I want to introduce you to exquisite creatures, human and non-human. The challenges they face reveal the immensity of the threat facing each one of us — and its urgency. Meet Brady Kluge.
Brady Kluge was crossing the patio area of Hunt Meadows Elementary School at recess, when he realized she was talking to him. She was a 4th grade classmate, someone he knew but not all that well. One of her friends was with her, a classmate who Brady thought was really cute. In fact, he had a crush on her.
Brady is a soft-spoken, sensitive nine-year-old. He’s a good student who communicates well in class. Other students are pleased when they learn they are teamed with him on a class project because they know they’ll get a good grade — but outside of the classroom, no one pays much attention to him. So, when this girl tells him she and her friend are interested in seeing how fast he can run, Brady hides his surprise. Can he run over to the playground area and back? Would he do that for them?
It’s a sunny, warm spring day in Easley, South Carolina. Flattered to be spoken to — almost polite to a fault — he glances at the friend, making the briefest of eye contact, trying not to blush as she smiles at him. She smiles at him. He isn’t used to this. So, he agrees. He runs, as fast as he can, over towards the playground. Arriving there, he steps demonstrably onto its surface edge marking his turn so they can see he didn’t cheat, that he is running the whole way.
Breathing hard, Brady runs back toward them. They are still watching him and they’re smiling — their attention stays on him the whole time. Inspired, he surmounts his fatigue, keeps running. Nearing, he can hear them — they are cheering, clapping – for him! He finishes strong, pulls up before them. “Good job, Brady! That was a really good job.” He thanks them, basks in their smiles. He says an awkward sheepish goodbye, their pretty faces, their eyes still focused on him, especially the friend. She is one of the most beautiful girls he has ever seen. As if he was a camera, he tries to freeze-frame her smiling face and store that image forever in his mind. Brady turns and heads away, not wanting to get all sweaty in front of them, aglow in the remnants of their attention.
About a week later another classmate, a girl who is a family friend, asks Brady about those girls and the day he ran for them. His spine tingles, nervous concern rising. His running for them wasn’t that big a deal, so why would she even be bringing it up? It turns out she’s friends with both girls and when they told her the story they were laughing. They asked Brady to run because he is overweight, and they wanted to watch his belly fat wobble as he ran. They didn’t seem to be laughing at him — not that Brady could tell — so he had no idea. Apparently, however, they found the story enormously entertaining recounting it afterwards to different groups of friends.
Brady Kluge has a gentle voice, “I felt ashamed learning that. And it certainly didn’t help my self-confidence.” Like most children, he is acutely self-aware. In the maelstrom most of us get to experience known as elementary school, middle school and high school, we yearn for inclusion, making friends. We also learn to mask that while trying to be cool, to fit in, to be interesting and to be accepted. To come across as too needy — let alone desperate — for friendly attention is a surefire way to attract the wrong kind or none at all.
When Brady had an experience that was a blow to an already fragile self-esteem, he would take stock, analyzing the situation in his characteristic way: He was polite and had good manners. He was well regarded in classes because he was smart and he knew the material. He even had a sense of humor, so his peers didn’t categorize him as a nerd. And he wasn’t immodest about his academics — he didn’t brag or exude any air of superiority. He offered to help others. He wasn’t bad looking. But he didn’t have any school friends. Not one. At home, he had his three brothers and his parents but every year on his birthday, his party turned out to be a family affair — no classmates ever came. The reason he was ostracized could only be one thing: his weight.
Brady was 5 feet 3 inches tall. He weighed 190 pounds and had a 36” waist. He had a face widened by fatty tissue, a small double chin and he had a bit of fatty skin across the back of his neck that made him appear slightly hunched over. He conceded to himself that his belly fat would wobble up and down — as it must have done while he was running as fast as he could for the girls.
Five years later, Brady is now age 14 as his mother drives him to Easley Pediatrics for his annual physical with Dr. Gary Goudelock. In an examination room wallpapered with pleasantly illustrated kid-friendly elephants, giraffes and other animals — one that Brady has been returning to for as long as he can remember — his pediatrician enters and performs his exam. Brady’s mom, Tinna, sits patiently as always.
Brady’s weight is now 215 pounds, his waist 38 inches around. Scanning Brady’s health history, Dr. Goudelock notes Brady’s inability to stop gaining weight. He has counseled Brady about this during previous physical exams. “I know it’s hard. I understand. I’m fighting this battle with you.” His doctor is empathetic. He struggles with his own weight.
Body Mass Index (BMI) is your weight divided by height squared. The Centers for Disease Control and Prevention (CDC) have defined “obese” as a BMI of 30 or higher. Based on this definition, 36% of adults in the United States — over 94 million Americans — are obese.[i] Approaching middle age, your BMI to body fat closely correlates: a BMI of 30 means that approximately 30% of your body mass is fat. The percentage is lower earlier in life and increases in your later years. A formula developed by Deurenberg, Weststrate and Seidell in the Netherlands precisely calculates body fat at every age level based on your BMI and taking your age and sex into account.[ii]
The CDC defines “overweight” as a BMI of 25 to 30. Based on that definition, 181 million Americans are overweight or obese.[iii] 33.4% of children ages 2 to 19 — one in three — in the United States are now either overweight (16.2%) or obese (17.2%). In Brady’s age group, children ages 12 to 19, obesity has increased from around 5% in 1976 to 20.6% today — one out of every five is obese.[iv] One of them is Brady.
There have never been, in all of human history, more obese and overweight people alive.
Obesity is the pathway to diabetes.
Dr. Goudelock regards mother and son, meets their eyes. Before this medical professional even speaks a word, a concern in his lingering gaze spreads out creasing his face, and Brady and his mother silently realize… there is a problem, something is wrong.
Based on Brady’s vital signs, his blood sugar level, and his BMI, Brady is pre-hypertensive. Hypertension is abnormally high blood pressure. He is on the path to becoming pre-diabetic. As his pediatrician explains his increasing risk of medical problems should he become diabetic as he approaches his twenties, the 14-year-old fidgets, avoids eye contact with Dr. Goudelock, wanting this visit to end. The slights at school, the glances-at shifting quickly into looks-away, the ridicule whispered sideways between amused confidants — almost privately — Brady’s radar field of nervousness is acutely attuned. Now, in this moment, he is again caught in the headlights, unworthy, weak, a glutton, a failure, the subject of condescending disdain, and all he wants is to mute it out, to flee, and get away to solitude and safety.
Hearing the word “diabetic” applied to her son actually doesn’t cause his mother immediate or inordinate concern. Tinna is overweight, as is Brady’s father, John. A number of people she knows, including her mother-in-law, are diabetic and the medications they take seem to be handling their situations just fine. Besides, Dr. Goudelock’s prefix “pre” and even better, the “becoming” before that offer the comforts of distance and time.
But as Dr. Goudelock provides more detail, growing apprehension slows and draws her breathing, the tiny muscles underneath the skin of her face release and her expression falls until she becomes aware of that, and of needing to mask any concern in front of her son.
A program, New Impact, has just opened at the children’s hospital nearby. Dr. Goudelock feels intervention at this stage is the best plan of action, and he wants to refer Brady there.
Brady and Tinna are quiet as she drives them home. As a mother, she’s usually savvy enough to think of something to say, to lighten things when moods dampen or topics become dour, but right now her mind is working, she’s thinking things through. She has an action plan in mind before they even set foot on their driveway.
Tinna and John love their children and are succeeding in providing a nice home for them, the best they can given their steady modest income. Evidence of that love is, in part, the food they serve at their dining table. Their food culture living in South Carolina consists mainly of the rich, fatty, sugary traditional dishes, the comfort food of the American south, combined with today’s national brands of appealing calorie-rich processed foods, snacks and beverages. Her husband, John, and Brady’s three brothers don’t know it yet, but Tinna is now resolved. It’s been torture for her, feeling helpless watching her son get bigger and bigger. She and John have been struggling with weight issues of their own. The entire family will now begin eating a healthier diet and exercising more. Done deal. Junk food and processed foods are going to become scarcer in her kitchen. Even though she doesn’t yet know what that “healthier diet” will consist of, she will be going with Brady to New Impact where they will learn more about it together. The family Kluge is going to be on board, this will be a team effort. Done. “Pre”-done. Even though neither Brady’s older brother, Joseph, or either of his younger brothers, Chandler and Nicholas, are overweight, Brady’s mom knows they’ll rally, that the family will circle the wagons around him. Done. Chandler is strident in his opinions — Tinna knows he’ll put up a fight and will still refuse to eat vegetables — but that can be tolerated. Double done.
Going forward, Tinna will be driving Brady weekly to New Impact. There, he will be provided with four specialists. Dr. Sease will be his medical doctor — she’s the clinic’s director so that sounds like a good thing — and Brady will also be assigned a nutritionist, a psychologist and an exercise advisor.
Brady and Tinna have just learned from Dr. Goudelock that Brady is on the path to becoming pre-diabetic. And what that means.
What that means is this…
Compassion For Self – Part 2 will post soon.
[i] Emelia J. Benjamin, Paul Muntner, Alvaro Alonso, et al. Heart Disease and Stroke Statistics — 2019 Update: A report from the American Heart Association. AHA Journals Circulation. Vol. 139, No. 10, Jan. 31, 2019, https://www.ahajournals.org/doi/10.1161/CIR.0000000000000659
National Center for Health Statistics, Health, United States, 2016 – Individual Charts and Tables, Keyword: Overweight/obesity, Centers for Disease Control and Prevention, https://www.cdc.gov/nchs/hus/contents2016.htm
[ii] There is a more accurate calculation of Body Fat based on Body Mass Index, which has been validated and shown to be precise. The relationship between BMI and Body Fat percentage is curvilinear, and the conversion depends on sex and age.
In adults the prediction formula is: BF% = 1.20 x BMI + 0.23 x age – 10.8 x sex – 5.4
In children the BF% could be predicted by the formula: BF% = 1.51 x BMI – 0.70 x age – 3.6 x sex + 1.4
Where the variable for sex is: males = 1, females = 0
Deurenberg P, Weststrate JA, Seidell JC. Body Mass Index as a Measure of Body Fatness: Age- and Sex-specific Prediction Formulas. Br J Nutr. 1991 Mar;65(2):105-14. https://www.ncbi.nlm.nih.gov/pubmed/2043597
[iii] Emelia J. Benjamin, Paul Muntner, Alvaro Alonso, et al. Heart Disease and Stroke Statistics — 2019 Update: A report from the American Heart Association. AHA Journals Circulation. Vol. 139, No. 10, Jan. 31, 2019, https://www.ahajournals.org/doi/10.1161/CIR.0000000000000659
[iv] Emelia J. Benjamin, Paul Muntner, Alvaro Alonso, et al. Heart Disease and Stroke Statistics — 2019 Update: A report from the American Heart Association. AHA Journals Circulation. Vol. 139, No. 10, Jan. 31, 2019, https://www.ahajournals.org/doi/10.1161/CIR.0000000000000659