Health Care Healthy Living

Lessons from the checkout…

I have witnessed this grocery-store checkout phenomenon countless times.

Haven’t you?

These two paragraphs are a direct quote from the blog, 33 Charts, authored by the very famous blogger, professor, and pediatrician (Dr Bryan Vartabedian)…

“So I’m in the checkout line at the grocery store. In front of me is an overweight mother and child. Their cart is filled with refined carbohydrates, microwave food and snacks. Not a hint of vegetable or fruit. Not a whole grain to be found. Behind me is a mother and daughter with what appear to be balanced weight and height. Their cart is flush with fresh vegetables, meats, fish and the rare-but-appropriate smattering of sinful snack food. A remarkable contrast really.

Every day I confront the parents of the dangerously overweight. And in many cases there’s a failure to ever recognize that habits and choices have even the smallest role in what’s making their children so sick. Obesity is complicated and its solution certainly goes beyond shopping cart critiques. But in many cases the solution’s most common denominator comes down to intake versus expenditure and the recognition that our actions can contribute to the problem.”

Two paragraphs nail the essence of the problem: The intake versus expenditure formula.

My only quarrel with such succinctness and clarity are the words, “our actions can contribute to the problem.”  Would it be too much to say that our actions cause the problem?

But it is so politically incorrect to suggest such simplicity and obviousness.

In the practice of medicine it has become clear to me that in explaining the therapy of a problem, we must speak frankly. Stating the facts is not necessarily judgmental, unkind or insensitive.

The stakes our high; our countries health teeters in the balance.  And we are clearly losing.


12 replies on “Lessons from the checkout…”

When my son was born we were fortunate to be able for my wife to stay at home. During this time she spent her time figuring out what the best available foods, AKA natural, that she would be able to feed our son. She found many but ended up making his baby food from scratch. Flash forward to today…My son lusts after fruits, vegetables and nuts. He does now and again request candy but it is a rear occasion.
Long story short healthy eating habits start at an early age.

Fine – but where are the unequal school systems (some have GOOD LUNCHES SOME SERVE CRAP), those in poverty, those who work 2 jobs, Why are the cheaper foods less expensive? why is poverty level FAR BELOW the ACTUAL standard of living costs, (aka buying REAL FOOD would never be sustainable on foodstamps for a family of 4)…

Where is recess, why do ppl Rx pill pill pill pill pill for so many problems when we KNOW that exercise and sleep is the ANSWER, why are so many healthcare workers MORE BROKEN then their actual pts,

We judge obesity as the monster– but in reality IT IS THE STRUCTURES – the culture, the REASONS WHY ppl get fat…

Research has already indicated time and again that weight loss does not make people more healthy but the LIFESTYLE DOES… THE LIFESTYLE MAEKS PEOPLE HEALTHY… but HOW does one have a healthy lifestyle if one cannot focus or work or if one lives below poverty or is a single mother or is born into a stressful life or if one's parents feed them soda and refined processed foods from the time they are born??? (I already likened this to a kind of child abuse because children have no choices- but school systems do it with OUR TAX DOLLARS!) …

Where do YOU stop pointing fingers at PARENTS and point a finger at YOURSELF AS A TEACHER AND PHYSICIAN AND CITIZEN and start joining forces in helping? where do WE as a society start making things BETTER FOR EVERYONE?



So it's my fault and Dr. John's fault and everyone else's fault, but not their own fault of course, that these people are fat and unhealthy.

Thanks for the insight Melissa.


Unless you are physically incapable, there is no reason anybody cannot live a healthy lifestyle. Several years ago I was working 2 jobs, spending time with the family,and BTW had lone atrial fibrillation to boot. My wife was going to school and working as well. Even though I was working tremendously long hours,I continued to exercise regardless of how I felt. I wasn't only doing it for myself but I was trying to set a good example for my family.
It is a personal choice and no mater what a doctor or somebody tells you it is up to you to do it.
If your doctor is prescribing too many pills then I would suggest that you find a new doctor. If your school is serving bad lunch the i recommend you child brown bag it.

Have any of you spent any time in Eastern KY. Try and find a source of good healthy fruits and vegetables at a reasonable price (reasonable on a welfare check) at the local markets. It's nearly impossible. In the past, when I have had trials down there, my eating goes literally down the tubes. You have to have a vehicle, and money, to hunt down and purchase fresh food. True, the creative can make do with frozen veggies, but that requires some resourcefulness. It is truely, easier said than done. And it must be done without pointing fingers. Years, generations, of inappropriate nutrition, can't be fixed with a quick discussion for veggies at school. It is going to take a systemic change. Groceries and markets are in it for the money…and if the veggies cost more to supply to the consumer, the consumer has very limited funds, the fresh veggies and fruits don't get purchased and go bad, then they stop being supplied.

Did you read the article about the 6 dead Jackson residents. I have a guy I work with who is from there, and was at the shooting site a few hours after the shooting. It is absolute utter poverty. The shooting was not about "bad eggs" as the paper reported. These people were being kicked out of their home because they didn't have th $150 in cash to pay the rent. He was on the edge, and cracked, so to speak.

If it costs .50 cents to a $1 for a load of white bread and fake cheese to make sandwiches for the week vs. $2 for a pound of carrots and apples…guess they are going to feed the family cheese sandwiches and survive. I am not supporting bad eating habbits…but survival needs generally trump the need to get a healthy plate in front of a kid.

Anyone who wants a tour of Breathitt County and the surrounding area to see what it takes to live…let me know, my friend Doug gives tours.

Some really good points…It is ironic; usually obesity posts draw the least interest. As if…not another post about the hopelessness of fatness.

Maybe these thoughtful comments are just an anomaly, or maybe we (as a society) are reaching a threshold.

I get what Melissa and Marcia are saying. The impoverished are at a disadvantage, and yes, I too, have spent time in southern KY. There are no Whole Foods.

Surely, a societal paradigm shift is in order. Recently, I wrote down my multi-pronged plan–"If I was Surgeon General." I posted it on my right column of helpful posts.

I also agree that the ultimate solution to obesity runs parallel to solving many of society's woes, as Melissa and Marcia speak of. There is much debate on how best to accomplish this, ranging from the Reaganesque pull yourself up by the bootstraps, to the euro-versions of socialism, where government provides much sustenance for its people. This debate is above my level. I am just a doctor who sees the ravaging effects of this incredible disease.


Marcia, you are nice.

I don't know Melissa, but I bet she is too.

But it is what it is until you make it what it wasn't.


Dr John,
The fact that you are compelled to continue working w pts or that their health upsets you means you are a good doctor and a good man. It shows your heart. Cheers.

And RDB – I'm probably a nice enough soul 😉

Thanks for the lovely dialogue and conversation. It is where we all start.

we can talk about the poverty stricken and I agree it's a terrible story. The worst is when I see parents (unfortunately mainly women) take their kids to McDs for Happy Meals or whatever fast food place but they make sure their food is fresh and organic and healthy. This has nothing to do with affordability, I just don't understand

I'm not worried about overweight people, its generally well know that when the aliens come, they eat the fat ones first.

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