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7Parents: What Helps, What HurtsTHE GRAND TOUR OF BUTLER, ALABAMA, is a six-stoplight trip. You'll pass a giant yellow smiley face painted on a sky-blue water tower, and you'll see about a dozen abandoned buildings, former banks and hardware stores and hair salons that shut down years ago. You won't see any movie theaters or shopping malls. You also won't see many kids riding bikes or playing catch-in fact, you probably won't see many kids at all unless you happen to drive by one of the town's two schools at recess. If you do glimpse a group of kids milling about, you'll realize that this small town just east of the Mississippi border has a big problem. It may be remote by most measures, but Butler is smack in the middle of the childhood obesity epidemic.In the halls of the Patrician Academy, Butler's private school, sixteen-year-old Amber Kearley hardly stands out. She has short light-brown hair, brown eyes, and the same school uniform as everyone else. She's quieter and more polite than most tenth graders. At 5'3" tall and 160 pounds, she's a little on the heavy side, but that doesn't set her apart in a school full of chubby kids. What does set her apart is that she's doing something about her weight. Since seventh grade, she has dropped fifty pounds and six dress sizes while growing two inches taller, and she's still heading in the right direction. She's a forward on the school basketball team, and she has more stamina and speed than ever before. She's no star-shooting free throws, she says, is what she does best-but she's had her share of victories.It isn't easy losing weight in the Deep South. The towns are blazing hot during summer and into the fall, and there aren't many bike lanes or walking paths. The closest thing to a walking path in Butler is a dirt road surrounding an abandoned clothes factory. And then there's the food. Although home-cooked meals still feature traditional sides of vegetables such as collard greens and succotash, just about anything else that can fit on a plate is in danger of getting deep fried. Recent innovations include the deep-fried turkey, deep-fried dill pickles, and deep-fried cheesecake. Southern culture is especially hard on growing children, says Louisiana State University's Melinda Sothern. "In the South, food is love," she says. "The more you feed your children, the better mom you are."Butler is certainly no enclave of good nutrition. On a Sunday morning, the local Hardee's is the sole choice for breakfast. Biscuits dominate the menu: biscuits and gravy, ham and cheese biscuits, and the sausage and egg biscuit. For those watching their carbs, there's a biscuit-free option: an enormous pile of eggs, cheese, ham, bacon, and sausage. For lunch, there are sandwiches from Subway, fried chicken from Church's, and deep-fried catfish sold from a trailer sporting a mural of firefighters at Ground Zero. Bargain hunters may want to try the fried chicken at the local Piggly Wiggly or the Hot Stuff pizza at the Exxon station: buy a large pizza and get a free two-liter bottle of Coke or Pepsi.If a city planner had set out to design an environment that would make everyone fat, the town of Butler, Alabama, would be close to perfect. How, then, did Amber Kearley defy the odds? You can find the answer if you happen to see Amber hiking around that abandoned clothes factory. She'll be walking with her mother, the exercise partner who's the key to her success.Amber says she couldn't have shed a single pound without her mother's help. "She told me I could do it," Amber says. Susan Ryals, a single mother to Amber and her thirteen-year-old sister Kindall, works in the shipping department of the Georgia Pacific paper mill. The family lives in a modest prefabricated house shaded by tall pine trees. Susan works plenty of late nights, but when her kids need her, she's there. In fall 2001, she started driving Amber once a week to nutrition classes in Meridian, Mississippi, a solid forty-five minutes down the road. Amber was the only girl in a class full of women, but she proved to be a top pupil. With her mother by her side at class and at home, she lost twenty pounds in just a few months, and her weight has steadily declined ever since.Working together, this mother and daughter have done something truly amazing. In the fattest region of the world's fattest country, they have beaten the odds. Susan's own weight-loss story is almost as dramatic as Amber's. Susan lost sixty pounds eight years ago through diet and exercise, and today she has the slender good looks of someone who never had to worry about weight. (Her face is glowing red as she heals from laser reconstruction surgery; she was tired of looking at those loose flaps of skin left over from her "fat" days.) Amber's still a little on the heavy side, but she's already thinner than many of the other kids at her school. A healthy, confident, athletic-looking teenager, she bears little resemblance to the chubby-cheeked sixth grader staring out from the pictures hanging in the family living room.Amber and Susan may be exceptional, but they're also emblematic of a larger trend. Whenever you find an overweight youngster who has managed to slim down, you almost always find a supportive parent (or two) who is dedicated to creating a healthy home environment. Susan Ryals and other parents across the country are starting to fight back against childhood obesity-and many are winning. They aren't putting their kids on radical diets or sending them on forced marches. They're attacking the problem with slow, steady, incremental changes, and their kids are slimming down.Time to ActAmber was slender as a young girl, and if her life had just gone a little more smoothly, she might have stayed thin. But in 1998, both of Susan's parents-Amber's much beloved grandparents-were killed in a car crash in Hattiesburg, Mississippi. The next year, Susan divorced Amber's father. Like many other kids facing major upheavals, Amber found comfort in a steady stream of snacks and junk food. "I would eat a bunch of chips and then move on to something else," she says. "It was like I couldn't decide what I wanted." The junk food helped her get through the day, but it also transformed her body. Throughout fifth and sixth grades, Amber put on weight at an alarming rate.Even as the pounds added up, Amber never seemed concerned. She never said she wanted to fit into smaller clothes or look like her "normal" friends at school or just have a thinner body. In retrospect, her acceptance of her body was an act. "She's really good at holding things in," Susan says. The truth came out when Amber and her younger sister started seeing a child psychologist to help them deal with the lingering grief over the loss of their grandparents and the divorce. In just two sessions, the psychologist uncovered Amber's hidden anguish. Yes, she was extremely uncomfortable with her body, and yes, she wanted to get help.Susan had worried about Amber's weight long before this revelation. Susan used to work as a respiratory therapist in a hospital, where she saw the consequences of obesity firsthand. "I saw a bunch of kids who were overweight and had health problems like diabetes or heart trouble," she says. "I didn't want that for Amber." Still, she felt she couldn't help Amber if she didn't want help. When she realized her daughter wanted to lose weight, she knew it was time to act.Karen Rodgers of Redwood City, California, has been worried about her son Jake's weight pretty much since the day of his birth. He was born a month early but still tipped the scales at seven pounds, four ounces. As he grew older, he had a seemingly unstoppable tendency to pack on the pounds. Serving him healthy food didn't help, Karen says. He'd gag every time he ate a vegetable. He wasn't crazy about fruit either. Cheeseburgers, however, became number-one on his food list. The ten-year-old is 5'3" and weighs 180 pounds. The good news is that, like Amber, he has a mother who is committed to helping him slim down. Karen-a management analyst for the county coroner's office, a part-time police dispatcher, and a single mom-is just starting this journey, but she's taking all the right steps.An easygoing fifth grader with a chubby, round face and shaggy, light brown hair, Jake has had the good fortune to escape cruel teasing by other kids. He knows he's heavy, but he doesn't see a problem with it. On a warm summer day, he wears shorts and a loose T-shirt and sees nothing about himself he doesn't like. But exercise doesn't come easily to him. At ten, he lacks the muscle coordination to ride a two-wheeler. And his mother worries that as Jake gets older, he'll face an onslaught of taunts about his weight that will undermine his self-esteem. Worse, she fears, if he remains as overweight as he is now, he'll be a strong candidate for diabetes and heart disease."I look at him, and I feel bad," Karen says. "Why did I let him get like that?"Fatness and the FamilyNot long ago, doctors expected kids to take full responsibility for their weight. They'd lecture young patients on the dangers of extra pounds and urge them to get more exercise. Some committed doctors would even send kids to see a registered dietitian, where they would learn about counting calories and the food pyramid and the dangers of fatty foods. All the while, their parents were somewhere else: in the waiting room, perhaps, or at home, or even at a nearby KFC. The kids may have become experts at nutrition, but, not surprisingly, they weren't always champions at weight loss.But doctors' attitudes changed after the publication of a landmark study in the Journal of the American Medical Association in 1990. Researchers from the University of Pittsburgh put overweight children and their parents through three educational programs, but only one involved both parents and children. Ten years later, in the group that took a family approach to the problem, the proportion of children who were overweight had dropped approximately eight percent. In contrast, the rates of obesity had climbed significantly in the other groups.The study energized obesity researchers everywhere. Doctors and dietitians who focus all their energy on overweight children realized they may be missing the real target: parents. Parents have more control over a child's weight than anyone else, and that includes doctors, nutritionists, friends at school, and even the child herself. No matter how deeply kids yearn for a slimmer body, it's hard for them to get anywhere without the support of the people who buy the groceries, make the dinners, and set the rules.Of course, not even a dedicated mother like Susan Ryals or Karen Rodgers can make a child instantly thin, but parents everywhere can make a difference. In fact, they are often the only ones who can. Even in the face of all the unhealthy influences in the world, parents have an astonishing power to shape their kids' eating habits, says Moria Golan, PhD, a senior teacher in the School of Nutritional Sciences at the Hebrew University of Jerusalem. Fast food companies could start building new restaurants on every corner, spend billions more on advertisements, and offer two or three toys with every meal, but they can't tell parents what to put in the refrigerator or on the dinner table. Childhood obesity is an environmental problem, Golan says, and parents are still a major part of any child's environment.Golan has long believed that parents hold the key to childhood weight loss. In 2004, she published a study that underscored her message. The study involved sixty overweight children ages seven through twelve. Half of the kids attended thirty intensive sessions where they learned about diet and exercise. The second half stayed home while their parents went to fourteen classes where they learned how to encourage children to eat well and stay active. Both groups of kids slimmed down after one year, but the kids who stayed home while their parents went to class lost significantly more weight. After three years, things really got interesting: the kids who had attended the thirty educational sessions were more overweight than they were before, while the kids who stayed home had moved even closer to their ideal weight. The message is clear: when parents are committed to creating a healthy home environment, kids can lose weight and keep it off.From the book, GENERATION EXTRA LARGE: Rescuing Our Children from the Epidemic of Obesity by Lisa Tartamella, Elaine Herscher, and Chris Woolston; Copyright (c) 2005. Reprinted by arrangement with Basic Books, a member of the Perseus Books Group. All rights reserved.