Excerpt From The Novel

Tuesday, 8-15

Hey, Mrs. Pope. I’m the diet-challenged kid who sits in the last seat by the door. I stay in the back so you don’t have to constantly hear, “We can’t see around Jimmy!” Just trying to help out. Besides, you can see a lot back here in the cheap seats. Like how nobody wants to do this stupid journal.

Man, I don’t get teachers. Why do you guys pile it on the first day of school? Can’t you let us get used to the idea that summer is really over, before you stick it to us? Man, this journal thing has me bummed, big time. Three half-pages a week is tough. That’s so NOT cool. It may not seem like much to you (Hello! You’re an English teacher), but for kids like me, it stinks. That’s one and a half pages every week for an entire school year. Why don’t you just ask us to write the great American novel and say it’s due in June? It’s not as bad for the girls. They keep diaries and write notes to each other nonstop. They write really big too. Just to take up space. That’s so fake.

Like any of us are going to write more than three pages a week. Half the kids won’t even do that. It’s too much to expect from us. I don’t have that much to write about anyway.

No offense, but some of the topics you suggested are cheesy, like “describe your room.” My room has four walls, a bed and a dresser. I have a built-in desk with a lamp. Last week my mother and I pasted glow-in-the-dark stars on my ceiling. Okay, that’s pretty cool.

But now what do I write about?

English teachers should have their students write essays about current events like we did last year in middle school, not just any stuff you want to write about. What’s the point of that? There’s enough garbage in the world already. You said to write really fast even if it makes no sense, so here I am writing a journal that makes no sense, or is that nonsense, or maybe nose sense, or stupid sense, or, in my pocket are no cents, or the locker room has lots of scents. So, I’m done. There’s my OVER a half-page. Sorry this is stupid, but what do you expect from a high school kid? Hope you enjoyed me ruining a tree.

Wednesday, 8-16

If you really are reading this, I’m surprised. My English teacher two years ago made us keep a journal and she never read them. We got check marks and either “that’s nice” or “good work” comments. I could’ve written that I was a space alien and she would’ve put, “That’s nice.” She collected everyone’s journal at the same time though. Your way is better— a different row every week. That way you might have time to actually read them.

You said that if we didn’t want you to read something in here, we should fold it and label it Please Don’t Read This Page. How do we know you really won’t read it? What if we don’t feel like writing three journals a week, and just write the same thing over and over again? You really couldn’t do anything about it, because if we marked two of them Please Don’t Read This Page, you couldn’t admit that you really read them, or the class would think you were a scammer. And if you don’t make comments unless we ask you to, what’s the point of writing a journal? You’re supposed to give us feedback about our writing. I don’t get your whole thing about “freeing our writing muse” (I didn’t know my muse was locked up) and “oiling our inner tin man.” Some people might think you’re really weird. Not me though. Ever since my mom made me watch The Dead Poet’s Society, I’ve kinda expected English teachers to be “out there.”

But I’m not sure how we’re going to “free our muse” if we think our English teacher might read our stuff. Like we’re going to write anything bad. I’m not the sort of kid who gets into trouble or uses bad language, so I don’t have anything to worry about anyway. But what if I was a smoker or doing drugs or something? Or had girlfriends? Like I would write about all that in here. Besides, a kid like me having a girlfriend? Yeah, right. I think your class will be okay. I’m excited about high school and learning things. I don’t play sports. I would like to be on a team but can’t right now because of my weight. And contact lenses would help. Last time I tried out for club soccer, I kept losing my glasses. It was a real pain.

We moved here over the summer, so I don’t have many friends yet. It’s bad enough being a freshman and getting picked on all the time by the older kids, but it’s worse when you don’t have anyone to share the grief with.

If you really are reading this, I have a request. Can you move Ricky Stockton away from me? He smells really bad.

Friday, 8-18

Hanover High’s a lot bigger than Adams Middle. It takes forever to get from the math hall to the English hall. And we only have five minutes between classes, which sucks. It’s too far to go to my locker and if I do, I have a hard time getting to class on time. Yesterday, I went to the wrong class during 3rd period. I sat there for like ten minutes before I realized I was in the right room, but I was an hour early. My teacher didn’t realize until he called roll. It was embarrassing to walk out while everybody laughed.

At lunch, we have to eat so fast, by the time I get there and get my tray, I’ve only got a few minutes left. I mean, this isn’t an eating contest at the county fair, where you stuff as many hot dogs and pies in your face as you can. Actually, that sounds pretty good right now, cause I’m hungry.

I haven’t found anyone to sit with yet. It’s hard being in a new school where you don’t know a soul, except this one kid from my old school, but he’s a real jerk.

Your class is okay but algebra really inhales, if you know what I mean. The teacher writes on the overhead all period and then gives us worksheets. I can hardly stay awake. If it wasn’t for Scott, the kid who sits next to me, I would go to sleep. He has “stomach problems” and it keeps us up. When Mr. L walked by, he coughed and looked straight at me. I put my hands up and shook my head and said I didn’t do it. Mr. L smirked and went back to his projector.

Monday, 8-21

School really sucks. I hate it here. Middle school was bad, but at least people talked to me. Sometimes.

Tuesday, 8-22

On the bus ride home today, I sat with a kid named Allen. He’s overweight, but in a worse way than me. I mean, he’s not any bigger than me, he just doesn’t get it. Like he wears these big pants that hang too far down, and you can see his underwear and sometimes a little more. The girls think it’s gross and scream whenever his pants creep down too much. And his shirts are too short and half his gut hangs out. Sometimes, he really asks for all the grief he gets. Then he smiles all the time and tries to talk to people. Everyone ignores him, and I tried to, but got caught sitting with him in the front of the bus, which was a big mistake because we got bombed with paper wads. Then someone yelled for the bus driver to split us up—they said we were making the bus lean to one side. The driver hollered at everyone for messing up her bus, then made Allen and me pick up all the paper at our feet. Of course, the rest of the bus cracked up laughing. Ha, ha. Real funny.

Now, I’m sitting in my room writing this journal. I still think it’s a waste of time. I mean, who cares about my boring life? Hold on a minute. I don’t believe it. My pimple-faced sister is yelling at me because she thinks I went in her room and snooped on her laptop.

Okay. She’s finally gone. She gets hysterical over nothing. I mean, what if I did get on her laptop? She must have something big time to hide. It’s like she’s making me want to get into her computer. I don’t have anything to hide on my laptop. I don’t get that many e-mails and none of my friends do the online chat stuff.

She really scared Nanook, our dog. He’s supposed to be the family dog, but he likes hanging out with me the most. He’s a mutt, but he has a lot of sheepdog in him. When I’m playing my PlayStation, he likes to watch.

Thursday, 8-24

The teachers really pile on the homework in high school. My sister complained about it all the time last year; now I know why. Every teacher thinks their class is the only one. Not you. I like reading the short stories you’ve assigned so far. After reading the one about Doodle, I told my parents we should go to Florida to see a real ibis. My dad wanted to know why, so I told him about “The Scarlet Ibis.” He thought I should talk about it in youth group. I might but church is not supposed to be like school. No offense, but I don’t want to sound like an English teacher or anything, even though English is my favorite subject. (I’m not saying that just to suck up.)

My dad said there’s so much pressure on kids today, it would be good to talk about some of the things in the story. I mean, look at Doodle. He died because his brother was ashamed of him and wanted him to be like everybody else. That’s sad because most kids will do anything to fit in, like smoking or stealing things from people’s garages. A lot of kids do worse things, like get into drinking and drugs. I tried chewing tobacco once, and hated it. I got so sick I turned green. My sister caught me and a friend from my old neighborhood chewing it and told on us. Boy, were my parents MAD. When I threw up in the front yard, my sister laughed at me. She can be a real jerk.

My parents talk to me about peer pressure all the time, but they really don’t have to worry because I definitely do not fit in. Besides, there can’t be pressure if there’s not any peers. Maybe Doodle’s parents should have spent more time with him, but they were probably embarrassed by him too. After all, they had a coffin made for him right after he was born—that’s so NOT cool. If your own family’s not on your side, how does a kid have a chance at anything?

Sunday, 8-27

Last night I finished my HW early and played against my dad on the PlayStation. He thought he could beat me. It sets off a spark inside of me, hearing him say this, because I refuse to lose to a person who was born thirty years before video games were even invented. I’ve been playing since the age of four and know for certain I can always beat him. And, I did.

Then, when I was watching a show on Animal Planet, my friend Paul called. He goes to Northview, but he’s in my youth group at church. He was all weirded out because a body was found in the woods behind his house—he and his dad watched the police carry it out. Even though there was a white sheet over the stretcher, Paul said the body appeared all lumpy under the sheet. Like they couldn’t lay it out straight. Like it had been in the woods for a long time.

It’s creepy to think that a murderer dumped his victim a few hundred yards away from Paul’s bedroom. I mean, the killer could’ve walked right by his window. Paul said his dad’s been in a worse mood than usual because of it, and his mom’s been screaming constantly. His parents aren’t exactly what you’d call good examples, but Paul’s real cool. He thinks the dead person is from Michigan or something, and the killer drove for hours until he found a safe neighborhood to hide the body. There aren’t many murders in Hanover. In fact, until today, there weren’t any. Man, I couldn’t stop thinking about it. I hope I can fall asleep.

Monday, 8-28

I woke up this morning thinking about the dead body. Like, it’s not even a person yet. Just an “it.” The whole thing really freaks me out. It could be a kid or a grandpa—Paul thinks it’s probably some girl, since most bodies found in the woods are female. Man, the weekend went by way too fast. Last week was the longest and shortest week of my life. I felt like I was trapped going to school all week, but now it’s over. This schedule is too fast-paced for me. There are so many things to keep up with—go to my locker, get my books, hurry to class, take notes, and repeat the whole thing like seven times a day.

Today was really hot, and it was even more disgusting than usual in the cafeteria. I don’t think the air conditioning is working in there. Allen eats lunch when I do, so I finally have someone to sit with. Not that sitting with Allen is the greatest. He stuffs food in his mouth as fast as he can, like he’s starving, and the other kids watch. Everything he brings for lunch really smells. I mean, why can’t he pack something normal like peanut butter and jelly sandwiches? No, he has to bring tuna fish, salami, sausage, and rotten cheese. One day he even brought sardine sandwiches. That’s so not cool. I half expect him to bring pigs’ feet or sheep brains. It wouldn’t surprise me one bit. Then he talks with his mouth open and it’s pretty disgusting. I try not to watch him, but he sits right in front of me.

When he’s not stuffing his face, he’s okay and is into some really cool hobbies, like chess, Warcraft, and he has some serious Yu-gi-on cards with heavy hit point potential. (Not that he’s trading.) He’s an online warrior like me. He’s actually kind of a legend in the gaming world. His online handle is KillingMachine and the dude earned it. I’ve seen him play and he is absolutely ruthless. I always imagined him to be some pumped-up Arnold the Terminator kind of guy. It just goes to show how much you can hide on the Internet. I wonder if any of the other kids at school know exactly who’s kicking their butts.

Thursday, 8-31

Mom’s making my lunch everyday now, since I told her about not having much time to eat. She fixed two PBJ’s this morning, and I stuck them in my backpack. I forgot they were there and put books on top of them. (I usually carry my lunch separately, but lately some kids on the bus have threatened to take it). The sandwiches were squished as thin as a CD and the sticky grape jelly leaked through the paper sack and got all over my math book. At lunch, when I remembered I had sandwiches, I pulled them out and had to peel them off the bag. At least I provided entertainment for Allen.

Allen and I talked some about the murder. He thought it was awesome that it happened practically in Paul’s backyard. Guess that makes Paul almost a celebrity. He says the police are all over the crime scene still, like 24/7. Paul said there’s been lots of news trucks in his neighborhood, some parked in front of his house.

I hate having math second period; it’s all I can do to stay awake in there. Then today, in the middle of a really boring class, Mr. L gave us a riddle about sheep. He asked, “If a farmer had 26 sheep and one died, how many would he have left?” Almost all the class said 25, except for Scott, trying to be funny, replied “420.” Mr. L claimed that we were all wrong. I guess old men get pleasure from riddles that make about as much sense as a Popsicle stick joke. It drives me nuts.

We also got our gym outfits in PE today. That means we’ll have to start dressing out soon. I wish I didn’t have to take PE.

Saturday, 9-2

It’s been all over the news—the dead body found behind Paul’s house. Just in time for Labor Day weekend. Kind of takes away from the whole family picnic scene. No one around here feels like celebrating much.

In case you missed it, the victim was a seventeen-year-old girl from Wilmington High named Kimberly Taylor. We play them in football and they usually beat us. Wilmington is a nice, safe place like Hanover. Well, it used to be.

My mom read about the murder in the Cincinnati Enquirer today. Under the cause of death it said, “Homicidal violence, type undetermined.” The police said Kimberly was wearing a Danskin hooded sweatshirt over a medium-top with sequins. She had a nose stud with a clear stone and a silver ring on her finger. Her boyfriend is the prime suspect. Paul thinks we should hide in the woods to see if anyone shows up. He read somewhere that the killer always returns to the scene of the crime.

Monday, 9-4

Please Don’t Read This Page

Yesterday was the first day of dressing out in PE. I hoped it would be different here but I guess I was wrong. We wear a red shirt with Patriot PE on the front and shorts to match. I tried to find a locker over in the corner so I could change shirts without anybody noticing me. I didn’t realize that the football players use the corner I picked. I was already there when several came in, talking and cutting up. By the time I got my shirt and t-shirt off, I could tell they were looking at me. My neck turned hot with embarrassment and I faced away from them so they couldn’t see my chest. One of the guys said, “Hey, aren’t you in the wrong locker room? People with tits like that should be on the other side.” I didn’t turn around or answer him. I pulled my PE shirt down and crammed my things in my locker. I half ran through the benches, trying to get out of there as fast as I could. Just as I was pushing open the door to the gym, I heard Robb Thuman, the star quarterback, say, “Maybe our mascot should be the Tomatoes instead of the Patriots. We’ve got one right here.” Everyone was laughing. When I went in the gym, I sat on the bottom row so I wouldn’t have to climb the steps. Coach Bronner called roll. I raised my hand when he called my name and he looked at me over his glasses. “You don’t have to raise your hand, son. Just say ‘here.’” I said, “Yes, sir,” but he kept looking at me. In the stands behind me, Robb said, “Just say, ‘Tomato, present and accounted for.’” Coach cut his eyes up there but said nothing to him. When we got dressed after class, I waited till everyone was gone before I changed. They were all out in the hall ready to leave while I sat in the locker room. It really hurts to have someone say those things. Don’t they know that I try to be a good person, and that I would cheer for them at the football games? Like I wouldn’t want to be on the team, running all over and not sweating like crazy? They have it so easy and they pick on me. I mean, why are these guys in a class with a bunch of freshmen, anyway? So they can pick on us? Allen said some of them don’t need any more credits, so they take PE classes all day. What’s the point in that? So they can make kids like me miserable?

I can hear Robb’s voice in my head. I’ll probably hear it in my sleep. When mom came in my room last night, I had to pretend I was asleep so she wouldn’t know I had been crying.

Tuesday, 9-5

Please Don’t Read This Page

Today’s my birthday—I just turned fifteen. One more year till I can get my driver’s license! Every birthday since I can remember, Mom measures my height. It’s a ritual for my sister and me. I measured 5’5”—two inches taller than last year. I’m glad Mom didn’t make me stand on the scale. I haven’t weighed myself since summer camp. I weighed close to two hundred; luckily, my counselor was the only one who saw the scale. He tried not to make a big deal out of it, but I could tell he felt bad for me. He gave me an extra dessert at dinner, which didn’t help my weight, but did make me feel special at the time. I’m in math class right now. It’s sooooo boring. I had all this stuff last year. Some of the kids don’t get it, so we have to go over everything again and again. They don’t understand simple things like variables and properties. When Mr. L asked what twice a number transfers into, hardly anybody answered. Then he put a bunch of examples on the board and we had to write them all down. It’s so easy—twice means times two, things like that.

I know all this stuff from last year because I had a really good teacher. Some of the kids act like they’ve never heard of algebra, but I know they have. They just want the teacher to go slow so they don’t have to work as hard.

The class is so rude to Mr. L I feel sorry for him, even though he is the most boring teacher I’ve ever had. At least he has an interesting classroom with cool posters and real fossils laying around. He has an aquarium with goldfish and he lets us feed them since it’s early in the morning. Why does he continue to answer all their stupid questions? Can’t he see they’re laughing behind his back? Nate Hammer does it just to show off. I know him because he went to the same middle school as me in the seventh grade. He hasn’t changed at all. He still loves to make fun of people, especially me. His eyes sure did light up when he saw me walk into class. Probably like when a hawk sees a squirrel. A big squirrel.

He has a huge crush on Whitney Elliot. She’s pretty and seems nice, too. I don’t know what she sees in Nate, but she always smiles at him. Her face gets all red. He’s what you’d call a jock—I call him a jerk, but he’s the most popular guy in our class. I swear he tries to make my life miserable. “It’s Slim Jim!” he said the first time he saw me in class. Everyone laughed.

“It’s Not-So-Slimmy-Jimmy,” another kid joked. The class laughed again. Mr. L quieted everyone down and I just wanted to disappear.

This year I’m even bigger than last year. My parents don’t say much about my weight, but I know they’re worried. I don’t understand why I’m so fat. My friends at youth group eat more than I do, but they never gain weight.

Mr. L keeps yelling for everybody to shut up, but they keep talking anyway. He just shakes his head and closes his book. There’s only a few minutes left, so I guess he thinks it’s not worth it to keep yelling at everybody. Nate is smiling at me, but I pretend I don’t notice. But it doesn’t matter. Nate still won’t leave me alone.

“What’d you have for breakfast, Fat Boy? All of McDonald’s? What’re you writing? Listing all the food you’re going to have for lunch?” Now the rest of the class is laughing.

“You cause an earthquake every time you walk.”

Ha, ha, Nate, you’re so funny.

One minute till the bell rings…hurry and ring…please ring…Mr. L acts like he doesn’t hear what Nate’s saying. I wonder if Whitney is laughing too.

Glad I didn’t tell anybody it’s my birthday.

Wednesday, 9-6

I’m so excited! I got a GameCube for my birthday and it’s awesome!

I got Super Smash Brothers Melee and it is so sweet. You fight other players with tons of characters. Depending on whether or not you use the best finishing moves, you can open up better characters as you move through the game. My favorite is Captain Falco because he does this move where he teleports onto the opposite side of the screen. Then you can throw one of his flaming swords at the other dude. You can cause major damage with that move, and it’s almost impossible to defend against.

I can’t wait to go home and see who else I can get. Maybe the teachers will give us a break and not give us so much homework because my parents said I have to get done with that before I can play. Maybe my English teacher won’t give us a lot to read tonight. Hint, hint.

Mom made fried chicken and dumplings last night, and then my favorite cake—German chocolate—topped with Moose Tracks ice cream from the United Dairy Farmers. I ate so much I could hardly move. On Saturday, my Nana is taking me to the all-you-can-eat steakhouse, like she does every year for my birthday. My sister gave me a really cool Bengal’s sweatshirt, but it’s too small so I have to take it back. I hope it comes in an XXL, because I really like it.

Thursday, 9-7

Please Don’t Read This Page

Paul doesn’t think the boyfriend did it. He thinks it’s some guy from another state, like Kentucky.

“Why Kentucky?” I asked.

“Because the body was dumped in the woods, and everyone knows Kentucky is full of woods.” Paul’s been on the Internet hunting for murderers in Kentucky. I don’t know why he’s so set on Kentucky when it could be somebody around here. We’ve decided to set up a fake MySpace account and pretend we’re this really cute cheerleader. Paul suggested we put my sister’s picture on it, and call her Starr. I don’t think my sister’s cute enough, but Paul thinks she’s hot. We’re hoping the killer will send us a “friend request,” then we can start talking to him and eventually Starr will ask him if he wants to get together. We’ll leave a note for him at the meeting place and ask him to write back, so we get a copy of his fingerprints. Then we’ll turn him in. The only problem is, my sister’s not the nose ring type, like Kimberly. So, maybe the guy isn’t into preppy girls like my sister. Paul said it wouldn’t be that hard to Photoshop a nose ring in.

I wonder if Kimberly had a hard time fitting in and that’s why she pierced her nose. From the pictures on the news, she looks kinda big, almost as big as me. The police thought maybe she was pregnant, and that’s why her boyfriend murdered her. But the autopsy showed she wasn’t. Some of the kids at school are making jokes, saying her boyfriend killed her because she was fat or that she ate herself to death. Seems like fat jokes never stop, even after you’re dead.

Friday, 9-8

Please Don’t Read This Page

We had school pictures taken today–I really hate picture day. It’s okay to get out of class but that’s about all it’s worth. Ever since middle school, when I started getting bigger, I have dreaded the long walk. I feel like Frodo walking to Mordor. It used to be fun waiting in line, watching everyone comb their hair or asking, “How do I look?” I guess about three years ago, I quit asking. I remember the first time someone answered with a smile and said, “Oh, you look great, Jimmy,” but I could tell they didn’t mean it. They wanted to say, “You look pretty fat, Jimmy.”

Today was no different. I got real nervous waiting and once again, it felt like forever before it was my turn.

“Sign this,” the picture-lady said. She shoved a form at me. “What grade are you in?”

“Ninth,” I told her.

She looked up at me. “Oh, really. Well, sign this,” she repeated.

I filled out the form and stood quietly in line behind a kid named Frank. There’s not much to do except watch the person getting photographed. White screen, bright lights, just great, let’s shine a big light on Not-So-Slimmy-Jimmy.

“All right kid, sit on the stool and face left.”

I sat down.

“Other left.”

“Yes ma’am,” I said. I could feel everyone’s eyes on me and I started sweating. I thought I could get in a quick wipe of my forehead and I raised my arm. Click!

“Don’t move, sit still,” the lady yelled at me.

Someone behind me giggled and then I heard, “I wonder if that’s a wide-angle lens?”

Haha.

I hate picture day. I could use a tan. The lights make my face look like a big pillow with eyes. At least it’s not like family pictures with my whole body showing. I’m not quite Mr. Photogenic, you know. Actually the only parts of me that would look good in a picture are my “tits,” as the football players call them, but they’d only be good if they were superimposed on an aging model that has been liposuctioned to the point of hanging flesh.

So, then, the lady goes, “Tilt your head down,” then, “Up a bit. Okay, hold it right there.”

She took forever and my eyes were drying out. I couldn’t stand it. Blink. Click. Oh, great.

“Gee,” she glanced at my form, “Jimmy. Let’s try again.”

I actually thought about running out. I didn’t want the pictures anyway.

“C’mon. We have lunch in thirty minutes,” someone said.

Then another one: “Maybe she’s taking his picture in stages. Like those panorama things.”

All I could think was Shut up! Shut up! Shut up! The last “Shut up!” I blurted out. Click.

The lady gave up. Mom probably won’t be buying these pictures.

“Retakes are in a month,” the helper lady told me as I went out the door.

Yippee. I can’t wait.

Foreword by Thomas H. Inge, MD, PhD

We are in the midst of an obesity epidemic the likes of which the world has never seen. In the U.S., more than two thirds of adults are obese or overweight, while about a third of all children suffer with a weight problem. What is fascinating though is that we see nearly the same proportion (about 5%) of adults and kids experiencing extreme obesity. For that extremely obese group, the adverse social and medical impacts of the disease are far more poignantly felt. In The Fat Boy Chronicles, Lang Buchanan takes the reader vividly into the day-to-day life of an extremely obese teenager who chooses to fight back against the all-too-common abuse, defeat, sadness, neglect, and ridicule facing kids with a weight problem. The extraordinary aspect of this story is how we (and the teen) arrive at a certain peaceful calm after a raging battle. Set in Cincinnati, Ohio, the authors demonstrate the magnitude and power of the social stigmatism, isolation, peer confrontation, and inner conflict experienced by millions of American teens of today who are just like Jimmy Winterpock.

How did it come to this? This is a tough one. First, we are what we eat. But it is obviously more complicated. In reality, what is most important is both the quantity and quality of the calories that we eat, and the number that we burn in physical activity every day. But the deck is clearly stacked against us and our kids. The deck is also stacked more against Blacks and Hispanics. We started out this human existence with a version of our genes assembled at a time when food was far less plentiful, but was actually healthier: it was never processed nor stuffed full of artificial sweeteners and flavorings. And in those ancient times, our genes and our metabolism were more efficient because we also had to work a lot harder to survive. Fast forward to now. Most people regularly praise the modern conveniences that allow us to lead faster-paced lives and eat on the run. We seldom dwell on the fact that the processing that makes frozen foods possible strips healthy ingredients, like vitamins and fiber, from vegetables. And, who complains about it when we get larger than necessary portion sizes? For sure, we don't pay much attention to the inundation in our diet, especially drinks targeted to kids, of high fructose syrup. HFS is the key ingredient that many scientists, including Rob Lustig at UCSF, feel is a major contributor to the obesity problem. HFS is a toxin causing fatty liver disease seen in adults and kids alike. Besides a diet of toxic food, we're also not getting the physical workouts our ancestors took for granted. We spend hours passively watching television and playing video games; we take the elevator instead of the stairs.

Extreme obesity is disease - a disease that affects kids and adults in ways we are only now starting to unravel. For instance, obese kids have a quality of life that is on par with kids stricken with cancer. Kids that are extremely obese actually report that the quality of their day-to-day life is actually much worse than those with cancer! This is in part due to the merciless teasing and cruelty of other kids. And, it is in part because these kids have aches and pains similar to those that 50 and 60 year olds have; it is astonishing how an extra 75-100 pounds of weight early in life can place wear and tear on the joints decades ahead of what is expected. It is in part because these kids are denied the simple pleasures and necessities in life that we all want to enjoy: amusement park rides, long walks on the beach, and even the safety and peace of mind that a seat belt offers to passengers. But beyond this, obesity can adversely affect most organ systems in the human body. It contributes to diabetes, breathing and sleep disorders, high blood pressure, high cholesterol, heart disease, asthma, skeletal deformities, depression, dementia later in life, and major disruptions in fertility just to name a few.

Obesity shares another similarity with cancer. Both can be difficult if not impossible to reverse. We often say that obesity must be prevented, since treatment options have seldom been successful. Indeed, most of us can lose a few pounds of weight, but recognize that the vast majority of us then put that weight back on plus some. And what about the kid who is about 100 pounds overweight? We see this level of obesity in about 2% of kids in grades 5-12 in the Greater Cincinnati area. We also see that over a 5 year period only 1 in 10 can reduce weight enough to shed the title "extremely obese". Sadly, you also find that on average, these same kids gain 1 inch on their waistline every year. In fact, most kids in this extreme category of obesity already harbor 2 or more risk factors for cardiovascular disease. By the time they become adults, there is a 100% chance they will remain obese, and they can look forward to loss of 10-20 years of life due to their weight problems. Big kids face big health problems.

The two main components to any successful weight loss program are diet and exercise; however, depending on the amount of excess weight, usual efforts may not be enough to get to a normal healthy weight. Our bodies give priority to energy (fat) stores since long ago these stores were very important to individual survival and reproductive capacity. So we find that each of our cells has hung onto those very genes that promote energy intake and storage and that minimize energy expenditure, as if our own bodies were designed to fail us when we try to shed weight. In fact, many scientists, like Rudy Leibel at Columbia University, have published examples of how our subconscious mind and core metabolic processes strongly defend our body weight against the attack of a "diet", - even when we really need to lose weight. Metabolism will slow and physical activity will subconsciously decrease during dieting in an effort to oppose the weight loss attempt!

So what message does this send? Are the problems so complex and the solutions so elusive that there is no hope? I don't think so. Back to basics for a moment: prevention of weight gain is always the first focus. Learning about and advocating for more opportunities for kids to get physical activity is clearly a goal. Getting greater access to healthy foods and learning and practicing how to avoid unhealthy foods is also possible. We also need to figure out ways to systematically ignore the misinformation about nutrition that advertisers want to share with us and our kids, and learn nutrition facts from someone who cares about our health and is not just trying to sell us something.

Due to the complex nature of obesity we should not be surprised that there is not a clear one-size-fits-all answer to reverse it. For those suffering with obesity, weight loss is a challenge, but the battle is winnable. Just ask Jimmy Winterpock. While his solution may or may not be the answer for others, his motivation for change is paramount. What is known is that it takes time, education, a lot of effort, and teamwork by the family. Sometimes it takes the advice of doctors to help with the medical and physiological complexities. And for years to come, it will take advocacy, a voice in government, and greater research efforts to overcome the weight and health problems facing a large proportion of our nation. The good news is that these efforts may be working, at least for some groups. According to a 2008 report from the Centers for Disease Control, there may finally be an improvement in rates of obesity in Whites in the U.S. Even so, that is still not enough. We want to see reversal of obesity numbers for all races and ethnic groups of kids and adults alike before declaring that the problem is turning around. We need to keep the pressure and advocacy on point. In this regard, thanks to both Jimmy and Lang Buchanan.