Shifts in mojo.

I was watching a little girl in the Grady Hospital cafeteria one day. She was standing with what I am assuming was her mother and appeared to be no more than four years old. It was a school day, so I'm guessing she was too young to be in kindergarten.

Anyways. She was an adorable and precocious little thing. I mean just as cute as a little button. Talking up a storm with her hand on her plump little pre-K hip. Her pink bedazzled t-shirt didn't quite clear the length of her torso. I could see her belly button and a roll of tummy skin protruding over her striped leggings.

"I want chicken fingers and I want the fries, too!"

"Okay," her mother replied. She then relayed that information to the gentleman working the grill. "I thought you wanted a burger?"

"I do want a cheeseburger. But I like chicken fingers, too!"

"Okay. Well we can just split it," the mom replied.

"What kind of fries do y'all want?" the grill-guy asked. He stood there waiting patiently with his clear plastic gloves on while patting his brow just below his hair net with the back of his sleeve. 

"Mama, get the mojoes!" the little girl squealed.

"Y'all got some mojoes?" Mama asked.

Grill-guy looked over his shoulder at the fryers. Sizzling behind him was a freshly dropped basket of battered and season-salted potato wedges. "Yeah, we got some."

"Okay. Then give me two orders of those."

And he did. Onto that platter went two cheeseburgers, some chicken fingers and two heaping helpings of mo-joe potatoes fresh out of the peanut oil.

I couldn't help but watch them as they walked off. First, a stop at the soda machine where two cups were filled with what looked like some kind of cola. I'm not sure if they got dessert. My guess is that they did.

That little girl's mother had to be at least three hundred pounds. And I'm almost certain that the child was well above the ninety fifth percentile for weight albeit in a lower than average centile for height.

Now.

Everything about their interaction was loving. The child appeared very well cared for -- from her matching pink outfit to her hair accessories of the exact same hue. Her mother kept her hand on her daughter at all times, and occasionally pulled her close into her side for an affectionate squeeze. That part was sweet.

That part was.

Sigh.

Anyways. The holidays has me thinking a lot about food, as always. That's what made me remember that little girl and her mama.

Yeah.

And speaking of the holidays -- ours always involve a lot of here-there-and-everywhere-ness. As adults, it's not such a big deal, but for our children that's another story. With so many visits to see cousins and grandparents and aunties and uncles, I promised them that today they wouldn't have to go anywhere. They could just stay home and play with their toys at their own house. Eating food from our fridge and hanging out in their own playroom. They were over the moon with that plan.

So that's been the day. Them -- literally in their pajamas for the entire day -- running, laughing and mostly playing games on their Wii console. The sounds coming from their playroom tells me what the game is and that's been quite a variety. Right now, they're bowling. Before that, it was a dance-off to every possible overplayed pop song that you've ever heard in your life.

Anyways. In between all of this, they've occasionally burst into the kitchen or wherever I am to ask me for something to eat. Harry had to do some work-related errands early this morning, so he surprised the kids with McDonalds hotcakes and an oatmeal for me. They love McDonald's hotcakes, so that was a reasonable thing to do. The only problem is that they'd already eaten some Eggo waffles.

"Oh man!" Isaiah said, "We just ate!"

And by "just ate" he meant that they had each held a toaster waffle in each hand while laughing at the kitchen table. No syrup. No sausage on the side or anything else. I guess what I'm saying is that it wasn't the most filling meal in the world. Surely they could make room for hotcakes, especially ones that they love as much as Mickey Dees' version.

But they didn't. Instead Isaiah thanked his dad on both of their behalf and off they scurried back to the video games. And that was that.

"Those kids eat to live. They don't live to eat." That's what I said to Harry as we both stared at the lonely hotcakes.

"I'm glad," he replied. "They just eat not to be hungry pretty much. They're lucky that you don't care about food as much as me. That comes from you."

"Not true. I love food."

"But not enough to eat any-damn-thing you want."

I thought for a moment. "You know? It's just hard to enjoy anything that isn't worth it. Like. . .some Key lime pie? Or a really, really good pound cake? Mmm or some Antico Pizza? Now that's worth every fat gram and every calorie. But a slice of pizza from Pizza Hut? Uhhh. . .naaah."

"Yeah. See, I'd eat the Pizza Hut and just pay for it later," Harry laughed.

"Food relationships are complicated. It all depends upon how you were brought up. Like, my mom always cooked for us. But mostly it was to make sure we'd have food. She's a fine cook, but I doubt she would have been cooking like that if she didn't have four kids to feed."

"And see, my mom? Food is love with her. Lasagnas and briskets and ribs and collard greens. A bad day got you something to cheer you up straight from the oven. And a good day? Man, please."

I laughed. Mostly because my sweet mother-in-law is still that way. Her food truly has love in every single bite. You want to clean your plate. And if you want more, she'll heat it up for you. There's love in that part, too.

It's true. Food relationships are super complicated. And let's be clear--do we take our kids to McDonald's sometimes? Sure. Do they enjoy their share of hot dogs here and there? Yep. But demanding them to eat everything (as opposed to something) and giving them carte blanche to the pantry for boredom eating? Nope. And constant celebratory eating? No way, no how. I guess I'm trying to think about their long term food relationships without being oppressive, you know?

I've been thinking about food relationships more and more over the last few years. Instead of telling my patients what and what not to eat, I often talk to them about their food relationship. Do they even have any idea about it? I ask questions like, "Can having the an unsatisfying meal ruin your evening? You know--like if you had your mind fixed on one thing but it either didn't turn out like you'd imagined or even it wasn't available for you to eat?"

I also ask how they feel when eating certain things. Or if there are things that they used to eat but no longer will. If the answer is yes to that last question, I ask why.

Here's what I'm learning from all of that: Food relationships start when we are children. Then, as adults, they can shift in a number of different directions depending upon where we are in our minds. For example, someone who always had full access to their family pantry and who was forced to clean their plate, might do the same with their kids. Or not, if they've shifted their own thoughts on food and eating as they've grown older and learned different things.

Different things? Things like how no matter how much you run, jump, leap and stretch, there comes a point in every adult person's life where weight will never, ever be controlled without redefining food ideas. Period.

Wait.

Let me just say that this is my own opinion. Nothing really scientific, although I'm certain that there is likely some medical literature somewhere to support it. What I mean is, these ideas have a lot to do with my own interpretations of things I've seen over the years. As a doctor and as a regular old person.

So that brings me to mojo potatoes. Have you ever had them? Well, I have. And let me tell you something -- they're delicious. Look. I'm no different than the next guy when it comes to enjoying fried morsels of yummy-ness. But where I am when it comes to such things has changed over the years. Lots of that has to do with my relationship with food growing up. But most of it has to do with the shifts it made in my adulthood.

Will I eat one or two mojo potatoes? Sure. Will I order my own next to a greasy hamburger? Probably not. Of course, the caveats are when such things are at places so good that eating there is more of an experience than a meal. Kind of like the difference between eating a burger at McDonald's and a burger from Farm Burger. In that instance, I would both eat and enjoy my burger and fries.

Just not every day.

I realize that I'm rambling. Mostly because I think a lot about obesity -- in both adults and kids. I have a lot of thoughts on all of it and am recognizing that they aren't exactly organized enough to be writing down.

Oh well.

So the food relationship thing. Okay, so my real point on it is that this is ground zero. Kids who are overweight don't lose weight just by being admonished every time they reach for cookies. Some hard lines have to be drawn in the sand. And the grocery cart. Like, if anyone in the house is the type that can't say no to Oreo cookies or mojo potatoes, neither of those should be in the house. If anyone in the house is the type that has slow as molasses metabolism then foods and drinks that aren't nice to them should stay on supermarket shelves for the most part.

At least, that's how I see it. For everybody to win, somebody's going to have to take one for the team.

And I know. There's always this argument where folks say, "Why should we punish our thin/fit/ideal-weight/healthy kid just because the other is overweight?"

My answer to that is simple: "Because that's how it has to be."

Some don't say that at all. Instead, their response might be to "just let kids be kids" and "if they exercise and run and play they'll grow out of it." This might be completely true -- and often is. But the problem is that the food relationship doesn't go away. That prepubescent pudge might melt away at first, but if mojo potatoes don't cause you to cringe a little bit by the time you turn thirty, that pudge will return just like a Jedi.

Fo sho, honey boo-boo.

Again, these are just my thoughts. And if I ever get a chance to break bread with Mrs. Obama, I'll chat with her about this since she has childhood obesity on her radar. Just another reason for me to love me some Michelle Obama.

But I digress.

So the taking one for the team thing. When my mom was on Weight Watchers some five trillion years back, I recall watching our whole house drop a few pounds. Why? Because everybody was on skim milk. There wasn't a cookie in sight. And full sugar soda pop? Chile please. We all took one for the team. And if you have a teammate that you love living in your house, that's just how it has to be.

Or else somebody is going to lose.

Hmm. I just thought of something. The more you have family members take one for the team, the less it feels that way to them. Like, eventually we got used to skim milk and no cookies. And because I have a full understanding of the BHE's food relationship and I do the grocery shopping, our kids don't even realize that they've been taking quite a few for the team for their entire lives.

Yep.

So I ask about those food relationships. I ask who is up in that house and what's up with them and they're health/body situation. Is Jack Sprat your husband? Meaning, is your spouse a hundred pounds soaking wet? And if so, does he or she do the grocery shopping? Whoever that person is and whatever their situation, that person has to get on the same team as you. Be willing to eat smaller portions with you and to forgo certain foods being in the house to help you win.

That is, until your relationship and body shifts enough to make you feel like mojo potatoes aren't even worth it. So much so that seeing them on a platter before you does little to affect you. But see, for a lot of people, that kind of shift never occurs -- especially if they are starting from a place where food is synonymous with love and comfort.

Yeah.

So anyways. I looked at that sweet little girl with her gelatinous middle and her delightful smile happily chatting and almost skipping with excitement. Following right behind her markedly obese, yet equally delightful mother, in more ways than either of them even realized.

What will happen next with that little girl? Honestly, I'm too inherently positive in my thinking to assume the worst so it's hard to say. It really all depends upon where her food relationship shifts.

I don't have a crystal ball to say what the future holds for her. But here's what I do know:

It's a hell of a lot easier to shift your food relationship just a little bit than a whole lot. And square one for food relationships start with the person doing the feeding . . . . and how far they're willing to shift their own relationship first.



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Happy Wednesday-almost-Thursday. What are your thoughts on all of this?