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Post Magazine
This Week: Obesity in America
Hosted by Peter Perl
Washington Post Staff Writer

Monday, March 31, 2003; 1 p.m. ET

Overeating and under-exercising have become a way of life for many Americans -- to the point where the federal government has declared obesity an epidemic. After years of struggling with weight, the Duyer family of Germantown is now attempting to confront that epidemic head-on.

Peter Perl -- whose article "The Incredible Shrinking Duyers" appeared in Sunday's Washington Post Magazine -- was online Monday, March 31 at 1 p.m. ET, to field questions and comments about the article.

Perl is a Magazine staff writer.

A transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

Peter Perl: Hello, readers and welcome. We have quite a few questions already lined up, so I will try to keep my answers fairly brief and hopefully get to all of your many interesting comments/questions.

Mt. Rainier, Md.: I wish the Duyer family all the luck in the world. Attempting to undo decades worth of bad habits is a real challenge. While I'm not in their weight division, I find I have the same challenges in losing weight -- and I only need to lose 30 pounds to be at a healthy weight. I don't eat at fast-food places more than twice a year (on the road usually), and I try to make most meals at home. When we eat out, we try to select restaurants for healthier food, and we make a point of taking the excess food home in a doggy bag. It seems that all restaurants these days specialize in "trucker" size portions. It would indeed seem to be something in the air that makes eating responsibly so durned hard!

Peter Perl: Yes, your comment sounds all too familiar to me. We have gotten in the habit of giant portions and until we as a society change our eating habits, restaurants will continue to overindulge us. It's both unhealthy and often pretty wasteful. It's not just something "in the air," making us fat--it's our own behavior and a food/diet industry that is reaping the benefits of it.

Fredericksburg, Va.: I'm sure I will not be the first person to ask why you limited your article to only three "diets" (for lack of a better word).

I believe the three you wrote about had the common theme of lifestyle change, as opposed to a "diet," which has a beginning and an ending. Gastric bypass is an extreme lifestyle change; WW and the other method are more moderate. But they all involve changing habits and being aware of what we eat. Am I right on the connection?

I wish the Duyers great success -- I'm also on WW and love it. The daughter (Emma) might want to check out the WW message boards for some non-parental support too, if she decides to come back. It is a hard journey, but I feel it's worth it!

Peter Perl: Fair question. I simply didn't have the space to take on more of the many different varieties of "diets." One of the points, actually, that I hope readers come away with is that "diets" as such, just don't work. Rather, educating yourself about food and changing your lifestyle and habits are the common-sense keys that have a much better chance of working.

Capitol Hill, Washington, D.C.: Hi!
Loved your article about the Duyers. How are they doing now? I'm really intrigued that one daughter was able to stay slender in a house that really lived a "fat" culture. That's a really interesting situation for the genetics/lifestyle problem.

Peter Perl: The Duyers are doing fine. As the story indicated, the mother & father are making progress, and it has been a bit harder for their daughter, Emma. As to the slender daughter, Sarah, it is a mystery of genetics & metabolism & behavior that individuals in the same family can differ greatly. There's also no predicting the future--as to future possible weight gains or losses.

Alexandria, Va.: I visited France two years ago and was amazed at how few fat French people there were, even though eating at restaurants appears to be a major activity for these people and they eat a lot while dining out.

What goes on? Why are there so many tubs of lard in my office and so few on the streets of Paris? Check out the antiwar demonstrators in Paris, you will see what I mean.

Peter Perl: There's no longer any question that America has become the fattest major country in the world. If you examine the lifestyles of the French vs. the Americans in terms of high-fat, high-calorie foods and the amount of walking/exercising, the answer becomes pretty obvious. We think of French fries and French cheeses & wines, but the "average" French person also eats a lot more fresh vegetables & fruits than the average American.

Washington, D.C.: I wish the Duyer family lots of luck in meeting their weight loss goals.

Peter Perl: Thanks. They have gotten a lot of well-wishers already and I'm sure they appreciate that.

Alexandria, Va.: I thought the article was great. I was stunned that a father of two wouldn't change his eating or health habits after multiple heart attacks! No wonder his wife nagged him so much.

Peter Perl: Well, the Duyers were very open and candid in allowing me to spend time with them and to observe their interactions. Remember, though, that the father does, indeed, change his habits eventually. It's just that it is an emotionally charged issue, so Kathy & George Duyer had some nagging and resisting to do before they found a better wave-length in which they could communicate better and try to reach a common goal.

Maryland: As someone who visits Spain regularly, I can tell you that American obesity is real! In fact, I've heard of Spaniards who visited here and took videos of obese people so that friends and family could see and believe! I think one reason for obesity is the eating habits of many Americans -- constantly grazing throughout the day, snacking here and there, etc., while Spaniards might take longer for the afternoon meal, but will eat just that meal and not spend the rest of the day grazing and snacking. Also, Spaniards still spend more time cooking meals from scratch rather than heating and eating something from a box that's probably supercharged with calories. What do you think?

Peter Perl: Thanks for your observation. I had the chance to visit Spain last year when my son was spending a college semester abroad living with a Spanish family, and your observation is very accurate. They eat heartily there, but as with the comment about the French, they eat differently.

Arlington, Va.: What use is Body Mass Index as a statistic to track obesity? Health professionals told us years ago to forget about height-weight charts. How is the BMI formula different? I mean, it's just another height-weight formula to fill in another height-weight chart. I realize we're not a nation of body builders, but can't we get a better number (e.g. body fat percentage) with which to make decisions?

FWIW, I'm a bit over 210 lbs, and 5'11". I have very low body fat; I bike over 3,000 miles/year (not including stationary all throughout the dark months) and circuit train 3x/week. Using BMI, I'm overweight to obese, and just another example of the obesity epidemic.

Peter Perl: Very good question and I'm glad you asked it. I agree that BMI is a flawed & limited measurement, but it's the best we have to give an overall snapshot of our society. You are right about how misleading it can be for an individual--particularly someone who exercises regularly and has lean muscle mass that actually weighs more than fat. By BMI measures alone, athletes like Michael Jordan would be "overweight" and the mighty Sammy Sosa would be "obese" technically--which vividly illustrates how limited BMI can be. Body-fat percentage is a more accurate measure, but it's more complicated and involves tests that make it less practical than BMI.
Nonetheless--despite the limitations of BMI--the total number of "obese" people who are really physically fit is not high enough to change the reality that we are indeed a very fat nation.

Arlington, Va.: Poor Emma! I know how she feels. You are not about your weight and your Mom needs to back off! Are you healthy? Are you happy? Answer these questions to yourself truthfully and the rest will take care of itself.

Peter Perl: Thanks for your comment. Emma, as I hope my story conveyed, is a resilient person and she has told her parents, in her own way, to back off. They realize she has to make her own decisions; it's just taken a while to get to that point.

Maryland: In some ways I can sympathize, and in some ways I can't. I was much heavier once upon a time, though nowhere near heavy enough to be classified as obese. The weight was indeed a factor of eating too much of the wrong things and not exercising enough. However, I can't blame anyone but myself. This mindset that it's someone else's fault (restaurants who supersize, fast food which is convenient, tasty and horrible healthwise, etc). is a cop-out. Good choices are out there. Even fast-food restaurants have healthy choices (i.e.: I go to McDonalds -- but I have a hamburger, a salad (little dressing) and a diet coke). A person can only lose weight once he/she decides that the immediate gratification from the comfort food isn't worth the way she/he looks and feels due to the extra weight. No one diet works -- it all comes down to calories in and calories out.

Peter Perl: Very good points. I can't disagree, but I also like to remind people that genetics makes it much harder for some people to lose weight than others.

Herndon, Va.: A great article! My doctor and high cholesterol have me trying right now to get down from 195 to 175. At 5'10" I'm, I guess, just overweight, not obese, but I admire what the Duyers are trying to do. Just getting 15 pounds off is driving me crazy. It would appear though, that, if so many of our children become obese -- we've lost the fight. It's so much harder to take the weight off, rather than not put it on in the first place.

Peter Perl: Thanks for your comment. Personally, I would urge you not to get too "crazy" over that last 15 pounds. Be patient with yourself and don't consider it a defeat if you don't lose all 15. Your long-term trend--your lifestyle and habits--are more important than the number on the scale.

Washington, D.C.: Thanks so much to you and to the Duyers for a horrifying/inspiring account. I am not overweight, but my habits could use some improvement -- this cautionary tale will stay with me for a long time (and inspire many more trips to the gym and lunches packed at home).

Peter Perl: Thank you. A sort of funny and happy byproduct for me personally is that I lost about 10 pounds during the 8-10 weeks I went to Weight Watchers with the Duyers. You can't help but absorb some of the positive message...

Albany, N.Y.: What role do you see our education system playing? Should gym be mandatory?

Peter Perl: Good question. I think the education system has fallen down in concentrating totally on mind over body. I think gym is really important, and most school feeding programs are horrible, with some rare exceptions. We also need more and better health education so kids realize the importance of good nutrition sooner.

Baltimore, Md.: I have had my own ups and downs with Weight Watchers and was impressed with how accurately you captured the emotional responses to the scale. While I recognize the increasing rate of obesity in the U.S. and its serious impact on our health, do you feel that we are at risk of obsessing too much about our weight and using this number as a judgement on our self worth?

Peter Perl: Yes. I couldn't agree more. That's part of the reason I was glad to include the section of the story in which Dr. Gloria WilderBrathwaite from Children's Hospital preaches the importance of changing your habits but not obsessing about the numbers on the scale.

Washington, D.C.: I liked your story and think it serves an important purpose. Americans do need to be educated on the obesity epidemic. Yet, I question your judgement in telling personal, embarrassing details about a 15-year-old girl with weight problems. Her friends, classmates, and peers are old enough to read that she was "squirreling away food in her bedroom." Earlier in the story, you describe her as "fat." While that may be true, I can't imagine too many 15-year-old girls who wouldn't find that to be a serious blow to their already low self-esteem. You even wrote that she didn't want to be interviewed for the story, but agreed after her parents prodded her. Did you have any moral qualms about using this poor child in your story? Are you aware of the harm that you could have caused her? Shame on you.

Peter Perl: Fair question. Yes, I had mixed feelings about Emma's role in the story and I talked about that extensively with Emma and her parents. Emma, though, is not the "poor child" and she has a lot going for her, despite her being very overweight. She was a reluctant participant at first, but became a bit more open to the process as we spent time together. She knows she will get some teasing, but she has dealt with dumb people in the past, she says, and is not intimidated by the prospect. She has good, supportive friends and she does not let her physical appearance "define her." I can understand your concern that the story may have damaged her, but I genuinely believe it won't and neither do the Duyers.

Washington, D.C.: Great article. I just want to make a comment about overweight children -- it all comes back to the habits they learn at home. When I was a kid, my brother and I played outside all the time. We had one soda a week watching a movie of Saturday nights, and there was rarely junk food in our house. As an adult, I have to admit I have strayed from these limits, but the fact is that I learned early on that there are some foods you should not eat all the time. Now I am watching my sister-in-law raise her kids in the opposite way -- they get snacks (hotdogs, cookies, chips) any time they want, eat insanely sweet cereal for breakfast, and get fried chicken and no vegetables for dinner because "that's what they like." So sad, but parents, it doesn't have to be like that!

Peter Perl: Thanks for your observation.

Virginia: Were the kids active in sports when they were growing up?

Peter Perl: The Duyer kids--and their parents--were not especially active in sports.

Washington, D.C.: I realize you have limited space, but I found it telling that Duyers joined a health club "two miles from their home" and drive over (separately!) to WALK on a treadmill. I don't know their neighborhood, so perhaps there just isn't any place to walk outside, but certainly many people bypass chances to use their feet as transportation. (I'm lucky enough to work only three miles from my home. By subway, it's a 20 minute commute. Usually I bike, which takes 15 minutes, and sometimes I jog home, which takes about 25 minutes. There's no extra "exercise time.")

Peter Perl: Good point. Those who are fortunate enough to be able to work exercise into their daily routine are usually more successful than those who have to make exercise a separate event. But the mother and father also do a bit of walking, as the story mentioned, and they are getting good workouts and (so far) sticking with new healthier routines. The kids are also joining them at the gym--when their busy school schedules allow.

Ashburn, Va.: My nine-year old daughter has a big build (tall and broad) and still has her baby fat around her middle, but she's not obese. I worry, though, that she's heading in that direction. She wants to be a cheerleader or a figure skater and she already feels the stigma of her size in those classes. Did you learn anything in your investigation about how young is too young to begin interventions to prevent obesity?

Peter Perl: Good question. It's never too early to "intervene" in terms of trying to instill healthy habits. But experts I talked to also stressed that it's not a good idea to try to push "diets" upon young kids. Best things you can do: encourage and reward exercise in all its forms; be a good role model yourself in terms of exercise and eating habits. Make sure there are plenty of healthy foods around the house. And don't nag too much, and don't get too hung up on weight. Your daughter was probably destined to be a big person, but she can still be healthy & active & happy, even if she learns she can't be a figure skater. (I wanted to be a professional athlete myself, but nature scoffed at the idea....)

Washington, D.C.: It is possible, as you state in your article, to be both fit and fat.

But as someone who has been both places -- I did exercise and weight training for nearly three years before joining Weight Watchers -- I can say that you are even fitter at the lower weight. And being fit at a higher weight will not always counteract the negative effects of extra fat -- hypertension, swollen ankles, high cholesterol.

Peter Perl: Good point. Losing weight can't hurt (until it becomes obsessive.)

Re: Emma: In think that the Duyers are doing the best possible things they can for Emma: providing healthy meals at home, encouraging family exercise time, and setting a great example of how to make healthy changes. She sounds like an intelligent young woman with a lot of interests, so I'm sure when she decides to lose weight for herself and not her parents that she will be successful. Thank you for sharing this inspirational story that I'm sure will resonate with thousands of families.

Peter Perl: Thanks very much.

Washington, D.C.: Great article. Do you have any personal experience with weight loss? And how did you find the Duyers?

Peter Perl: Thanks. I wrote a first-person piece in the Post Magazine in 1994 about my own struggles with weight in middle-age. I grew up and became a fat kid up to my teens and the topic has always fascinated me.
I contacted many nutritionists, weight-loss doctors,and groups such as Weight Watchers and interviewed about a dozen individuals and families before choosing the Duyers, whom I met through WW.

Arlington, Va.: Is no one else upset by the fact that the doctor in your story trying to curb obesity is, in fact obese? I was shocked by her statements. She considers herself "fit" because she can walk up one flight of stairs without breathing heavy? So the only people who aren't fit are those who can't push themselves up off the couch?

Peter Perl: In fairness, she can do a lot more than walk up a single flight of stairs. And yes, some people find her advise upsetting. I thought she raised important points because the fact is that many, many people find themselves obese--and then the question is what to do about it. Her message is a hopeful one, even though some may be "shocked."

Alexandria, Va.: I follow several chats on the Post that have dealt with weight loss, and I see a recurring theme: People equate being thin with being fit. They are not the same thing at all. I know plenty of thin people who are not fit. But on the other hand, I also know plenty of overweight people who claim to be fit, but really aren't. You can't become fit by taking 10-minute walks, or doing a few leg lifts. If you exercise at the bare minimum 30 minutes a day (60 minutes is more like it), 5-6 days a week, then you are in danger of becoming fit.

Peter Perl: A point we should all keep in mind.

Rockville, Md.: Doris Wray was very successful in her gastric bypass surgery. She was not successful in trying to diet and keep it off. She looks wonderful! And is much healthier.

Peter Perl: Yes, fortunately, things are going very well for Doris and she is a much happier person. It is, though, a dangerous operation only for those who really need it.

"Exercise" vs. being active: The Duyers (and many others) seem to have to "work" to inject exercise into their lives. But, one quote from Mr. Duyer (about burning off a sandwich-worth of calories) seemed to frame exercise as an excuse to eat.

The Duyers (maybe the daughter) might benefit from being active and doing things they ENJOY as opposed to paying penance at the gym. Learn to play tennis, take some yoga classes, take martial arts classes, buy a dog and then take it on long walks and try to teach the dog how to catch a frisbee.

Maybe these activities alone aren't adequate to avoid spending time at the gym to keep up with their weight loss goals -- but going to a gym (for them) is still about their relationship with food. Being active and doing something new is about having fun (without food).

Peter Perl: Thanks for that point.

Falls Church, Va.: Peter - Thanks for the well-written story. As a desk jockey, I can empathize with Mrs. Duyer's sedentary lifestyle. In my office, lunch means getting in the elevator to the deli downstairs, grabbing a sandwich and coming straight back up. Do you think it is in employers' interests to provide exercise facilities for mind and body relief from the 12-hour days we seem accustomed to? Are more doing so? How can one get one's employer to see this? I eat decently, but with no exercise, I still find a slow steady weight creep.

Peter Perl: Good point. Smart employers who would invest in their employees probably would reap benefits from it.

New York, N.Y.: As someone who can see many similarities in my own family to the Duyers, I can sympathize with Emma. As someone who went through high school overweight and who felt constant attention from her parents starting from possibly the second grade about weight issues, I was overly self-conscious about my weight and image. Not only that, but I resented my parents for making my weight such an issue, as if I wasn't aware of the fact that I didn't look like everyone else. I think Kathy has the right idea when she says that Emma must want to participate out of her own volition. Despite her parent's concern, it is only when she feels the internal motivation and desire that she will be able to see results.

And a question -- was Emma embarrassed at all that you were going to write this article? I think I would have been mortified if my weight problem and lack of success with dieting had been on the front of the magazine while I was a teenager.

Peter Perl: Thanks for sharing your experience. Emma told me that most of her schoolmates would not read the Post Magazine, so she was not terribly worried. But I told her that indeed, word would travel and she might face teasing in school. She said she was quite prepared for it. I hope she's right.

Woodbridge, Va.: My daughter and I both were on the WW program, she at the time was still in high school. The program was great. My daughter lost weight, began to exercise, and ate very healthy. So did I, but it didn't take long for me to slip back into my bad habits. Today my daughter still eats healthy, works out on a regular basis, and looks great and she's very happy. Me, I'm back at WW making up the lost ground. I think it's great to do this as a family, but maybe the daughter would be happier attending meetings alone or with a friend that's close in age. Her WW Leader maybe be able to help in this area. Good Luck to the Duyer Family.

Peter Perl: Good points. Emma actually had a friend with whom she attended WW for a while, but unfortunately the friend dropped out. It usually helps to do programs together as a family, but indeed sometimes it's best to strike out on your own.

Washington, D.C.: Just from reading the article, it seems that Kathy Duyer is projecting her feelings from her own adolescence on her poor daughter. The girl sounds like any parents' dream -- 4.0 average, involved in activities both in and out of school, and has friends. You cannot make someone lose weight if they are not ready to do so (I know from experience). It is obvious from the daughter's reluctance to initially answer questions for the article (until encouraged to by her parents)that she wasn't ready to participate with her parents in Weight Watchers.

Peter Perl: Yes, Kathy was pretty candid in acknowledging that she was projecting her feelings on her daughter. She learned over time, though, that she couldn't really continue that.

Christchurch, New Zealand: No question. Just a quick thanks for an informative read and a little inspiration. Big ups to the Duyers!

Peter Perl: Thanks.

Alexandria, Va.: Our "make it easy" lifestyle really contributes to lack of exercise. We have escalators or elevators everywhere, our suburbs almost never encourage being able to walk or bike-ride to a desired destination, etc., etc. I notice the difference immediately when I travel, have to walk more just in the course of daily life. We have to make an effort to get more exercise in here in the U.S., where in many places in the world it's just part of what you do to get through the day.

Peter Perl: Yup.

Sterling, Va.: In the article you mention that weight watchers is like 95 percent female and attending was like a "sorority meeting." Would you contend that is is not really conducive to a more male focused program? Of which I can't think of a single one by the way. Why the focus on women in these kinds of organizations?

Peter Perl: Seems to me that our society (particularly advertising, TV, popular media) is obsessed with sex and women's bodies. So it's no surprise that women are desperate to be closer to the ideal that society keeps hammering at them.

Bethesda, Md.: Peter:

Isn't the growing obesity of America the logical end product of suburban planning that provides little incentive (or safe opportunity) to walk anywhere, combined with the crazy lives that most of us lead that puts a real crimp on spending time shopping and cooking. That combined with portion creep. I remember as a kid when bottled of soda came in 8-ounce sizes and the introduction of the 12 oz can was a big deal. Now bottles have grown from 16 oz to 20 and now 24 oz--three times more than the average serving 20-30 years ago.

Peter Perl: Yes, I think you have touched on some of the major causes.

Washington, D.C.: I really enjoyed the article, but I had a problem (like many) with the way the parents treated their overweight daughter. As someone who was obese as a teenager, nagging parents are more likely to push you in the other direction. She has to decide for herself that it's a priority for her. Sad to say, that sometimes can only come after dealing with some of the frequent consequences of being overweight (limited wardrobe options, less visibility to members of the opposite sex, etc.).

Peter Perl: Agreed.

Washington, D.C.: How hard is it to draw the line between helping a family member lose weight and crushing their self esteem (especially the kids')? On the one hand, no one should be made to feel bad about not being model thin, but on the other, it's a legitimate concern to watch your overweight kid stuff themselves on snack food from outside the home. It's such an emotional subject, even if it's medically based.

Peter Perl: Yes. Some readers may feel that the Duyers were too hard on their daughter. But in my view, they were not doing it in a hurtful way--and having both been overweight themselves, Kathy & George are careful not to attack Emma's self-esteem. I think they are good parents, trying to do their best.

Rockville, Md.: I think many people have forgotten that healthy low fat food can also taste good. It doesn't take any more work than cooking fattening foods.

Peter Perl: Very true. The obese pediatrician quoted in the story has raised four very healthy kids by feeding them a good, balanced diet.

Washington, D.C.: Dear Mr. Perl,
Your article was very interesting, but I was wondering why you did not spend more time highlighting the class dimension of the obesity epidemic. Clearly, the family you profile has resources to fight fat, but the poor and low-income are much more likely to be obese than the middle class, as CDC statistics clearly show. These folks do not have the resources to buy good foods, join exercise clubs and WW, and even to walk around outside in a safe park. While you mentioned this a bit, you missed, I think, the chance to show that this is not just a health issue, but also a socioeconomic issue and, arguably, even an issue of inequality.

Thanks for your comment.

Peter Perl: Good question. I selected a middle-class family to make the story relevant to the largest number of readers possible. But you are right that there is a strong class aspect to obesity. Education, income and social class all correlate inversely to overweight. It is indeed a socioeconomic issue, which is why I included the section on the Childrens Hospital pediatrician who works in low-income populations.

Gaithersburg, Md.: How do you maintain your motivation when its 10 p.m. and its been a really rough day? Nothing like a box of Wheat Thins and a re-run of "Law and Order" to calm those stressed out nerves.

Peter Perl: That's why we have carrots & celery and pretzel sticks.

Gettysburg, Pa.: Maybe you could comment on an observation I've made in recent years: This country makes it extremely difficult to engage a simple forms of exercise such as walking. For example, in many business areas, we don't have sidewalks, but only busy highways that are unsafe for pedestrians. To walk across the street from the mall to the grocery store means taking my life in my own hands. When I've gone to Europe, I've always lost weight, because I've had to walk from the train station to wherever I am staying or visiting. I think I would be twenty pounds lighter if I could this type of thing on a regular basis.

Peter Perl: Very good point. I agree.

Ballston, Va.: Our society sends such a mixed message - First, advertisers and Hollywood scorn anyone not twig thin or buff, yet fad diets, plus-sized clothes, and junk food are sold at record rates.

Individuals can choose to change. Where can a national change begin? Articles like yours are a good first step.

Peter Perl: Thank you. As an earlier message indicated, our schools have to pick up the ball here. We need to educate younger people sooner and better about the importance of this problem.

Northern Virginia: As someone who lost nearly 150 pounds after a lifetime of morbid obesity, I read your article with intense interest, and enjoyed it very much. My personal experience (and success) has led me to two key insights about losing a large amount of weight. The first is stop kidding yourself! Losing big weight requires a big commitment. The second is that once you have truly decided that you want to lose weight -- once you have bottomed out on being obese -- making the big commitment is easy and even fun.

You hinted strongly in your article that at least some members of the Duyer family lack the true desire to lose weight -- the section on the father's refusal to acknowledge that multiple heart attacks are a good reason to lose weight was both sad and familiar to me, as was the doctor's insistence that living with obesity was all a matter of having the right attitude.

What are your thoughts on the desire or lack thereof to lose weight among your subjects? Do you believe, as you hinted at the end, that acceptance of obesity (by obese individuals and society at large) is as great a threat as our toxic nutritional environment?

Peter Perl: Thanks for sharing your experience. I think some people need to make peace with the fact that they will never achieve their ideal weight. But I think there's a delicate balance here--we can't ridicule and isolate and, essentially, abuse people who are obese; we also can't throw up our hands and allow bad habits to threaten the health of so many people either.

Arlington, Va.: I believe we eat pretty well for an American family. Neither my husband nor I are overweight (although I would like to lose that ever-present 10 pounds). However, a German friend who stayed with us once commented that we don't eat enough vegetables! And I thought we were atypical in provided fruits and veggies!

However, not only do Europeans eat more intelligently, it seems to me they have greater access to more fresh produce. It is an effort to leave the supermarket stash and go to specialty markets and farmer markets. And, as you pointed out in year article, even decent supermarkets aren't in neighborhoods for the poor.

How can this access to fresh foods be addressed?

Peter Perl: You raise a very good point. I don't know the answer--except that when more consumers demand better, fresher produce, more of it will appear in markets. Right now, it does, indeed, require major effort to get it.

Washington, D.C.: I am disappointed that your piece didn't really focus on the number one dietary cause of obesity -- meat. Even with Weight Watchers and other combined exercise and diet programs, too many people are taken in with the "lean meats/lean cuts" fads, ignoring that chicken has as many bad calories as pork.

Peter Perl: A point worth hearing, although I'm not sure about the contention that meat ranks number one in dietary causes.

Recently Returned From Paris: It's true; I saw maybe two people in eight days in Paris who looked maybe 250+ (women). I saw several times that many within 24 hours back on U.S. soil.

The Parisians eat great meals, but they eat smaller portions. They don't snack much. Even the McDonalds there have smaller portions, and the prices are no bargain. A glass of wine is cheaper than a bottle of Coca Cola.

Yes, you can buy snacks in Parisian stores, but they don't have nearly the amount of shelf space devoted to empty calories. And, they walk everywhere and use the Metro.

They also smoke. A lot. Especially the women. Not a good fact, but could be contributory.

We were there for eight days, I ate pretty much what I wanted, within reason (I did some limiting) and a week after coming back I was 3.5 pounds lighter than before leaving for Paris. We walked miles and miles every day.

I'm on WW and have lost nearly 70 lbs and am about 10 lbs from goal. I have never been happier -- and I'm eating a surprising amount of food for my age and height (I'm also a long-distance bicyclist, which helps burn the calories).

We can learn a lot from the food habits of people in other countries -- good and bad.

Peter Perl: Thanks for another interesting international perspective. These days, more than ever, we need to be open to learning things from other cultures.

Gaithersburg, Md.: I'm sure I won't be the only one asking this question, but what motivated this family to be the focus of this article, specifically including their children? As a parent, I can't imagine subjecting my child to this interview process. Although the daughter with the weight problem appears to be tough enough to deal with her peers, kids can still be really mean to heavy kids and with the "fame" from this article, it could prompt intensified taunting from her classmates. Thoughts?

Peter Perl: Good question. Kathy Duyer believed (I think correctly) that participating in the story would actually help their weight-loss goals. The added pressure of being in the public eye was another motivator for them.
They also are aware that their struggle is a very common one, and they were willing to be part of a hopefully educational process of letting readers know what it's really like to fight this fight every day.

Bethesda, Md.: I am a member of Weight Watchers and have been on and off for several years. It is a good program, much better than some of the other group organizations. It can, however, be a bit disconcerting to see people lose amounts of weight when you're only losing 1/2 a pound, etc. I have found that when the family is involved, the weight comes off a lot quicker. Also, when you live with someone who doesn't want you to lose weight, it can be difficult.

Peter Perl: Yes. As with other things, personal support can be crucial.

Bowie, Md.: Obesity is a problem to which our culture has not yet developed a psyche. On the one hand, we don't want to judge people on their looks, but being overweight is not solely a beauty matter (like being bald or grey) but also a health issue. Obesity is also not just a facet of who a person is and cannot change, but is at least in part a behavioral choice.

As we face the entry of the first baby boomers into Medicare in just eight years, the implications of health on the economy is about to explode as a political issue. The old paradigm that what I eat is no one else's business needs to be re-thought.

Peter Perl: That's a very interesting point. And yes, our culture has very mixed messages and ambiguous attitudes--and the issue looms larger as the baby boomers age--and expand their waistlines.

Cottage City, Md.: Exercise is the hard part for most of us. And the heavier you are, the harder. I sympathize with Mrs. Duyer's attempts to nag her overweight daughter into better habits, but she has already found it doesn't work -- even works against her. She might have more success if she can find physical activities her daughter enjoys. If the gym isn't doing it, then a yoga class? or karate or judo? Dance? These have the additional benefits frequently of improving the mental self-image as well as moving the muscles and burning fat. A teenage girl needs all the positive image she can get. Obviously her daughter does have self-discipline and intelligence to do so well in academics, just need her to see this as one more place to apply the same qualities.

Peter Perl: Thanks.

Washington, D.C.: Very interesting article on the Duyer family and their efforts to lose weight and get healthier. I was really happy that at the end of the article the mother decided to back off of her daughter and let go of attempting to micromanage her diet. I was a slightly overweight teen whose mother was a constant nag and all it did was make me did in my heels further. And nothing makes a teen more recalcitrant and angry than someone looking over your shoulder 24/7 monitoring every morsel of food you eat. I sympathized with the mother's desire to try to shield her daughter from the pain she experienced as an overweight teen, but her daughter will have to come to her own decision on her own time about dealing with her weight and what, if anything, she will want to do about it.

Peter Perl: Thanks. There is no easy "happy" ending to this story, but I think the family collectively has made a lot of progress on both the physical and emotional aspects of dealing with overweight.

Peter Perl: Thank you all for some very interesting observations and questions. I've heard from quite a few readers and am particularly pleased that a number of you found the story inspired or educated you.

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