Obesity

Despite the fantasies of celebrity magazines, in which bone-thin women drop baby weight before they've changed a diaper, for the average-size American woman -- that is, a size 14 -- pregnancy is a gateway to years of elastic waist bands. It's not hard to see how this happens: When you've given up caffeine and alcohol, when you have to struggle to tie your shoes or roll over in bed, chips and Häagen-Dazs are no small comfort. A friend confided in me about the last few miserable weeks of her trimester: "I was drinking a chocolate milkshake every freaking day. I was shameless." Problem is, however easy it is to pack on the pounds, it can be really, really hard to get them off.

In decades past, the dominant way of thinking was to acknowledge this reality and fight against it tooth and nail. But lately, against the backdrop of eerily vanishing celebrity baby bumps, a kinder, gentler approach is on the rise. Forget fitting back into your skinny jeans a few weeks postpartum. Love your post-baby body. Embrace the extra "you." Katie Gentile writes in the Daily Beast that, "When women shed the baby weight, they are not merely getting back their pre-baby bodies, they are obliterating all evidence of ever having had a baby in the first place … The post-baby body is wrung of its recent life-giving feat." In a Jezebel item, Sadie Stein admonishes the new "baby weight craze. She quotes a commenter on UrbanBaby who tells women to "think about all your body's been through and don't be so hard on yourself."

There's even a book devoted to this anti-Hollywood, anti-dieting perspective, a feel-good meditation on baby weight -- "Does This Baby Make Me Look Fat: The Essential Guide to Loving Your Body Before and After Baby." Its authors plead with new moms not to be too hard on themselves for having a little postpartum flab, encouraging women to love their bodies, to eat healthy and to embrace their roundness. All of this is part of an understandable pushback to the beauty-industrial complex, which creates impossible standards for women made worse through airbrushing and Photoshopping. But the big, fat truth is that most mothers aren't going too far to shed their excess baby weight. We're not going far enough. Sixty-two percent of American women are overweight, and so for the majority of American women, excess, lingering baby-weight is a real problem: health-wise, self-esteem-wise, and otherwise. There's a reason women are buying those "baby weight craze" tabloids; because in a world of stubborn belly fat and clinging cellulite, that fantasy is powerful.

If I'd heard someone making this argument four years ago, I probably would have rolled my eyes. What's changed between then and now is a 2-year-old (mine), two pregnancies (I'm currently in my third trimester for No. 2), and 15 pounds of excess weight that have made my second pregnancy a lot more uncomfortable than my first.

I take full responsibility for this predicament. I have a profound and unshakable love of good eating. A slice of perfectly buttered, warm-from-the-oven bread has been known to bring tears to my eyes. I don't know that I want to live in a world without cheese. I adore cooking and baking and holiday feasts and dining with friends and spending too much money on mind-blowing meals in wonderful restaurants, but mostly, and quite simply, I love food. Before my pregnancy, I stayed healthy (never skinny) by exercising regularly, eating tons of fruits and vegetables all summer and not getting too down on myself if I plumped up a little, hibernation-style, in the winter. It was a delicate equilibrium that took years to achieve and only a few months to unravel, specifically the first few months of my pregnancy, a dark, cold winter in Chicago when, elated by the knowledge that I was nurturing a little life and relieved by the fact that I could keep nausea at bay with the continuous ingestion of egg bagels, plain pasta, white rice, baked potatoes and every other starchy goodness known to woman, I dispensed with moderation.

For the first time in my life, I felt light and free, even as my thighs and hips grew heavy. I did things I never would have done sans fetus. I "treated" myself to drive-through junior bacon cheeseburgers on my way home from the gym. Guacamole-laden tortilla chips replaced seasonal salad as my first course of choice. I bought a maternity tee with the words, "We're hungry," printed across the belly. I didn't stop exercising, but it seemed like the more I exercised, the more I ate. In 39 1/2 weeks of pregnancy, I gained 39 1/2 pounds, and then delivered, to my astonishment, a little peanut, a 6-pound, 10-ounce baby boy. When I came home from the hospital, I hardly recognized myself. It took me about a year to lose the first 25. I was still working on the last 15 when No. 2 made an appearance on the sonogram screen.

It's because of women like me, or women in far worse health predicaments -- women entering pregnancies with a lot more than 15 excess pounds -- that many healthcare providers are beginning to focus more on nutritional counseling programs as an integral part of prenatal care. The medical director of one such program at Northwestern University, Alan Peaceman, explains that in addition to the risks of gestational diabetes, preeclampsia, and cesarean sections, new research suggests that "women who gain excessively during pregnancy may be putting their children at risk for obesity. So they're not doing this to fit back into their jeans six weeks after pregnancy. They're doing this for the health of their babies."

When I asked Peaceman if he worries some women might take the message too far, falling prey to the body-hating, "pregorexic" mentality, he laughs: "That's just not the major issue that affects the population in this country. The much bigger problem is the women who gain too much and then can't lose it. A lot of women who've fought weight issues their whole life look to pregnancy as a time when the rules are off, when they don't have to engage in the struggle. We need to get the word out that this is not the case."

The program is intended for women with a pre-pregnancy BMI over 30, which means I'm not quite fat enough to join in. Nonetheless, it inspired me. I wouldn't say I've been on a diet during this pregnancy, but I haven't been throwing caution to the wind, either. Unlike last time, the woman at the fast-food drive-through doesn't know me by name. And unlike last time, when after the birth of my son I put off diet and exercise for as long as possible, I plan to be working off the weight this time as soon as my doctor gives the green light. Look, any woman who's given birth and nursed a child knows there's no fighting physiology at least in some respects. But I want to recognize myself in pictures. I want to feel sexy again in a short skirt. I don't want an entire lot of pre-baby clothes to languish in the back of my closet for the next 20 years until I pass them along to some smug, skinny niece who loves their "vintage" look. I could say that I'm doing it for my health, and this would be partially true. But frankly, I'm doing it because however short my pre-pregnancy body might have fallen from the celebrity ideal, it was mine, and even with two babies in tow, I want it back. 

Yesterday, the Department of Education shifted its policy -- not to re-allow homebaked goods, not even zucchini bread, but to allow the sale of certain packaged snacks meeting nutritional guidelines. The guidelines specify that these snacks must in in single serving packages, have a calorie content of 200 calories or less, with less than 35% of those calories from sugar or fat, and cannot contain artificial sweeteners.

The argument is the inability to quantify the fat and sugar content of homemade treats, versus the nutrition information that is available for packaged snacks. This new policy was issued to address the concerns of parent and student groups who found themselves unable to fundraise without bake sales.

You'd be shocked at what meets the guidelines: certain flavors of Pop Tarts, Doritos, and Nutri-Grain Cereal Bars make the cut. Per the New York Times,

Under the new rules, students may sell fresh fruits and vegetables, or one of 27 specific packaged items that have been approved for sales in city vending machines, between the start of school and 6 p.m. on weekdays. The same goes for parent groups, except for an exception carved out for one no-brownies-barred Parent Teacher Association bake sale during the school day per month.

Students interviewed by the NYT were not pleased with this compromise. Even from a fundraising point of view, one student commented that the changes would not be enough:

"With the packaged goods, half the profits are going to the companies," said Anya Lehr, a senior at LaGuardia High School for the Arts. Her club, Model U.N., she said, was having trouble raising the $200 it costs per student to compete at the United Nations. A good bake sale, she said, used to earn up to $500 per day.

Still, the policy was approved unanimously. This, despite the fact that administrators themselves weren't even convinced of the nutritional value being put forward

Kathleen Grimm, the deputy chancellor who oversees the regulation, told members of the panel that the permitted snacks were not "necessarily foods we recommend that students eat."

Does anyone smell a rat?

Say what? The federal government is trying to limit big food’s footprint in our schools?

If Agriculture Secretary Tom Vilsack gets his way, he intends to do just that: "Food served in vending machines and the a la carte line shouldn't undermine our efforts to enhance the health of the school environment," he said.

A short introduction to school food

On any school day more than 30 million kids eat a school lunch and 10 million kids eat a school breakfast. Fifty-nine percent of the kids eating a school lunch are from low-income homes, as are 80 percent of school breakfast eaters. The school lunch program operates in all public schools and in many private schools.

The National School Lunch Program was created with a dual purpose -- to feed kids and prevent dietary deficiency and to provide an outlet for surplus agricultural commodities. One can already see that the dual purpose of the program throws in some problematic conflicts of interest, but let’s go on.

The government provides $2.68 per day for kids qualifying for a free lunch, $2.28 per day for a reduced-price lunch, and $0.25 per day for all other kids. That sum includes the overhead and facility costs associated with the meal, which leaves just $1 -- or less -- for the food itself. This is clearly not enough money to fund from-scratch cooking or quality, fresh produce. President Obama proposes bumping up the school lunch budget a tad -- which will be better than nothing -- but the additional funding probably won’t afford a huge amount of change.

What kind of meal can you get for $1?

An adventurous school teacher vowed to eat the school lunch every day this year, and she’s posting musings and photos of her cafeteria meal in a daily blog. Take a look at the pictures (take note of the amount of packaging) and you’ll get the idea.

I’ve devoted several posts to this subject and analyzed the typical school lunch menu, concluding that the best description for this food is "fast-food" (Full disclosure: I’m both a pediatrician and vice president of product development for a company that makes herb-infused water). Overall, it’s salty, sweet and fatty; the meat is breaded and crunchy; and it’s been highly processed -- even the fruit and vegetables aren’t fresh for the most part. Most of the schools have no kitchens and just heat and un-wrap low-grade foods. Nevertheless, the subsidized school lunch complies with some nutritional guidelines and provides plenty of protein and vitamins, and while I think guidelines based on the nutrient profile of foods alone are an ill-advised way to evaluate food quality, at least some rules exist.

But if the federally sponsored and regulated school lunch program leaves much to be desired wait till you get the full picture, because challenging the school lunch, are what are called competitive foods.

These competitive foods -- comprised of foods and beverages sold in the cafeteria or in a school store, from a vending machine or in fundraising events -- are expressly marketed to our kids and make up a big part of what kids actually eat while they’re in school.

Kids love the vending machines and the school stores, but that’s not the only reason these outlets exist. Schools depend on the revenues that vendors bring in to fund much-needed programs. This creates an unusual and worrying conflict, in which schools share an interest with the manufacturers of snacks and junk foods.

School candy-land

Here are some facts about the scope of the competitive food problem. (The source is an article in the Journal of the American Dietetic Association that looked at data collected in 287 nationally representative schools and included 2,314 kids.)

Availability:

• One or more sources of competitive foods are available in 73 percent of elementary schools, 97 percent of middle schools, and 100 percent of high schools.
• À la carte foods sold in the cafeteria are common in all school levels.
•  Vending machines are available in more than one quarter of elementary schools, 87 percent of middle schools and virtually all high schools.

Consumption of competitive foods :

• 40 percent of school kids consume these foods on any given day.
• Consumption is much higher among high schoolers -- 55 percent.

Energy contribution of competitive foods:

• Kids consume about 280 calories per day from competitive foods, and almost two- thirds of these calories were from "low-nutrient" and "energy-dense" foods. (The study defines “low-nutrient, energy-dense food” to include cakes/cookies, desserts, donuts, toaster pastries, snack chips, French fries and caloric beverages, excluding milk and 100 percent juice.)
• A typical high school kid gets about 340 calories per day from competitive foods, 65 percent (or 220 calories) of which are from junk food.

The most commonly consumed competitive foods:

• Desserts, snacks (cakes, cookies, candy and ice cream) and sweetened beverages.

So, we have low-quality foods sold in the schools competing with a low-quality school lunch -- a competition that’s a lose-lose for our kids. Wherever our kids turn they have snacking opportunities that contribute mostly empty calories.

The only existing federal restriction on foods sold in school is that foods of "minimal nutritional values," such as candy and soda, won’t be sold in the cafeteria during meal times. That of course doesn’t mean they can’t be sold right outside the cafeteria doors. And although some school districts have taken initiatives to impose restrictions banning some junk food sales in schools, progress is very slow.

It is high time school food begins to resemble a lesson in how to eat healthfully. Right now, the school lunch -- and especially the school foods for sale -- resemble all that’s wrong in our popular food culture, and explain quite well why one in three American kids is overweight or obese.

Kids spend half their waking hours in school and consume half of their daily calories while on campus. Changing school food is critical in the effort to combat obesity.

I applaud the White House and especially our First Lady for taking on this important issue. "Let’s Move" is the politically savvy way to name what will have to really become a "Let’s Eat Less Junk" effort—but whatever it takes let’s indeed move it!

But it's about that other 10 percent. Specifically, my issues are with how you're framing this as a strategy to "solve the epidemic of childhood obesity within a generation," rather than to improve health and well-being across the board, and whipping up fear and disgust of the very fat children you're supposedly trying to help. You've gotten so much right, but here are five things I think you and your partners are getting wrong.

Fear-mongering part 1: Exaggerating the crisis

The president's memorandum on establishing a childhood obesity task force, your remarks at the Let's Move launch, and countless news reports about fat kids uniformly paint the situation as horrifyingly out of control, nigh onto hopless. "Across our country, childhood obesity has reached epidemic rates and, as a result, our children may live shorter lives than their parents," begins the memorandum."Nearly one third of children in America are overweight or obese -- a rate that has tripled in adolescents and more than doubled in younger children since 1980."

Now, let's unpack that a little bit. According to the CDC, for children, "Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex." 12.5 percent of preschool-aged children, 17 percent of kids 6-11, and 17.6 percent of adolescents up to 19 are obese by those criteria. So the key words in that one-third stat are "overweight or" -- combining the two categories makes the "childhood obesity epidemic" sound a lot more dramatic than it is. Granted, there has been a big jump in the childhood obesity numbers since 1980 (up from 5 percent, 6.5 percent and 6 percent, respectively), but the good news is, there's evidence that it's already leveled off. Which means -- good news for you -- this is the perfect time to launch a childhood obesity initiative, since a population that's been so thoroughly convinced we're all headed straight for a Wall-E scenario will think the intervention was a rousing success if all it does is maintain the status quo. But it's kind of disingenuous to act as though you're stepping in to stop an increasing problem that's not actually increasing at the moment. That just confuses people.

As for the threat that this could be the first generation not to outlive its parents, with all due respect, I'll believe it when I see it. So far, the U.S. lifespan keeps increasing like nobody remembered to tell it what a bunch of lazy gluttons we've been turning into since the mid-20th century (when, as we all know, nobody had unhealthy lifestyles). Could that turn around? Sure. Is there any reason to think the current number of overweight and obese people (oh yeah, the rates have leveled off for adults, too) will cause that, especially when research has shown that overweight is not associated with excess mortality (in fact, it carries a lower risk of premature death than so-called normal weight) and "the relative risks of mortality associated with obesity were lower" (emphasis mine) in more recent years? Let's just say I'm not convinced.

Fear-mongering part 2: Exaggerating kids' laziness.

Says the press release about the Let's Move launch: "Children need 60 minutes of active play each day. Yet, the average American child spends more than 7.5 hours a day watching TV and movies, using cell phones and computers, and playing video games, and only a third of high school students get the recommended levels of physical activity." That sounds horrible! But wait, let me think about that for a minute. You've told me how long the average child spends passively consuming media, not how active he or she is. You've told me two-thirds of high-schoolers aren't getting enough exercise, but said nothing about younger kids. I like a good "video games! cell phones!" tsk-tsk session as much as the next geezer, but could we see some more data here?

For instance, we could look at a study published in the Journal of the American Medical Association in 2008, which found, according to the Associated Press, that "90 percent of 9-year-olds get a couple of hours of exercise most days" -- in fact, an average of three hours of "moderate to vigorous activity" -- and "[t]hrough age 12, well over half the children got at least the government-recommended amount of activity every day." There is a dramatic drop-off in activity levels when kids hit high school, but I'm still waiting to see the proof that it's because of video games or laziness and not, say, the fact that older kids have far more intense workloads (which demand a certain amount of time in front of the computer, I might add). Researchers interpreting a 2007 Statistics Canada survey "tallied the hours that teens aged 15-19 spent at school, doing homework, working part-time jobs and doing chores, and found that they did an average of 7.1 hours of unpaid and paid labor per day in 2005," according to Scripps Howard News Service. "That adds up to a very adult 50-hour workweek."

So, here's another way to describe children's activity levels: "The vast majority of younger kids and more than half of young adolescents are getting plenty of exercise; many are getting more than the government's recommended levels. This is fantastic! But as kids get older, their activity levels drop -- at the same time their schoolwork becomes more challenging and their responsibilities increase." Problem is, addressing that would involve looking closely at what we demand of older kids and how it affects their ability to care for themselves -- sleep deprivation is another health issue at that age -- instead of blaming technology and couch-surfing.

I realize that getting people's attention requires a bit of drama, but when it borders on flat-out lying -- implying that obesity rates are still increasing apace, or that most children (as opposed to most teenagers) are getting less than the government's recommended amount of exercise -- you're going too far.

Conflating fitness with thinness, and using BMI as a measure of individual health

"Normal weight" and "cardiovascular fitness" are two different things. It is possible to be fat and fit. It is possible to be thin and unfit. Cardiovascular fitness is associated with improved health outcomes for people of all sizes. These statements are not controversial.

Population-wide, the overweight and obese BMI categories are associated with increased "cardiometabolic risk factors," but nearly a quarter of normal-weight adults are "metabolically abnormal" and a third of obese people are normal, while it's about half and half for those in the overweight category. BMI doesn't tell you anything about body composition, and a 2000 large-scale study of children found that one in six normal-weight kids had excess body fat, while 25 percent of "high-BMI children" had a normal percentage of body fat. BMI also doesn't tell you how muscular your child is, if that suddenly chubby kid is due for a growth spurt that will even things out, or whether she's gaining weight at a consistent rate for her own body.

Yet you insist on targeting fatness instead of fitness, heaping stigma on healthy people with high BMIs and neglecting the needs of many of those within the "normal" range. Richard Telford, research director of the Lifestyle of Our Kids study at Australia's Commonwealth Institute summed up the problems with that kind of thinking in a 2009 article,, "Measure for Measure, BMI Has Big Flaws":

Given the difficulty of measuring fat, especially in children, evidence that inactivity rather than weight alone puts children at risk of ill-health, and that natural changes in body composition are hard to predict as children grow, politicians and education authorities should think carefully about any proposal to measure the BMI of schoolchildren.

Let's get off kids' backs about possibly being fat and let's get them active.

Indeed.

Assuming that people will respond to all this hullabaloo in a reasonable, healthy way

"Before governments and other agencies leap into actions that they assume to be beneficial in the battle against child obesity, we must remember to employ one of the most important principles of modern medicine and prevention science, ‘First, do no harm,'" wrote Jennifer A. O'Dea in a 2005 Health Education and Research article. "There are many examples of perfectly reasonable and well-intentioned health messages being partially misconstrued or misunderstood by members of the general public, resulting in the inadvertent production of undesirable effects in the implementation of supposedly health-promoting activities."

In a 2006 review of childhood obesity prevention literature, Dr. Margaret B. Brown of the University of Delaware gives us the bullet points: "Well meaning efforts to prevent obesity may unintentionally

• create body image issues even for youth who are not overweight (O’Dea, 2005)
• result in unsupervised weight control attempts which interfere with proper development by limiting energy intake, engaging in vomiting and use of laxatives, and adopting “quick fix” diets and fads (O’Dea, 2005)
• further stigmatize overweight children (Latner & Stunkard, 2003; Strauss & Pollack, 2003)
• result in avoidance of health care visits (O’Dea, 2005)
• leave overweight people and unsuccessful dieters feeling like failures (O’Dea, 2005)
• further victimize low SES parents and children"

So there's that. Which brings us to:

Underestimating the impact of body shame and fat hatred

I'm sure you don't have anything against fat kids, Mrs. Obama. But you know who does? Other kids. And a lot of adults, including parents who see their fat children as reflections of their own failings, as disappointments, as embarrassments, and doctors who see them as problems to be solved. You said in your speech yesterday, "Teachers see the teasing and bullying; school counselors see the depression and low-self-esteem." But your solution to that is to get rid of the fat, not the hate.

And that worries me a lot, not only because I care about the fat kids enduring that torture right now, or because, frankly, I'm not optimistic that any of these interventions are really going to eliminate childhood obesity, or because, generally speaking, it's not ideal to teach kids who are bullied for being different that they should just try harder to be normal. It also worries me because body shame can lead to disordered eating and self-destructive behavior in kids of all sizes and -- are you ready for this? -- it might even make them fatter.

In a 2007 study of over 2,000 teenagers, researchers found that many of the same risk factors -- including teasing about weight -- are predictive of disordered eating, "extreme weight-control behaviors" and overweight itself. It's not just normal weight kids who take unhealthy risks when they're encouraged to freak out about their weight -- it's fat kids, too. Only, as long as they stay fat, people aren't so likely to notice them starving or purging or replacing lunch with a cigarette. "We usually look for these behaviors in very thin girls, but here we see a very high prevalence in overweight girls," said lead author Dianne Neumark-Sztainer in an interview. And considering your goals here, Mrs. Obama, I'd ask you to pay special attention to the fact that being shamed about weight predicts overweight status. Weight-teasing by family members was found to be especially damaging. You think that's going to go down when parents are being lectured at the annual BMI check and made to feel like failures if they can't control their children's bodies?

Says Neumark-Szteiner, "We have seen over the years that it does not work to make people feel worse about their bodies. The data are striking — talking about weight, worrying too much about diet, focusing on it increases risk not only of eating disorders, but also of being overweight." That's why the paper concluded, "Support for a lifestyle that is based around healthful eating and physical activity behaviors, and not around weight per se, may prove to be most effective in decreasing the high prevalence of overweight youth, without leading to an increase in an unhealthy weight preoccupation and disordered eating behaviors." My emphasis. Couldn't resist.

It's all well and good to say you don't intend to shame fat kids or their parents, but the reality is, by framing this as an obesity prevention initiative rather than one with benefits for children of all sizes, by emphasizing BMI over fitness and setting a goal of, quite literally eliminating fat children -- could you send a clearer message to big kids that they're unwanted? -- you're tapping into a deep vein of fat hatred running through this culture.

This is a culture in which fat people can't get health insurance or adequate medical care because of prejudice, where teachers, nurses and medical students report having "very strong anti-fat attitudes," including that "obese people lack self-control and are lazy, obesity is caused by character flaws, and failure to lose weight is due only to noncompliance." And in addition to parents, educators and medical professionals are at the heart of many of the strategies you're proposing. O'Dea writes that the problems of "transference and misinformation" among those people can cause more problems than they solve:

Health professionals may need to examine their own beliefs and attitudes towards fat people and fat children before embarking on any child obesity prevention activities, and they may need specific training in order to undertake any role in child obesity prevention. The potential for inadvertent transference of misinformation, inappropriate advice and prejudice from educator to child needs to be examined during the design of health education and health promotion strategies for the prevention of child overweight. In a recent study of the teachers most likely to be involved in school-based obesity prevention activities, we found a low level of nutrition knowledge and knowledge of weight control, a great deal of misinformation being conveyed from teacher to students, and a very high level of body dissatisfaction and self-reported eating disorders, particularly among the young women teachers.

Children raised to hate and fear fat grow up to become teachers with eating disorders who recommend "strict calorie-controlled diets to their overweight students" and doctors who neglect, misdiagnose and disdain larger patients. As long as fat people remain scapegoats for everyone's fears about overconsumption, illness and mortality, our health will remain at risk because of ignorance and prejudice as well as physical illnesses correlated with obesity. And by framing this as a strategy to eliminate childhood obesity rather than a positive nutrition and fitness strategy for people of all sizes, you're contributing to the problem. You're using people's fear and disgust of fatties to sell this project -- because who could get excited about simply making nutritious food more accessible or increasing opportunities for physical activity because it would be good for all of us? No, history has shown that the public only gets excited about boring stuff like that if you tell them it will rid us of the monstrous scourge of obesity. So hey, who cares if it means more fat kids get bullied by gym teachers and fellow students, and berated by parents who are ashamed of their inability to produce "normal" children, and harangued by medical professionals who think fat is not just dangerous but repulsive?

I'm sorry, Mrs. Obama. I shouldn't get so snippy with you, when it's prejudice and hatred that really anger me. Like I said, I think what you're doing here is great for the most part. But gosh, I wish you'd consider focusing on Health at Every Size instead of childhood obesity.

Sincerely, Kate

The problem was no such study existed, Weight Watchers said in a federal lawsuit filed in January. At that point, the campaign had run for less than a month on TV, in print and online, and a federal judge in Manhattan temporarily barred Jenny Craig from broadcasting, publishing or distributing the ads.

Weight Watchers said Jenny Craig's claim was not supported by fact or science.

The purported trial actually was two separate studies, each comparing one company's program to do-it-alone diets. And they were conducted 10 years apart, looked at different outcomes and didn't include Weight Watcher's current diet methods, Weight Watchers said.

Jenny Craig CEO Patti Larchet said in a statement that her company -- a subsidiary of Swiss food maker Nestle SA -- admitted no wrongdoing and has agreed not to compare the results of its own research to past data about the Weight Watchers method.

"In fact, Jenny Craig has such faith in its program and feels so confident about its performance in clinical trials that we challenge Weight Watchers to compete directly with us in a head-to-head clinical trial," Larchet said. "If Weight Watchers refuses to take up our challenge to compete head-to-head in a new trial, we suggest that they offer consumers up-to-date rigorous clinical studies to support the advertising of their current program."

Weight Watchers, which is based in New York, also alleged the Jenny Craig ads' launch was deliberately timed at the height of the diet season. Late December is a crucial period for both companies because it's when people are mostly like to seek help losing weight.

"We are pleased that Jenny Craig will no longer be allowed to continue using this false and misleading advertising, now and in the future, and to put this situation behind us," Weight Watchers President and CEO David Kirchhoff said in a statement.

The feuding weight-loss companies use different approaches to help their clients shed pounds. Jenny Craig's method is based around company-provided food and one-on-one meetings with a coach. Weight Watchers uses a points-based system for food and exercise and offers group meetings.

But oh my God, they weren't perfect! Their BMI was off balance!

Now, Mrs. Obama is trying here. She's a real woman who is raising two little girls in a country with a mounting obesity problem and an incredibly fucked-up relationship to body image. She understands our challenges in getting our kids to exercise and eat right, and she wants us to see her family is like our family. So when she stood up and said, "Knowing that you’re going home to an empty refrigerator and kids who are hungry and fussy and not wanting to eat anything you have in mind. All they want is some pizza and some burgers. Right? And you don’t want to argue, you want a peaceful meal. You want everyone to be quiet and just eat," it was like she was looking at every mother's life. But while to the rest of the world she's an accomplished  leader, to Sasha and Malia, she's Mom. And Mom just made an example of their less than perfectness. Lesson here: Parents are so embarrassing – even when they're the first lady of the United States. (Dad's no slouch either. In 2008 he told Parents magazine, "A couple of years ago -- you’d never know it by looking at her now -- Malia was getting a little chubby.")

As it happens, Sasha and Malia have two physically fit, slender parents, so the genetic deck is already stacked in their favor. And while some studies show a correlation between childhood obesity and future weight and health problems, it's not the only thing. Many people, like our president, for instance, go through a variety of childhood fluctuations before settling into their adult body type. I was a lumbering, chubby kid myself -- though my parents were neither of those two things. But my eventual slimmed-down outcome didn't help when I was a little girl and, in my whippet-thin mother's words, had "thunder thighs."

I live in a lower-income, predominantly immigrant neighborhood where the rate of childhood obesity is downright grim. It's a problem that affects everything from future health to academic performance.  Getting kids away from the computer and TV screens, away from the fast, overprocessed foods, is something we can all get behind, but not first and foremost because they might wind up with a higher BMI -- a number that is not the be-all and end-all by a long shot anyway.

The way to instill healthy habits in children cannot involve anything that smacks of critique. Trust me, they've got the entirety of pop culture to make them feel bad about themselves, they don't need our help. We've got to sweeten the deal, so to speak. It's fun to run around! It's fun to help with the grocery shopping and the cooking! We've got to walk the walk ourselves as mothers, in the way we eat and live and keep our damn mouths shut when we feel a wave of criticism about our own or anybody else's body coming on. We've got to similarly zip it about food being "good" or "bad" and let it just be food, because our kids are going to have to spend the rest of their lives eating the stuff. It's not always easy. Believe you me, there are days when my own daughters give me the "you're not fooling anybody" look when I offer them apples for an afternoon snack. But if we don't obsess or fetishize, if we demand better options at the supermarket and support initiatives like Wellness in Schools  and generally bring in more broccoli than corn dogs, it'll be OK. And if after all the running and the cooking and the broccoli and periodic corn dogs, our kids grow up healthy and with a number on a scale or BMI that's somehow different than the ideal one on the chart, that's OK too. Because they're still our kids. And they're perfect.