."

BROWN: To realize that my mother had three heart attacks at my age. My father, my brother, obese their whole lives. Now, my father has Type II diabetes, high blood pressure. My mother has high blood pressure. My sister, a lot of medical problems and I was heading towards that way.

ROMANIELLO: In 1997, when I was 46 years old, I looked in the mirror and I had an epiphany. I saw my father staring at me and I thought, you know, I love my father, but I don't want to live in his body. And so, I thought I'm going to have to do something about this.

My father died with heart problems as an obese 72-year-old. I knew that if I had -- if I let it go, that I was next in line for a heart attack or even worse. It's the death.

COHEN (voice-over): Experts are still untangling the mystery of human genetics. But they know this much is true, to some extent, your genes predetermine your body size.

LEIBEL: Not more than a couple of weeks or a month goes by that somebody doesn't find another gene that may play a role. And what we are trying to do now -- at least part of what we're trying to do is to assess the role of these various genes in individual human beings.

COHEN: For Karen and Robert, their family's genetics were a wake-up call to ask themselves why they ate so much. One answer for both of them, food had become an emotional crutch.

ROMANIELLO: I know for a fact that when I was eating the wrong way, I was eating just to make myself happy.

COHEN: Karen agrees, saying she no longer uses food as a friend in times of loneliness.

BROWN: Being able to feel good about who I am, that's the success in this.

COHEN: She still keeps her mementos from her old life.

BROWN: These are so ugly. But I keep them just for motivation, just for -- just going -- I put them on and I feel, you know.

COHEN: A reminder of her old life so different from the one she has now. And when "Fat Chance" continues, we'll tell you how Karen and Robert went from being coach potatoes to doing this.


ROMANIELLO: I mean I ran 50 yards. I ran a 100 yards and then, ran a quarter a mile, then a half mile, and slowly but surely got up to the five K's, 10 K's until I was doing marathon.




ROMANIELLO: I had a double chin. I had the middle-aged jowl. I had the stomach that was hanging over the belt.

COHEN (voice-over): Robert remembers back when he weighed 218 pounds.

ROMANIELLO: I'd bend over to tie my shoelaces or put on my shows and I'd had a hard time because the gut was in the way.

COHEN: But not anymore. How did Robert go from weighing 218 pounds to a 160 pounds? Well, that brings us to tip number three, weigh yourself often.

ROMANIELLO: When I first went on this regiment, I decided to track my progress. I found a GNC in a strip mall that had tapes that actually showed how much you weighed.

COHEN (on-camera): And you saved the little slips here.

ROMANIELLO: This is my badge of honor. On the second of September, I was 208.12, 207.5. You can see them just coming off -- 177.15. Here's 177.4, less than a pound.

COHEN: So you were at August 25, 1997 to December 29, 1997, 211 pounds to 176 pounds.


COHEN (voice-over): Robert then lost another 19 pounds over the next two months.

ROMANIELLO: This was my (UNINTELLIGIBLE). This was my motivation, to actually have instant gratification, an instant record of exactly what was happening.

COHEN: But of course, the constant weighing wasn't the only thing that helped Robert lose weight and that leads us to the fourth hint -- nine out of 10 people on the registry do serious amounts of planned exercise, about an hour per day. They can't lose weight and keep it off by dieting alone.

Robert runs 25 to 30 miles a week. And he does lots of sit-ups and push-ups.

ROMANIELLO: I'm not super, but you know, not bad for a 50-year- old guy, almost 51, especially considering the fact that I used to be fat and flabby.

COHEN: Robert's advice to people who feel they're still fat and flabby -- take it slow and don't give up hope. When he started to lose weight, he could do only five push-ups at a time. Five years later, he can do 80.

ROMANIELLO: I think that's about it.

COHEN: When Robert started out running, he didn't get very far.

ROMANIELLO: I mean I ran 50 yards. I ran a 100 yards and then ran a quarter mile and then, a half-mile and slowly but surely got up to a five K's, 10 K's until I was doing marathons. But that took about three or four years to develop. COHEN: The same thing for Karen Brown. Back when she weighed nearly 200 pounds...

BROWN: Oh, I had a cramp in my arm; you know, from drinking and my thumb, the remote.

COHEN (on-camera): So you would really exercise, getting the fork to the plate to your mouth?

BROWN: Yes, and my vocal cords. Will you get that for me?

COHEN (voice-over): Then, starting out slowly, over the course of many years, she got to the point where now she runs every day and does weight training every other and runs after her four children and teaches 10 aerobics classes a week.

(on-camera): Karen, I'm exhausted just watching you. And this isn't enough for you, right?

BROWN: Oh no.

COHEN: You're going to go work out again?

BROWN: I am.

COHEN (voice-over): Now, wait a minute. Karen Brown may be a poster child for weight loss, but frankly, I can't picture myself doing 10 aerobics classes a week. So we asked Professor Hill for advice.

HILL: If you enjoy the things Karen and Robert do, great! If you don't, all you have to do is walk a little more.

COHEN: He says one in four registry participants has choose brisk walking as their form of scheduled exercise. But planned workouts are not enough. This brings us to tip number five -- most of the registry participants find ways to add little bits of physical activity into their daily routines.

HILL: So did you guys get the data back from the weight...

COHEN: Professor Hill does that himself.

HILL: It's amazing how many meetings you can have where you would ordinarily come in and two or three people sit in your office and you say, "Hey, it's a nice day. Let's go walk around the block while we talk." And in fact, people often find those are more productive meetings.

COHEN (on-camera): Remember how I told you that at work, I tend to get lazy and take the escalator instead of the stairs? Well, Professor Hill calculates that instead, if I took the stairs every workday for a whole year, I'd keep off three pounds of weight. Well, three pounds might not sound like much, but that's just one small change in my daily routine. What if I also started parking at the far end of the parking lot at work. Professor Hill says with enough changes like that, I could really start to make a difference.

HILL: Think about it, five minutes here, five minutes here, five minutes here, little things that don't seem very much, can, in fact, add up.

COHEN: If you hate the thought of any exercise, perhaps these mice will be your salvation.

UNIDENTIFIED MALE: Well, it is the couch potato pill, that you can sit and have your potato chips and watch the TV.


COHEN: When "Fat Chance" returns, we'll explain how scientists are using these mice to develop the ultimate diet pill.


CALLAWAY: Hello everyone, I'm Catherine Callaway at the CNN Center in Atlanta. "CNN PRESENTS" will continue in a moment, but first, the latest headlines.

Nebraska's governor said today, "Whoever left bombs inside mailboxes definitely has captured the attention of authorities." After a preliminary investigation, FBI agents say those bombs are similar to eight others that were found in Illinois and Iowa yesterday. Those bombs injured six people.

A nine-alarm fire at the Charlestown Navy Yard in Boston is now under control. Firefighters, however, say that they will be dousing flames throughout the night. Two hundred firefighters and 40 engines raced to the scene there when fire broke out in the vacant old rope block building. The Navy Yard along Boston Harbor is home to the USS Constitution.

At least 105 people were killed when a Nigerian airliner crashed into a crowded neighborhood. The fiery crash burned 10 homes, two mosques, and one school, killing 31 people on the ground. Two of the 76 people onboard somehow survived and one of them, Najib Ibrahim talked about what happened.


NAJIB IBRAHIM, PLANE CRASH SURVIVOR: We were about to take off, but then, we start hearing some noise coming down from the plane. And it started coming -- by then, we had taken off, so it started coming down from -- we almost got -- we found ourself in one of the (UNINTELLIGIBLE). So I look at myself. I surrounded by fire all over the places. So I was lucky because I was sitting next to the exit door. That's how I found my way outside.


CALLAWAY: As you just heard Ibrahim say, he believes that he made it out alive because he was sitting in an exit seat.

In Bethlehem today, bloodshed and negotiations. Israeli military sources say that soldiers shot and killed an armed gunman who came out of the Church of the Nativity. Dozens of Palestinians wanted by Israel have been holed up there for weeks now. Talks in the standoff are now said to involve Yasser Arafat.

That's the headlines. I'm Catherine Callaway. And now, "CNN PRESENTS."


COHEN (voice-over): When you walk into a bookstore, all the diet books claim to have the answer to winning the war against fat, but they contradict each other. This one says eat lots of protein and fat, but this one claims the low fat, high carbohydrate diet is the answer. This one says go ahead, eat junk, but this one, makes you count every calorie. So which one's right? The answer, according to a federal government study, is all of them.

HILL: You go out and you pick your favorite diet book and you follow it and you lose the weight. The problem is most people regain it.

COHEN: The government study found one type of diet is best to keeping the weight off and it's the low fat, high carbohydrate diet, which is what most of the National Weight Control Registry participants have found and that's their tip number six -- eat a high carbohydrate, low fat diet.

After trying all sorts of diets, that's what Robert Romaniello settled on. The day we were with him, he had, among other things, oatmeal for breakfast, tuna with low fat mayo and vegetarian chili for dinner.

And there's one other thing about these successful dieters, something you might find kind of surprising. It's tip number seven; they eat, on average, about five meals a day starting with breakfast.

Karen Brown says instead of devouring three big meals, she eats little bits of food throughout the day.

BROWN: I'm a grazer. I really take everything a little bit and I'm OK with it.

COHEN (on-camera): Is it easier to burn your calories if you spread them out throughout the day?

HILL: Well, the information on that is a bit controversial. So at this point, I don't think we can say that. I think it's more likely that by spreading them out over the day, what you're avoiding doing is overeating at any given situation.

COHEN (voice-over): In other words, perhaps, you're less likely to super size it if your stomach is always at least partly full. So there we have it. The seven habits of highly effective dieters. One, keep trying, two, don't deny yourself, three, weigh yourself often, four, exercise an hour a day, five, get other bits of physical activity, six, eat a low fat, high carb diet, and seven, eat five meals a day. That's what's worked for these two and for thousands like them.

BROWN: Fifteen.

COHEN: But it's not the path to success for everybody because it's hard to do all seven of these things all the time. Experts tell us Robert and Karen are highly unusual in their ability to maintain their routine. If you don't have their incredible discipline, don't despair because soon, there may be another way, a Plan B -- drugs.

HINSFIELD: I think there are some people in the long run who will only respond to drugs.

COHEN: Dr. Steven Hinsfield (ph) is the leading authority on obesity. And while he's all for telling people to change their ways and be like Karen and Robert, he says, in his experience, it usually fails perhaps because of emotional issues or lifestyle or something a person can't even control, his or her genes.

(on-camera): How might your genes make you eat too much or might they make you overweight?

UNIDENTIFIED MALE: Well, there are genes that regulate our food intake and if certain of those genes are abnormal, genetically abnormality, then, they might allow us to overeat without stopping us, like not having breaks on a car.

COHEN: They're supposed to feel full after a hamburger, fries and desert and they just don't?

UNIDENTIFIED MALE: Yes, there are some people who don't ever really completely feel full.

COHEN (voice-over): This fat mouse is proof because of one mutated gene, he eats too much and stores up more calories as fat. That's why he weighs three to four times as much as the normal mouse next to him.

LEIBEL: You don't have to be a mouse doctor to understand that, right? Right. This shows you very, very clearly that there are genes on this planet that have very profound effects on body weight. And in fact, some human examples of this have been discovered as well.

COHEN: Scientists haven't figured out a way to alter human obesity genes yet, but they've done it in mice. Dr. Salwy Aquel (ph), a biochemist at Baylor College of Medicine, genetically altered a mouse and put it with a normal mouse.

UNIDENTIFIED MALE: When we put them next to each other and have them eat to their heart content, with the food that put in the cage.

COHEN: The genetically altered mouse ate 30 percent more than the normal mouse, yet, weighed 15 percent less. That's because Dr. Aquel (ph) altered a gene causing it to burn calories at a higher rate. He hopes to develop a drug to do the same thing for people.

UNIDENTIFIED MALE: Well, it is the couch potato pill, that you can sit and have your potato chips and watch the TV.

LEIBEL: I think in terms of drugs that will be very, very effective, based on better understanding of the genetics and physiology, those may be five to 10 years off in terms of availability.


COHEN: When we come back...


BROWN: It was because of his weight. He was being persecuted and ridiculed and harassed.


COHEN: Karen Brown's new battle, helping her son fight the family genes.


BROWN: They watch us. They watch what we do. I learn my eating habits, unfortunately, from my father. And I got the same result.




COHEN (voice-over): When Karen Brown lost 70 pounds and kept it off, she was on top of the world. She felt like she finally conquered her weight problem. What she didn't know was that waiting for her, just around the corner, was another problem. Continuing in her family's pattern, Karen's son, Jamie was gaining too much weight.

BROWN: He's just a love. And he's got the kindest heart and to see other children just -- this is hard -- for other people to pick on him about his weight, I just -- it breaks my heart. Sorry.

COHEN (on-camera): Then there was an incident recently in the neighborhood.

BROWN: Yeah, there was. Kids pretty much ganged up on him, were ridiculing him and badgering him about his weight, that he was so fat that he couldn't climb this tree, break all the branches.

COHEN (voice-over): Unfortunately, more and more kids are experiencing the same problem. LEANN BIRCH, PROFESSOR, PENNSYLVANIA STATE UNIVERSITY: The prevalence of obesity has doubled in children in the last 20 years or so, which is really very, very dramatic.

COHEN: And it's nearly tripled in adolescence. And the health consequences are devastating. Type II diabetes, the kind brought on by obesity, the kind once found only in adults, is now becoming more and more common in children.

DR. WILLIAM DIETZ, CENTERS FOR DISEASE CONTROL: That's a new phenomenon. We haven't seen that before. And it's -- I think it emphasizes just how concerned we ought to be about the epidemic of childhood obesity.

COHEN: And once a child is obese, chances are he or she will stay that way for life.

BIRCH: If you're overweight as a 10-year-old, you are quite likely to be overweight as an adult.

DIETZ: By the time you're an adolescent, the risk is about 70 or 80 percent that that individual -- that that overweight individual will become an overweight adult.

COHEN: Many people see overweight kids and believe they must have a slower metabolism than thin kids. But research like this dispels that myth.

LEIBEL: If you look at the metabolism of an obese person and a lean person, when they're at, what we refer to, as usual or normal body weight, they're indistinguishable if you correct for the fact that the obese person has more tissue in their body, as a larger individual. They are metabolically virtually identical.

COHEN (on-camera): So then if it's not metabolism, why are some children heavy while others are lean? Experts tell us it's a mixture of the child's own genes and the world around him. It's interesting that babies and little children who aren't so exposed to the outside world usually have no problem just saying no to too much food.

JOANNE IKEDA, UNIVERSITY OF CALIFORNIA, BERKELEY: You know, babies are born with the ability to self-regulate food intake. They will drink breast milk or formula until they're full and then, they spit the nipple out.

BIRCH: Younger children, three-year-olds, still seem to be very tuned in to what their stomach is telling them.

COHEN: But at some point, around the time kids start school, they stop listening to their stomachs and they start listening to the world around them. And the world around them says, "Eat, eat, eat."

IKEDA: The halls in schools are lined with soft drink vending machines. There's no quality physical education in the schools anymore. COHEN: And then, when kids get home from school, what do they do? They watch TV. In fact, the average child watches four to five hours of television each day.

DIETZ: Well, historically, about 40 percent of the ads on television shows directed at children have been commercials that promote foods. Those foods tend to be high in calories. The more television a child watches, the more likely they are to eat the foods advertised on television.

COHEN: And again, there are fewer opportunities to burn off those calories. For example, only a third of all children who live within a mile of school actually walk to school, partly because so many neighborhoods are without sidewalks.

So what can parents do about all of this? One thing that's tempting is to tell kids they can't eat yummy foods like burgers and candy. But that's exactly what you should not do, according to Leann Birch, a psychologist who studied the issue of children and eating for 25 years.

BIRCH: What seems to happen is that if kids are restricted -- if foods, for example, are in the home but not made available to kids, that they become much more interested in those foods. When they do have the opportunity, they'll eat those foods in larger quantities than if they hadn't been restricted.

COHEN: Instead, she says, emphasize to kids what they should do rather than what they shouldn't -- eat healthy foods, get lots of exercise and set a good example for your kids. That's what Karen Brown tries to do with her son.

BROWN: Just to be active and to be healthy and to eat right and teaching good eating habits. Right now, he's almost down 20 pounds. And so, he's -- it's exciting, it's -- to see what he's doing. He's really doing good. He's really sticking to our program.

COHEN: She's trying to end several generations of obesity.

BROWN: I really do think we're teaching him some pretty good skills that he can carry over into being an adult whereas, with me, where I carried over to being an adult was my father's eating habits.


COHEN: When we come back, a very different story about a lifelong struggle with weight.


LYNN MCAFEE, LIFELONG DIETER: Oh, I started my first diet when I was three weeks old. When I was six or seven, I started on diet pills.




COHEN (voice-over): Karen Brown is unusual, so too is Robert Romaniello. They've overcome their genetics and their environment.

BIRCH: I mean I'd say they're a bit weird in that they're able to maintain, on a long-term basis, these changes that they've made and their food intake patterns and their activity patterns.

COHEN: Much more common are dieting failures.

MCAFEE: Oh, I started my first diet when I was three weeks old. When I was six or seven, I started on diet pills. I was nine years old when I tried to kill myself because I went to a doctor and he gave me a lecture. "You're going to die anyway before you're 30. You're disgusting. You're revolting. No one will ever want you."

COHEN: Lynn McAfee says that from the time she was a baby, doctors have said, "Diet now or you're a walking time bomb."

(on-camera): What do you think when you walk into a bookstore and you see that section with all those diet books, one after another, that say they have the answer?

MCAFEE: I remember buying those books. You know, it's not like I never bought those books. It's not I never read them. It's not like I never tried that. It all makes sense except that it doesn't work.

COHEN (voice-over): Lynn kept gaining weight until eventually she decided to stop dieting, to take the emphasis off food and onto as being as active as possible.

UNIDENTIFIED FEMALE: Are you still doing these at home?

MCAFEE: Yeah. I love it so much. We think of fitness as very tough. You know, it's like the triathletes. You know, the people who are, you know, doing all the 8,000,000 reps, the people who are really strong. And that's not what it's about. You know, I think more about active, being active at any size.

IKEDA: I really admire her for being determined enough to be physically active.

COHEN: Nutritionist Joanne Ikeda and Lynn McAfee are involved in the Fit But Fat Movement that says be as active as you can, eat as healthfully as you can, but don't go on a diet because chances are it won't work.

IKEDA: I think Lynn is fairly typical in that she has dieted numerous times. She was put on diets on a child. She's lost and regained hundreds of pounds and she has ended up at a very high weight.

COHEN: Ikeda is studying Lynn McAfee and more than a hundred other woman who weigh over 250 pounds.

IKEDA: Fifty percent of them have dieting more than 20 times. Two-thirds of them were put on a diet before they were 13 years of age. Did dieting help them? No, it didn't.

COHEN (on-camera): If you were at the CDC and you saw these obesity rates climbing every year, every year, would you say, you know what, let's just forget about this; let's forget about fighting this? Or would you say, you know what, we do have to do something about the fact that Americans are getting heavier?

MCAFEE: It is serious that the population is getting fatter. Absolutely, it's serious that diabetes is increasing. Absolutely, that's the number one killer of fat people. But you can't just yell at us louder. That's not working. Clearly, that's not working. It's been 40 years that there has been study after study after study that shows spectacular failure rates of dieting. Forty years of people getting fatter and fatter and fatter.

COHEN (voice-over): We asked someone who succeeded -- how can we get rid of obesity in this country?

BROWN: It's with exercise, motivation, determination and if that could be the magic pill that all these people want, I wish I could package it for them and give it to them.

COHEN: So many of us don't have Karen Brown's incredible self- discipline. So until scientists succeed in developing ways to help us, Americans may continue to grow to super sizes and people like Karen Brown will remain the exception rather than the rule.


BROWN: The obesity rate in American among adolescents especially is now so alarming that some schools are taking the extraordinary step of sending letters home to parents, letters warning parents that their children may be overweight. The idea being that such notes might encourage parents to change their kids eating habits or to encourage those kids to get more exercise.

And that's this edition of CNN PRESENTS. I'm Aaron Brown. We'll see you next week.




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