The Child-Fat Problem

Just three months ago, a major study published in the Journal of the American Medical Association confirmed what any American with eyes even half-open could already have reported — that not only our adults, but also our children, are fat and getting fatter all the time. As the Department of Health and Human Services put it in a summary of this latest study’s evidence, “Among children and teens ages 6 to 19, 15 percent (almost 9 million) are overweight according to the 1999-2000 data, or triple what the proportion was in 1980.”

The widespread media attention given to this bad-news story would appear to be justified, for the jama study followed at least two other blue-chip examinations during the past year or so of the underage fat explosion. One of these, a report on the whopping economic costs of child and adolescent obesity, was published in Pediatrics magazine by researchers for the Centers for Disease Control (cdc). The other publication was a less prominent but also intriguing report in the May issue of the Journal of Nutrition written by researchers at the University of North Carolina. This one emphasized one of the lesser-known aspects of the fat problem — that “adolescent obesity increases significantly among second- and third-generation immigrants to the United States,” in the words of a unc press release.

This is not to say that underage corpulence is unique to Americans and their offspring — far from it. Misconceptions and undeserved reputations to the contrary, most other advanced countries (and for that matter, a number of not-so-advanced ones) do indeed share in the child-fat-and-obesity problem, for the most part differing from us in degree rather than kind. In England, reported the Guardian earlier this year, “Adult obesity rates have tripled and those in children have doubled since 1982.” In Canada, says the Globe and Mail, also in 2002, “More than a third of Canadian children aged 2 to 11 are overweight, and half that number are obese, according to newly published Statistics Canada data.” Moreover, “Canada now has more fat children than fat adults.” As for Australia, a 2000 study there found that children of either sex were twice as likely to be defined as overweight in 2000 as in 1985.

Nor is the Anglo-speaking world the only one with a child-fat problem. Its svelte reputation quite aside, for example, continental Europe and its children are ballooning as well. In Italy, report researchers for the Bollettino Epidemiologico Nazionale, “Neapolitan children were more at risk of obesity than were children from France, Holland, the United States, and also than children living in Milan in northern Italy,” while in the province of Benevento, “The prevalence of overweight and obesity was greater . . . than in England, Scotland, and the United States.” In Germany, according to researchers in the International Journal of Obesity, a “large study on all children entering school in Bavaria in 1997 shows patterns of overweight and obesity which are comparable with other European data” (though still “lower than us and Australian data”). Even vaunted France, if the French National Institute of Health and Medical Research is to be believed, admits an obesity problem among 10-year-olds of “epidemic proportions.” “The number of seriously overweight children in France,” reports the same institute, “has more than doubled since the 1980’s.”

Yet even granting the ambiguous relief of knowing that we are not the only giants pounding the earth, there is still no denying that the world’s sole remaining superpower is also its most supersized. We Americans are remarkably catholic in this fat problem of ours — and, the nod to egalitarianism aside, our universalism here works to just about everyone’s detriment. The fact that we fatten up even our immigrants, several subsets of whom are measurably bigger here than are counterparts in their home countries, means that we are virtually guaranteed a steadily growing quotient of bigger and bigger people, with an unhealthy degree of heaviness becoming ever more the unremarkable norm.

In fact, exactly that sort of necessity-driven renorming is already on display ubiquitously. Witness the explosion of “husky” sizes in children’s clothes. Witness the popularity of “hip-hop” styles among adolescents of all races — a form of bodily tent more akin to, say, the burka than to traditional Western couture. Look too to the famously enlarged portions of every processed thing one can imagine ingesting or imbibing, and the ever-larger cup-holders and the ever-larger cups to put in them — even those ever-larger vehicles designed to comfortably transport our ever-numerically-smaller families. And let us not forget, either, just to round out the class participation in all this, the enduring appeal of such middle- and upper-class sartorial favorites as fleece and spandex and velour and washable silk — all of which, whatever their other virtues, have more “give” than the traditional cotton and wool.

Of course the fast food industry, as a recent lawsuit against McDonald’s indicates, is everyone’s favorite scapegoat answer to the question of how we got this way. Corporate America is also the culprit in a recent book by Greg Critser called Fat Land: How Americans Became the Fattest People in the World (Houghton Mifflin, 2003). But it is at least as reasonable to suppose that the opposite is true — that fast-food franchises and the like are responding to demand rather than creating it. Maybe Americans are not in fact wallowing zombie-like to the trough because Colonel Sanders tells them to. Maybe fast-food and other companies unable to ignore our capacious appetites are just engaged in business as usual: trying to keep the customers — with apologies — fat and happy.

Thus, for a host of reasons, will something like the corpulent continue to be with us. On the other hand, as the analogous case of tobacco smoking would appear to suggest, the stigmatization and eventual diminishing of fat are hardly impossible; indeed, both would appear to be already underway, led as before by near-unanimity among medical and other experts. As with smoking, however, such a massive change in entrenched personal habits will not come easily or quickly. More likely, it will take several generations, numerous surgeons general, a great many lawsuits, and plenty of personal backsliding along the way. Still, anyone who has ever wondered what a spittoon was for is a case in point of how the stigmatization of human behaviors ebbs and flows. The longer-term question, one would bet, is not whether Americans of future generations will be tipping the scales more to their doctors’ satisfaction, but when.

If free-choosing adults were the only people implicated thus, we could perhaps rest philosophical here, content in the knowledge that the fat problem — again, like smoking — will ultimately right or at least ameliorate itself in the long run. The problem, however, as the latest round of headlines demonstrates, is that the casualty count goes beyond those with free choice. For there is something uniquely worrisome, both as a public health issue and as a social fact, in one important subset of that problem — namely, the cavalcade of new evidence about obese and overweight children.

Child fat, though obviously related to adult fat in a variety of debated ways, is nevertheless a different order of problem — as experts already agree and the public is only beginning to recognize. The many American adults who might arguably be said to weigh more than they “ought” are one thing. (For the best and wittiest recent review of current thinking on that subject, see Rhoda Rabkin’s essay, “Fatter Than Ever,” in Policy Review 106, April-May 2001.) As one of many risky behaviors in which adults manifestly take pleasure, overeating — like, say, drinking, smoking, drug-taking, and promiscuous sex — will have certain adverse consequences; these consequences will vary in seriousness according to how often and how long the risky behavior has been going on; and adults, though they may injure themselves by any and all of the above, are by common near-consensus qualified to make their own decisions about self-inflicted risks and injuries (subject to a certain measure of hectoring from others).

In fact, a compelling case can be made that of all the above-listed personal behaviors prone to abuse, adult fat is least injurious to the greater public good — even given the issue of its medical costs, which are surely more than offset by the fantastically successful diet and fitness industries which naturally exploit the problem. Excess weight, in and of itself, does not cause traffic accidents, wreck marriages, impair moral and social judgment, or cause upswings in communicable diseases. Moreover, one might bear in mind the fact that the “problem” of adult corpulence, while real, remains the sort of problem that much of the rest of humanity would like to have. “To be sure, obesity is a major health problem,” as Stephen Moore put it recently on National Review Online (November 27, 2002). “But it is not nearly so problematic as the nutritional problem for most of mankind throughout the ages: chronic hunger and periodic famines.” In sum, the fact that some half of American adults may be carrying around more pounds than their doctors think fit may not be what admirers mean by national greatness. But compared to a good many other social ills, adult fat would appear (except perhaps from the point of view of trial lawyers) more socially negligible.

No such rationales, however, can be applied to the case of child and adolescent fat. As the New York Times put it the day after Thanksgiving in an editorial clearly reflecting the gravity of the phenomenon, “the issue has serious long-term implications. For the first time, children are being diagnosed with weight-related chronic ailments that usually strike much later in life, including hypertension and diabetes.” Poignant evidence of the same appears particularly in the cdc report mentioned earlier, which documents the dramatic increase in obesity-linked hospitalizations for children — the doubling of diabetes diagnoses, the fivefold rise in sleep apnea cases, and the tripling of gall bladder disease admissions, all during the past two decades. The European and other national reports mentioned earlier note the same phenomenon; that is, the appearance in even very young obese children of diseases and disorders hitherto thought limited to older adults. And though a handful of contrarians have stepped forward in the Atlantic Monthly, the New Republic, and elsewhere to deny that American supersizing is either problematic or new, the facts about youngsters in particular quite obviously point otherwise. It is one thing to see shirtless obese children paraded like circus freaks on the Maury Povich show and to think the problem a subset of trash tv. It is another to read accounts written by actual doctors of what is suffered on account of this trend — the children who are so heavy that they routinely wake in panic because their windpipes have temporarily closed up; the growing incidence not only of early heart trouble but of fat-linked cancers in children only years removed from babyhood; the experiments, some of them parlous, with drugs and surgeries of all kinds to counter the unprecedented medical woes of overweight children. Whatever else may be said about them, the public health issues raised by child fat are no media inventions.

Moreover, even those children and teenagers who are merely heavy, rather than clinically obese, find their weight affecting them adversely in other ways — for example, by making exercise more arduous, and hence less likely. And there is also the troubling fact that fat children tend to grow up into fat adults. This means that the very personal health of those children who are fat today is a continued and lifelong battle.

There are other, extra-medical problems in store for such children as well. Less arresting from a public health perspective, but probably more so from the point of view of most actual children and teenagers, is the personal suffering endured by many overweight children. As if that suffering were not compelling enough in its own right, there are also longstanding and unanswered questions about possibly related problems: for example, the relationship later in life between the repeated drive to eat more than one ought and other forms of medically questionable oral compulsion, notably smoking and drinking.

Thus, though a range of opinion on the subject of fat does still exist within society at large — with poorer, black and Hispanic subgroups generally least likely to see child fat as a serious problem — the opinion of actual medical experts is by contrast virtually unanimous. For a constellation of physical and psychological reasons, most now believe that child obesity is no longer “simply a cosmetic problem,” in the words of cdc lead researcher Dr. William Dietz, but “a serious medical problem” in itself. And while the poorest children, here as elsewhere in this vale of tears, are more likely to be burdened with the child-fat problem than are the rich, even the best-off children are participating too in the long caloric march, as the growth charts and weight charts and the declining age of menarche across class and race prove beyond doubt. In short, to switch metaphors, a rising tide of fat is rocking all our social and economic boats.

The whys so far

Naturally enough, and as most people also know, considerable industry has gone into pinpointing exactly how we came to live so large. From sociological observations about the simultaneous explosion of American prosperity (we eat too much because we can) to more ideological anti-business analyses (we’re fat because McDonald’s rules our world), explanations of U.S. rotundity abound. Evolutionary biologists blame our survival-riveted “hardwiring”; dietitians, our meat-and-dairy intensive diet; advocates of breast-feeding, our reliance on the highly more caloric alternative of baby formula. Still other observers point naturally to the greatly diminished physicality of American life: the fact that vehicles rather than feet get most people where they want to go, that recess and other run-around time has been curtailed in schools around the country, that sedentary pursuits of television and electronic games are climbing alongside those juvenile body-mass indices.

At the moment, the explanation that appears to enjoy most support in the popular mind is that of heredity. This idea — that kids gain weight because they are genetically programmed that way — appears to have two main virtues. One, it is consonant with a well-documented clinical (and easily observable) fact, which is that maternal heaviness is the single best predictor of child fat. Two, the argument from “programming” has the added advantage of being nonjudgmental about an issue uncomfortable and embarrassing to many people. If children cannot help being fat, after all, there is little they or their parents should feel badly about. (The fact that this line of thought is defeatist and passive, and thus exactly what kids themselves might least need to hear, has perhaps been insufficiently reflected upon.)

Despite its surface appeal and current popularity, however, the argument from heredity is seriously limited, for reasons familiar to researchers. In essence, genetic programming alone cannot explain the great leap forward into heaviness and obesity these past two or three decades. If people were truly “blueprinted” to gain weight, then the obesity problem would presumably have developed many years earlier, as soon as they had access to extra food. In other words, most Americans (and other moderns) have been prosperous enough, for a long enough time, that they could have eaten themselves to today’s weights long ago; for some reason, however, they did not. As the lead author of yet another 2002 study — this one in the Annals of Internal Medicine — told a reporter, “People born in 1964 who became obese did so about 25 to 27 percent faster than those born in 1957.” Heredity cannot explain facts like these.

To suggest that the genetic explanation of fat is overused, of course, is not to say that the problem is divorced from our chromosomal marching orders. Plainly, individuals metabolize calories and much else differently, as well as varying in age, height, sex, health, social class, fecundity, fertility, and many other dimensions of experience that affect whether and how much they gain weight. Just as plainly, however, heredity does not really “explain” our fat problem as thoroughly as many people commonly assume it does. Rather, on the emerging evidence, the conjecture about heredity — like theories that focus on processed food, lack of exercise, and so on — explains only part of it. To be sure, all of these explanations resonate with common sense; to reiterate, each captures a part of the truth.

The one part of that larger truth that no one has raced to discuss, however, is arguably the most important part of all. That question is not so much how children and adults get fat — on those issues, we are all experts now — but rather, why. By “why” I mean simply this: Historically, either parents or extended family or both have controlled most of what and when children could eat. The fact that this control was typically born of necessity — i.e., of making sure there was enough to go around — does not confute its significance. After all, this parental or familial power has been exercised virtually everywhere in human history, from the savannah to the igloo to the Raj and back again. And it has been exercised by rich as well as poor, else the history of better-off social classes would be replete with the oversized children and adults we see today (as it markedly is not). Thus, the why underlying the child-fat problem can be formulated something like this: Given that parents and related adults across history and cultures have policed their children’s eating habits, in what kind of social universe do adults cease to perform that task? The answer, which is as obvious as it is unwelcome, is that our universe has become one in which adults, particularly related adults in the form of parents, are not around to do the policing in the first place. In other words, there would appear to be an obvious relationship between absentee parents — meaning particularly, for reasons we will see, mothers — and overstuffed children.

Mothers at work

In all the volumes and bulletins and articles dedicated to the fat problem, there has apparently been only one serious American effort to examine that relationship head-on. This was an important paper published earlier this year by Patricia M. Anderson, Kristin F. Butcher, and Phillip B. Levine of the Joint Center for Poverty Research (funded by the U.S. Department of Health and Human Services). Titled “Maternal Employment and Overweight Children,” their study uses data from 10,000 children participating in the National Longitudinal Survey of Youth (nlsy), among other sources. Its authors set themselves the goal of “help[ing] to determine whether a causal relationship exists between maternal employment and childhood overweight.” (Obviously anticipating the ideological fusillade likely to be trained on anyone who distinguishes between mothers and fathers in this regard, the authors explain that they focus on maternal, rather than paternal, employment for three reasons: because “it is mothers’ labor supply that has changed dramatically over recent decades”; because, whether working outside the home or not, women do “still bear the bulk of responsibility for child rearing”; and because “data limitations in the analysis . . . only enable us to link the employment histories of mothers and children.”)

The answer, according to the authors, is yes. In the arresting language of what they found, this study, “among the first to grapple with issues of causality,” “presents robust evidence of a positive and significant impact of maternal work on the probability that a child is overweight.” And while the percentages derived are not overwhelming — at one point, the authors show how increased maternal employment could “explain” 6 to 11 percent of the growth in childhood overweight — there is no underestimating the social dynamite of the strength of the relationship between the two. As the authors emphasized, their work showed not only correlation but a clear causal connection: that “the mechanism through which this [child weight gain] takes place is constraints on the mother’s time; it is hours per week, not the number of weeks worked, that affects children’s probability of overweight.” Nor did the authors shy away from reporting a perhaps unexpected class twist here: “This effect is particularly evident for the children of white mothers, of mothers with more education, and of mothers of a high income level.”

As Anderson, Butcher, and Levine also note, though their study on maternal employment is so far unique in American annals, other efforts to gauge the connection have indeed been undertaken. In particular, a 1999 study of obese Japanese three-year-olds outlined a similar causal chain, identifying “the mother’s job” as the environmental factor contributing most to child obesity. That study aside, however — which anyway appears little known in the U.S. outside expert circles — not much attention has been paid to the maternal-absence question.

Even given the dimensions of the problem, as it were, such reticence on the part of other researchers is hardly surprising. Drawing attention to the connection between childhood fat and absent parents, especially absent mothers, is about as close to an ideologically thankless task as social science can get. Yet while “Maternal Employment” may be among the first to examine the link directly, it is not the only way of making the case for a connection between absent mothers and fat kids.

Watching and eating

Nothing, for example, is as firmly established in the fat literature as the fact that television watching and overweight children go hand in hand. This phenomenon, which has been studied many times over, is pretty easily grasped: The more television a child watches, the more likely he is to get fat. As to the mechanism at work here, this too appears clear. For one thing, people — including children — eat more in front of the television than they do sitting at a table. For another, the way in which metabolism slows to almost sleep-like levels after enough time in front of the tube means that the food taken in is metabolized more slowly, hence in a more fat-friendly way, than would otherwise be the case.

So far, so agreed: The television is an excellent proxy for child fat. The larger question becomes, therefore, whether the absent-parent household is also one in which children are more likely to watch television or play video games than they are when parents are at home. Common sense, of course, fairly shouts that they will — i.e., that unattended children are less likely to govern and limit their use of such entertainment than are children with a parent on the physical premises. Yet surprisingly — or perhaps not, given the socially loaded nature of the inquiry — little direct research appears to have been applied to the specific question of whether children whose mothers are out when they come home watch more television or play more video games than those with a parent on the premises.

Nonetheless, intriguing pieces of other, indirect research on the question suggest that the answer here too is an unequivocal yes. For while little may have been written about the viewing habits of middle- and upper-middle-class American children (some of whose working parents take ideological exception to this sort of inquiry), at least some other expert thought has gone into the question of what lower-class parents who are absent from home during those same after-school hours can expect to result. And the evidence here comes from an unexpected source: welfare reform.

One might think, for example, as many probably do, that a couch potato is a couch potato is a couch potato. In other words, given the strength of the link between low income and television-watching, television-watching might appear to be a kind of domestic constant immune to other ongoing human activity (particularly, to whether the mother of the house was out working or not). But this prejudice turns out to be wrong. Or so at least is suggested by a major four-year post-welfare reform study in California whose results were published this year. What that study found, as the San Francisco Chronicle put it, was that “welfare reform’s biggest effect on children is that they spend less time with their mothers and watch 22 more minutes of television [a day] on average.” What makes this evidence even more credible is that the researchers — from Stanford, uc Berkeley, Columbia, and Yale — were not looking for such a result but uncovered it incidentally in the course of their survey of 700 women. That increase nonetheless effectively puts to rest any notion that television-viewing is some class-based constant unaffected by other domestic variables.¹

Then again, how much social science do we need to tell us that when parents are away, kids will play? And they will particularly play at electronics. Again, to whose surprise? The screen in any color (and perhaps most especially the personal computer, that “pool of electronic wonders,” in journalist Peter Hitchens’s words) is a hypnotizing force. Of course children are more likely to turn it off if there is an adult around reminding them to do so. What could be more obvious, at a time when many adults need the same outside prodding in various forms — boss, co-workers, spouse, or children at home — to unplug from their own screens?

Breast milk as nature’s prophylactic

Another indirect way of establishing the causal link between heavy children and absent parents — in this case, by definition, absent mothers only — concerns an altogether different practice at odds with the paid marketplace: breast-feeding. One does not have to be a card-carrying member of La Leche League to understand why physicians everywhere support such efforts on behalf of feeding babies human milk as opposed to formula (indeed, the American Academy of Pediatrics now officially recommends breast-feeding for at least the first 12 months of life). Over the years, a substantial body of evidence has developed to suggest not only that mother’s milk in the first year of life confers immune and other protections for a variety of baby problems — that much has been known for decades — but that such feeding also apparently reduces the likelihood of obesity later in life.

Perhaps the most comprehensive recent instantiation of this relationship was an essay in the Lancet in June 2001 by several researchers based on a study of some 32,200 Scottish children. Their conclusion, which agrees with (and actually understates) the consensus of other research on the subject, was that “breast-feeding is associated with a modest reduction in childhood obesity risk.” The causal mechanism here is probably manifold, if also transparent: first, that human milk is lower in calories than formula; second, that babies must work harder to extract it, meaning that the amount of mother’s milk ingested in, say, 10 minutes’ time is both less in volume and less caloric than the same timed feeding of formula; third, that insofar as heaviness and obesity later in life appear increasingly linked to the fat cells laid down in one’s first years, breast-feeding is ipso facto more inimical to the preconditions of future fatness than is formula-feeding.

And here, again, maternal absence in the first year of life would appear causally linked to childhood and adolescent obesity. For such feeding, as all medical experts and experienced mothers agree, works best when baby and mother are in constant proximity to one another. As many new mothers discover to their shock, the typical breast-fed baby eats anywhere from two to four hours apart, often around the clock and usually (if the baby has his way) for months on end. It is true that some working mothers diligently pump breast milk at work, thereby attempting to square nature’s feeding circle (and, if they labor arduously enough, partially succeeding). Again, however, unless they are able to do so at anything resembling nature’s own apparent pace — and it seems unlikely that most offices would not notice a 20-minute absence, say, three or four or five times in a working day — they are not able to provide such protection around the clock. Moreover (and as many feminist-minded cheerleaders for the practice seem invincibly unaware) the physical strain of such a regimen, between its added fluid and caloric requirements and the hormonal changes induced by it (lactation releases oxytocin, which causes drowsiness), can be prodigious — as working mothers who do pump milk for mother-absent consumption will attest.

It is hard to believe that, however laudable many such mothers may be in sacrificing themselves thus, most do not simply find it easier to throw in the breast-feeding towel sooner rather than later given the stress and inconvenience involved in shoehorning into minutes here and there a practice designed by nature to be very nearly a full-time job. In this way, too, therefore, lengthy maternal absence during the first year of life seems inarguably linked to the risk of child heaviness and obesity later in life.

Exercise

A  third way in which absent parents appear linked to the child-fat problem is in the obviously related matter of child exercise. Generally speaking, the many children left unattended by their own mothers and fathers after school fall into two categories: those in after-hours care institutions of one sort or another and those who are “caring for self” during those hours, the current euphemism for latchkey children. The question for both groups is whether exercise is more or less likely during those late afternoon hours. For reasons varying in both cases, the answer would appear to be “less.”

Ideally, of course, those after-school centers would include plenty of physical activity for children who have, in addition to their intrinsic needs, been cooped up in various classrooms for the preceding eight or so hours. The best such programs, one has to assume, do just that. What often transpires instead, however, is a free-for-all in which barely supervised children do more or less as they please within the geographical and other institutional limits of school grounds. Nor is it obvious how matters could be otherwise without a great deal more money being heaped on the problem than most schools seem wont to throw.

The fundamental problem, of course, is that after eight or so hours spent largely indoors, most children and adolescents are not going to be corralled by adults into yet another group activity. Those who want to play a game of pick-up ball will; those who shun such things are unlikely to be forced into them. The long-term interest in physical health that supervising adults ought to have is more than counterbalanced each day by the short-term problem of having to manage large numbers of tired, cranky, and rambunctious children until their parents arrive to take over. One can hardly blame the caregivers, or the children, for failing to make a concerted effort during those hours to put exercise first.

This is not at all to say that such programs are all to the bad; to the contrary, they are obviously far superior to no such programs at all. For some children, these hours of the week are the best, even only, opportunity to socialize with their friends; for others, depending on the noise and crowding, it may be the best time to do their homework; and for those growing up in worse-off neighborhoods especially, such programs are obviously safer than the same amount of time spent on the streets. Such ends, however, though obviously worthy in their own right, only prove that what happens after hours on school grounds is a multitude of events of which physical exercise may be only one — if, indeed, it isn’t skipped altogether. Snacks in such programs can be counted upon; exercise is for many just one option.

Even so, it is the children who “care for self” after school who would appear to be most sedentary of all. The reason is obvious: Generally speaking, what they are supposed to do is go home and stay there. “If you’re parenting a latchkey kid,” as Parenting.org puts the typical exhortation, “you need to teach him or her self-care skills, set rules and limits and talk about basic safety information.” Among the tips, according to the National Crime Prevention Council’s also-typical checklist, are: “Check[ing] in with you or a neighbor immediately after arriving home”; “Operat[ing] doors and window locks”; “Answer[ing] the doorbell and phone safely”; “Avoid[ing] walking or playing alone”; and related items. As is obvious from such a list, all of these are built on the assumption that children are going home to stay put. Of course this is as it should be: If school kids are going to be alone after school or at any other time, it is safest to be so behind locked doors rather than unsupervised out in the world. Here again, however, the paramount short-term concern of absent parents — physical safety and security — is obviously inimical to the longer-term benefits of something that does often require an adult body nearby, at least in urban settings, namely supervised exercise.

Though the argument that absent parents may be linked to lesser rates of exercise may seem novel, at least to some, misgivings about precisely that are endemic to the anecdotal literature on working parents and latchkey children — proving that many parents, at least, if not always their children, themselves suspect that today’s young are far more sedentary, especially in the after-school hours, than were most of today’s parents. And though the evidence is anecdotal, it is surely highly suggestive. Ask yourself this question: Has any contemporary observer ever suggested that today’s children get more exercise than their parents did?

Even more significant, though, is the fact that astute observers of the national scene, from Jane Jacobs through the contemporary examples of Robert D. Putnam and Alan Ehrenhalt, have long argued for the related connection: that of absent adults to a lack of safety in the streets. As Ehrenhalt writes of a Southwest Chicago neighborhood in his interesting The Lost City: The Forgotten Virtues of Community in America (Basic Books, 1995), what it and others like it now lack is exactly what made such places real communities: “the sociability of the front stoop on summer evenings, the camaraderie of the back alley as an athletic field, the network of at-home moms who provided an instant neighborhood bulletin board seven days a week.” By contrast, “On weekdays now, for long stretches of time, no one walks down the quiet residential streets. That is in part because the older people worry about crime and fear the streets almost as much as they took sustenance from them in the old days.” Of the development of Elmhurst 10 miles away, he observes similarly, “there is the same sense of physical continuity and social upheaval . . . if the streets are pretty, they are also empty just about all the time. Emery Manor, like nearly all the suburban subdivisions in America, is now a neighborhood of two-job families, so you don’t see mothers with strollers on their way to and from the park the way you would have in the 1950s. Nor, for that matter, do you see many older children playing outside by themselves in the late afternoon. . . . The social consequences of the two-job family,” he concludes, “extend far beyond the empty streets in the daytime.”

As Ehrenhalt, Putnam, and other observers would agree, the effect of the adult exodus from home during much of the day has been to reduce precisely the “eyes on the street” that is shorthand for what makes neighborhoods good rather than bad, safe rather than unsafe. Of course that reduction encourages crime itself (as policemen in Washington, D.C., will attest, for example, break-ins in affluent neighborhoods often occur between 11 a.m. and 1 p.m., when by the criminal calculus people are least likely to be at home). But it has also contributed to a vicious circle: The more parents are out of the house, the more reluctant they are to have their kids play outside — because, since so many other adults are also out of the house, there is nothing like an informal network of like-minded adults to be alert to them. But the fewer the children who are allowed out to play, the less likely it is that other children be allowed out.

In the end, one enduring image of even our affluent neighborhoods is that of a child, or perhaps two, huddled indoors for hours on end in front of one screen or another with a cell or portable phone nearby, the burglar alarm system on, and no related adult in sight anywhere before dinnertime — if there is a dinnertime, that is. Whatever else may be thought of such a snapshot, it is manifestly not making children any slimmer.

Unwelcome truth

In the end, we are left with an intriguing array of evidence about a public health problem that is underexamined and undeniably ideologically explosive. No wonder that at least one commentator’s response to the Anderson/Butcher/Levine study was to blast it for the “guilt” it might induce in working mothers. Such was not the authors’ intent, of course. But at a time when many (divorced and single) mothers work because they cannot do otherwise, and when many others are out of the house for reasons of overriding importance to them — everything from bills to pay to personal fulfillment to the extra goods money can buy, including such child-emphasizing goods as tuition and travel — the news that absent mothers may be contributing to the fattening of their kids can hardly expect a soft social or political landing.

The child-fat problem coincides with an interesting moment in the debate over feminism: For while the benefits of working motherhood have been well-advertised throughout literature high and low, the possible downside of all this success remains virtually taboo.² One notable exception among feminist-friendly writers — about the only one of which I am aware — was an unusually frank acknowledgement made by Margaret Talbot in the course of a review of Robert D. Putnam’s Bowling Alone (Simon & Schuster, 2000) in the New York Times Book Review (June 25, 2000). There, Talbot conceded a point that other writers have judged too controversial to touch — that the mass movement of mothers into the paid marketplace has had a deleterious effect on the aspects of domestic and communal life to which those same women would otherwise direct energy and attention. “Not many of us,” as Talbot put it,

leap to the defense of couch potato-ism as a civic virtue, whereas quite a few of us defend the expansion of autonomy and opportunity for women. But to say that the large-scale entrance of women into the labor market has exerted a significant effect on community life is not to deal in blame. It’s to accept the reality that we are all in this together now, men, women and children. Women who work all day at demanding jobs have fewer hours and less energy to devote to community activities. . . . [I]t may be that with women in the paid labor force, we will never enjoy quite the level of associational life we had in the 50’s. And in the end that trade-off may be worth it.

By “couch potato-ism,” Talbot is clearly referring to adults rather than children in defending the lesser engagement of many working women in the world immediately around them. Whether she or other feminists would extend the same logic to the child corpulence reality — whether that too might be judged “worth it” from the point of view of women’s social and personal gains — is so far unanswered.

Nonetheless, it is a question whose time has come. Indeed, the idea that non-parental care plays a role in the child-fat problem is not only defensible, given the evidence, but is also intellectually satisfying on a couple of counts as other theories are not. For one thing, such a link would explain aspects of the child-fat problem that have so far eluded explanation. One is the fact that, as mentioned earlier and as is contrary to popular preconceptions, child fat and obesity are rising among most developed countries (where mothers are also typically out of the house), irrespective of differences in diet, culture, and the rest. Another is the fact that this link would also help explain why immigrant families in which mothers often work are at particularly high risk of becoming overweight.

The point here is not metaphysical, and it is not even intentionally contrarian. I mean only to draw attention to a pedestrian fact: that a parent or other responsible adult in the home can mean the difference between a supervised diet, on the one hand, and an auto-gluttonous free-for-all on the other. Common sense itself demands the recognition that these events are indeed related — that children are eating more because they are less likely to be around anyone, particularly an adult anyone, telling them that this is a bad idea.

Of course, to observe that parents can exercise such influence over diet is not to assure that they will. As several generations of statistics now show, today’s parents cannot be relied upon to be nutrition martinets, including for themselves (recall that heavy children most commonly have heavy mothers themselves). Moreover, even if mothers were around to supervise and take an educated interest in what children eat, there is no guarantee that their offspring would be svelte. Fate can be too unforgiving, and genetics unfortunately too influential, for such an equitable outcome. Whether in the home or outside it, parents may overfeed their children for a variety of reasons — force of habit, indirect peer pressure from other children who are allowed to eat exactly as they please, an overly literal translation of their nurturing instinct, perhaps even the idea that, in a world riven with problems like terrorism and drug addiction and imminent war and the rest, a few extra pounds here or there amount to small stuff that shouldn’t be sweated. Even so, the fact that some parents are part of the problem does not mean that getting rid of them will improve the eating habits of their children. Who is more likely to gain weight — the child who comes home to a mother telling him to wait for dinner, or the one in an after-school program or empty house with access for hours on end to snack trays and fast food and bulging cupboards and refrigerators?

It will be objected that more ought to be said about fathers in all this, and that mothers who are already busy to the point of exhaustion are being unfairly singled out for their offspring’s good. Any mother, this author included, will heartily sympathize. Here as elsewhere, however, life is nakedly unfair. For reasons so deep as to be unplumbable, it is mothers, more than other adults in a child’s life, who experience the felt need to police what their children eat and to cajole and order them into eating as the mother believes they “should.” It is mothers, not others, who in general have the strongest opinions about these things — often vehement opinions, whether they are home with their children or not. Institutionalized care centers, whether day care or schools, use snacks and food for crowd-pleasing, if not crowd control. And even the best paid help is simply unlikely to be as attentive to what children eat as a mother would — for the long-term health of the child is not in fact the caregiver’s chief concern (that, rather, is the short-term goal of keeping the child supervised and happy). Again, for reasons that remain as mysterious as they are intuitively obvious, it appears that mothers, more than any other figures in a child’s life, are willing to risk the short-term gluttonous dissatisfaction of the child for the longer-term benefits of a better diet. Some readers no doubt will decry that formulation; the open-minded will acknowledge its domestic truth.

Deplored or not, the link to which current research is only beginning to draw attention stands as is: a Janus-faced signpost showing the sunny side of our material wonderland, one in which everyone is free to leave home for the paid marketplace, and the darker side of what that social exodus is leaving behind. There is an argument latent here for a notion so culturally incorrect as to be incendiary — that perhaps some of what children of the better-off countries are doing with their mouths and stomachs is filling gaps made elsewhere in their lives. Maybe the “void” being “filled” by overeating, to use the intriguing terms of Overeaters Anonymous and other dietary theorists, is even more acute in young human beings than in others. Maybe a little more contact and companionship, with real rather than virtual parents and other family, might make them a little less ravenous.

For that matter — to be truly transgressive about it — a case might also be made for this corollary: that perhaps part of the increase in overweight women, many more of whom are heavy or obese than men, reflects a similar yearning being answered by compulsive recourse to high-calorie food and plenty of it. Domestic life has its trials and traumas, without question, but it has also its pleasures and consolations. Unable to enjoy these traditional comforts in anything like the doses to which humanity has for better or worse been long accustomed, perhaps the Western child — and perhaps also the absent Western mother — uses food to try to compensate for other things that are being missed.

After all, throughout the domestic social upheaval of this century — changes documented by batteries of social scientists, and dubbed by Francis Fukuyama the “Great Disruption” — no form of human contact has been as strained throughout the advanced world, as historically transformed when measured by the known facts of almost every other human society, as the bond between mother and child. Virtually undetachable throughout most of history, these figures commonly find themselves catapulted in our own prosperous time into separated spaces, spending many or most of their waking hours apart.

So are American children fat and getting fatter because their mothers are? Or are both of them getting fatter in one another’s absence, and for the same reason: because the worlds of home and work are out of joint? Maybe, just maybe, that is partly what the consolation of calories is about.