It is an unpleasant reminder, just in time for those new year's resolutions.

“It is difficult to lose weight,” said Dr. Marian Tanofsky-Kraff, an associate professor at the Uniformed Services University of the Health Sciences in Bethesda.

The best weight loss method is prevention. That is why a study by the Uniformed Services University and the National Institutes of Health starting later this month will treat children at risk for obesity.

Although adults in Montgomery County are healthier than in other parts of the state, some children have a higher than average obesity rate. Children are encouraged to eat healthier and get active by a variety of county initiatives and regional programs.

Although data on childhood obesity is limited, in 2006 the Maryland Department of Health found obesity among children ages 13-18 was as high as 8.5 percent in Montgomery County. In Somerset, up to 19 percent were obese. Obesity increases the risk of heart disease, type 2 diabetes, endometrial, breast, and colon cancer, and other conditions, according to the Centers for Disease Control and Prevention.

Tanofsky-Kraff's team will provide intervention to above average weight girls ages 12-17 with early signs of binge eating disorder who volunteered for the study. A similar study on boys and girls ages 9-12 will begin later this year.

People with binge eating disorder, a condition strongly linked to obesity, repeatedly eat larger than normal amounts of food. They may eat more rapidly than normal until uncomfortably full, and feel disgusted, depressed, or guilty after overeating, according to its proposed definition in the Diagnostic and Statistical Manual of Mental Health Disorders.

“The kids who have it, they will tell you, ‘I felt totally out of control',” she said. “They know it.”

There is no single treatment for binge eating disorder, but helping children before they become obese is a promising strategy, she said. In previous studies, adults were able to lose modest amounts of weight with intervention. Obese adults recalled their first episodes of out of control eating as children or teenagers.

One possible cause of out of control eating is modeling — children mimicking behaviors they see in their parents, Tanofsky-Kraff said. Food can be used as a coping mechanism, in response to negative experiences or emotions. She said studies also suggest a genetic component.

“I think that the most important thing I have learned in all my work, obesity doesn't always manifest from the same thing,” she said. “There used to be a feeling that people who were lazy and ate too much became obese.”

Measuring obesity

One measure of obesity is body mass index, a number calculated based on height and weight, according to the Centers for Disease Control. A BMI of 30 or more is considered obese. That means a man who is 5 feet 10 inches tall and 209 pounds is obese, according to the National Institutes of Health Body Mass Index calculator. A 5-foot-4-inch tall woman is considered obese at 175 pounds or more.

One of the few sources of information about childhood obesity is the Women, Infants and Children program, a federal program that provides food and nutrition information to low-income women and children up to age 5, according to the county health department.

In 2007, Montgomery County had the highest rate of obesity in Maryland among WIC participants ages 2 to 5. The average rate of obesity in WIC children in Maryland was 17 percent, versus a high of 20 percent in Montgomery County. Also higher than average were Cecil and Talbot counties. Calvert and Garrett counties had a low of less than 10 percent.

Montgomery County's diversity could be partly to blame, said Linda Goldsholl, program manager with Montgomery County's African American Health Program. As a minority-majority county — about 49 percent of Montgomery residents are white — Montgomery has high black and hispanic populations, where obesity has been a greater problem.

Between the prevalence of fast food and commercials that advertize junk food, she said our entire environment is set up to promote poor eating habits.

“There's no place we get off the cycle and really teach how to eat healthy,” Goldsholl said. “We're going to be embarking on trying to get healther food in the county vending machines.”

Informed and active

Among County Council's initiatives was a vote in 2007 to eliminate trans fats in restaurants, and in 2009 to mandate restaurant chains post calorie counts on menus or menu boards.

Goals in the county's longterm growth plans tie into obesity prevention, said Valerie Berton, a spokeswoman for the county planning department. Residences built above or next to retail and offices allow people to use vehicles less and walk or cycle more.

“That's been a real push at the planning board for the last seven years,” Berton said. “The less people need to drive, and the more they can do those other alternatives. And that certainly does tie into health.”

It is never too cold to go for a walk if you dress appropriately, said Mary Bradford, director of parks for Montgomery County.

“Don't change your plans, change your gear, is my motto,” she said.

Part of the park department's mission is to promote healthy lifestyles by offering recreational facilities.

Staff administer 36,000 acres of parks, including 220 miles of trails, 300 athletic fields, ice skating rinks, stables and community gardens.

Playgrounds are open year round and are designed to get children's muscles working.

Parks staff work with the recreation department, which offers indoor activities, including sports, dance, and exercise classes.

“I like to see muddy kids go through the door,” Bradford said. “That means they've been outside exercising.”

Learn More

More girls are needed for the Uniformed Services University/NIH study. Parents of above average weight girls ages 12-17 who are not yet obese can call 1-800-441-1222 until Jan. 16. Eligible participants will be compensated.

Visit www.clinicaltrials.gov and refer to study # 08-CH-0139.

@$:jablamsky@gazette.net