Why Weight Matters in Childhood – Takeaways from Magic Pill by Johann Hari

SKIP TO: Key Takeaways re why weight matters in childhood from Magic Pill by Johann Hari

SKIP TO: Action Items for Parents

Buy Magic Pill by Johann Hari HERE.

Johann Hari wrote Magic Pill for those curious about using Ozempic and Wegovy as weight loss drugs. I found the book’s exploration of the reasons so many people struggle to lose weight in a traditional way very helpful. The book ends up making a clear argument for why weight matters in childhood, along with healthy eating habits. Hari describes how many people are essentially trapped at an unhealthy BMI, with all of its health implications, by a combination of biology, psychology, and their established eating habits. The book explores the potential role of these new drugs in our current weight loss landscape.

Johann Hari’s book focuses on the new weight loss drugs, Ozempic and Wegovy. However, I found the discussion regarding why people struggle to lose weight such that they need to resort to these drugs in the first place the most interesting part of the book. Therefore, I pulled my takeaways from Hari’s descriptions of why so many adults and children find themselves in the predicament of needing to lose weight.

The key takeaways from Magic Pill relating to why weight matters in childhood as follows: (1) Obesity is very bad for your health; (2) Statistically, diets don’t work; (3) Overeating is a common coping mechanism; (4) Processed food plays a key role in overeating and obesity.

There is so much chatter today about how kids need to learn to be comfortable in their own bodies. I’ve seen many threads on parenting groups where a mother describes her daughter’s increasing weight. She asks for advice on how to manage the issue. Nearly all the responses say the mom ought to focus on teaching her daughter to love her body. They discourage the mother from focusing on weight loss. They may ask her why her daughter’s weight matters so much to her. Perhaps some commenters will suggest the mother focus on getting the daughter to eat healthy, but not on her weight. Almost as if being overweight bears no relationship to unhealthy eating patterns!

Certainly, there is merit to teaching girls to love the bodies they have. The point is to set up girls (and boys!) for a happy, healthy life in the body they were born into. But there is a difference between loving your body even if it doesn’t meet conventional beauty standards, and refusing to see symptoms of an underlying issue for what they are. When something is precious to you, you treat it well. That means taking action when there are signs of a potential health threat.

Very, very brief overview of health impact

Until reading this book, I did not realize just how bad obesity is for your health. And I was even more surprised by how poor my own knowledge in this area is. I’m very familiar with the claim that it is possible to be healthy at any size. I had intuitively felt that this attitude probably glossed over some important caveats and painted a picture that was too rosy. But I didn’t investigate the details.

This book articulates the reality that you become significantly more likely to have health problems when you are severely overweight. This occurs with a BMI over 35. This is the first reason why weight matters in childhood. It is a huge disservice to a child not diligently attempt to get his or her weight back within a healthy range if she has an elevated BMI.

In brief, the more weight a person gains, the more predisposed she will be to health risks. Being overweight or obese increases your risk for diabetes, heart problems, stroke, cancer, and knee and hip problems. The longer a person stays at an elevated weight, the more difficult it will become for her to lose weight. Our bodies learn to defend a higher weight as a new normal and enact a multi-faceted defense to weight loss. From a psychological perspective, weight gain can be a symptom of emotional distress which parents should not overlook. Overeating is a common coping mechanism. From a quality of life perspective, being overweight can affect the ability to enjoy exercise and engage with nature. Both of which of course have their own psychological and health benefits.

Another reason why weight matters in childhood: it is very difficult sustain weight loss as an adult. Childhood is a period where a person is growing and should be gaining weight. Therefore, controlling weight gain in a child may be easier than reducing weight in a developed adult.

Research shows diets aren’t effective over time

In the short term, there is no disputing that diets work. However, Hari describes research from Traci Mann, who reviewed 21 studies tracking dieters over a 2-year span.¹ The studies showed that the average person weighed only 2 pounds less after two years than at the start of the diet. Hari interprets this information to mean the majority of diets fail.

I agree that this means that the diets fail in the sense that most people do not achieve their desired objectives. After dieting, they do not weigh meaningfully less. But before we say that the diets “fail” shouldn’t we understand the alternative outcome? I am curious how the weights of people who did not diet trended. Did they weigh more, on average? Perhaps much more?

When I briefly dug into this research myself, I found a study that was even more depressing. Although many dieters had lost weight at the 6-month mark, all the benefits of the diet had largely disappeared by the 12-month mark. Alarmingly, some studies suggest that a sizeable number of people actually gain weight on average after a diet. (Again, what would have happened if these individuals had not tried a diet? Might they have gained even more weight?)

But dieting may still have health benefits

Although this outcome may appear quite dismal, a 2020 study suggests that there are benefits to yo-yo dieting. Researchers divided obese mice into four groups. First, those on a high-fat diet who remained obese throughout their lifetime. Second, those on an extreme caloric restriction. Third, those on a moderate caloric restriction. Fourth, those on cycles of unlimited and restricted feed who gained and lost weight in cycles. The mice that remained obese throughout the experiment lived only 21 months on average. Those on an extreme caloric restriction lived 26 months on average. The moderate caloric restriction mice and the yo-yo dieting mice both lived 23 months on average. This suggests that the yo-yo dieting may have similar benefits to sustained modest weight loss.

Set point theory

In the 1970s, a predominate theory was that each person has a predetermined range, or “set point,” for weight.² In theory, if a person’s weight rose above her natural set point, she would not be as hungry. She would therefore eat less, and she would lose weight.  If her weight dropped below her set point, she would get hungry and gain weight.

Scientists updated this theory to explain why so many people have trouble losing weight. The update was that the biological set point is not inborn, but acquired.³ In other words, as we gain weight, our biological set point rises. When we try to lose weight, our bodies fight back. Our resting metabolic rate will drop. We move around less. Our hormones change to make us hungrier and more likely to notice food.

Importantly, some scientists believe that the set point is acquired early in life, and only changes afterward for specific triggering events. These include childbirth, menopause, aging, obesogenic environment, and disease. This is another reason why weight matters in childhood — this may be the key time where a child calibrates the baseline set point.

Changing your set point

Once the set point is in place, it is not totally clear how long it takes to lower it. Some studies suggest a period of several years at least. These studies show that after losing weight, the body will continue to operate with a reduced metabolic rate, reduced energy expenditures, and reduced satiety hormone (leptin), even after holding a lower weight for several years. Some studies point out that individuals who maintain weight loss for two years are 50% less likely to regain the weight. Perhaps this suggests that it takes at least 2 years to lower one’s set point.

As a parent, the fact that a person’s set point may be set early in life is a key reason why weight matters in childhood. It is a great opportunity. First, parents can work hard to ensure the child enters adulthood at a healthy weight (i.e., with a low set point). Second, parents can teach the child that his or her set point may change based on his actions and that this why consistency in maintaining a healthy weight important.

There is another reason why weight matters in childhood. More specifically, sudden changes in weight matter. One of the many reasons people eat (other reasons including basic sustenance and enjoyment among others) is to self-soothe. Just imagining a girl eating Ben & Jerry’s straight out of the tub to me immediately conveys the message that she’s encountered a very stressful event (most likely a break-up).

Magic Pill notes that this effect is visible on a large scale for both sports games and politics. In a review of 475 games from the 2004-2005 NFL season, sales of common comfort foods (such as pizzas) spiked by 16 percent where the home team lost. On the other hand, they fell by 9 percent if the home team won. On the night Donald Trump won the 2016 election, there was a 46 percent surge in pizza orders, a 79 percent surge in cupcake orders, and a 115 percent surge in taco orders. In LA the next day, sales of fried chicken rose by 243 percent, while in Chicago sales of mac and cheese rose by 302 percent.⁴ Regardless of your politics, there is no denying that the 2016 Trump victory was an emotional shock for a lot of people.

Surely, to some extent it is instinctual to self-soothe with familiar foods. However, Hari notes that the habit can have many causes. Therefore, for parents, I think it is worthwhile to delve into a few of them.

Eating as a coping mechanism may be a learned behavior

One reason people may self-soothe with food is that it can be learned from parents who soothed them food. Magic Pill describes how the psychologist Leann Birch conducted over thirty studies confirming that parent behavior influences a child’s likelihood of self-soothing with food.

In one study, Birch split 279 first-time mothers into two groups. The first group received intensive training in differentiating hunger cries from overstimulated, distressed, or tired cries. They were taught to feed their babies for hungry cries. They were taught to use other methods to sooth an overstimulated, distressed, or tired baby.  The other group received no similar training. Over time, the children of the mothers in the first group (who had learned to sooth their babies with methods other than food) were half as likely to be overweight as the children in the second group.⁵ For this reason, parents should be mindful of soothing children with food. This is a behavior many children will pick up.

This is another reason why weight matters in childhood. An overweight child may be an indicator that a parent or other role model may inadvertently be blessing eating as a coping mechanism. Because life is full of stressful events, he or she could potentially benefit from learning some healthier coping methods.

Overeating may signal a child in distress

Regardless of how it was learned, eating can become an established coping mechanism. Therefore, checking in when a child’s weight increases can help pinpoint whether a child is suffering emotional distress. People use food in order to feel better about a range of issues, from feeling bad about being overweight, to coping with stress, depression, anxiety, etc.

Hari cites a study of 93 women, some of whom believed they were overweight and some of whom did not. Researchers split the women into two groups. One group received an article about the stigma of overweight people in the job market. One group did not receive any articles. The women who believed they were overweight and who received the article about overweight stigma ate significantly more afterward than the others. Hari describes this study as one of many supporting the notion that feeling shame about one’s weight tends to contribute to further weight gain. He also articulates a point from the author Lindy West: “Loving yourself . . . is intrinsic to health. You can’t take good care of a thing you hate.”

To summarize, I mention that overeating can be a coping mechanism for four reasons. First, if a child is overeating, it is probably worthwhile to confirm whether there are any overlooked stressors at play in the child’s life. Second, if the child was overeating to manage his or her feelings, if a parent takes away the eating, the child will need a new, healthy or unhealthy, coping mechanism to manage stress. Third, a child who feels ashamed about his or her weight may have more trouble losing weight. And fourth, because eating may be a learned coping mechanism, parents may be able to teach their children healthier ways of coping.

Satiety and the addictiveness of processed foods

One of the major takeaways from Magic Pill is on the topic of satiety. Namely, people tend to overeat processed food because processed food does not provide us with a natural sense of satiety. Because we don’t feel satiated, we crave more and more processed food. Ozempic and other similar new weight loss drugs are so effective because they create a feeling of satiety.

Magic Pill details several reasons⁶ that processed foods don’t create a feeling of satiety, ranging from how softer processed foods require less chewing, to the potent combination of sugar, fat, and carbs (which only naturally occurs in breast milk), to blood sugar spikes which cause cravings, to low protein and fiber content, to the impact of flavored drinks, to hijacking our evolved nutritionary wisdom, to gut malfunction. The book delves into these points, but I won’t here.

For these reasons, perhaps, at least one study has found that those eating processed foods will eat approximately 500 more calories per day than those eating similar whole foods.

“Cheesecake Park” study

Hari describes research from Paul Kenny,⁷ dubbed “cheesecake park.” Kenny took rats that ate a diet of heathy food. Given unlimited access to the healthy food, the rats would eat and stop when they were full. They did not become obese.

Then Kenny divided the rats into two groups: one received cheesecake, snickers, and bacon for one hour every day. The rest of the day they had access to their usual healthy rat food. Kenny determined that the rats received approximately 70% of their calories from the unhealthy food. Because they only had access for one hour, when the food was brought out, the animals went into a frenzy. They would dive into the cheesecake, emerging “slick with cheesecake.” The second group of rats had cheesecake, snickers, and bacon throughout the day. Kenny determined that this group received approximately 95% of its calories from the unhealthy food. Unsurprisingly, both groups became obese within six weeks.

The surprising bit came when Kenny took away the unhealthy food. He had anticipated that the rats would eat more of the unhealthy food. But instead, the rats refused to eat their usual food, until they reached the point of starvation. Kenny says it was as if they didn’t recognize it as food any longer.

Implications for children

The study has interesting implications regarding the impact of processed foods given at regular intervals on a child’s eating patterns. Specifically, even if a child is only permitted to eat processed food one time per day, he or she may reject other foods in order to take in the majority of calories during that one meal. Remember, the rats who only had one hour’s access to the junk food still managed to take in 70% of their calories during that period. Second, if a child does begin rejecting healthy foods, it may be necessary to completely eliminate the processed foods from his or her diet for a while until he learns to recognize the healthy food as good food again.

What is processed food?

There are different definitions of processed food depending on how granular you want to get and the reason you’re having the conversation about processed food in the first place. For purposes of this article, I mean food that is not fresh off the tree or the bush etc. It means food that has been transformed in some way, not by you, and not by a restaurant immediately before you consume it. Hari mentions that he had unconsciously thought that processed food was prepared in a giant, busy kitchen somewhere. I believe I had a similar mental picture.

What makes processed food bad?

The ugly truth is that processed food is prepared in an industrial manufacturing plant in the way that other industrial goods are produced. This means that delicate, perishable ingredients in our most beloved foods are far more likely to be destroyed in the manufacturing process or the necessary shelf life before the item is consumed. For this reason, the inputs are often not the ingredients that you would choose were you making the food from scratch in your kitchen. They are often not even the ingredients pictured on labels. They are often “chemical bath bomb” approximations. Additional ingredients may be needed to mask some of the bad flavors that develop during processing.

Hari describes how for a strawberry milkshake, there may in fact be no strawberries at all – rather, a strawberry flavor is achieved with a combination of fifty different chemicals. As Hari notes, “To make food cheaply at this scale, you have to strip it down to its chemical elements, get them delivered in bulk, and assemble them to make an approximation of the food that we expect – a kind of ersatz curry, a replica of a cheese and tomato pizza, made out of dozens or hundreds of chemicals.”

See my takeaways from Salt Sugar Fat regarding the challenges of mass producing food and what that means for food composition and quality.

Animal feed

Hari makes a disturbing tie-in to the way that most animals raised for slaughter eat.⁸ To keep production costs low, it pays to get the animal as big as possible, as fast as possible. Less time to get big means less time on the farm, which means fewer expenses. Farms accomplish this is in part by restricting movement, but also by feeding animals an ultra-processed feed instead of their natural food. Because the animals sometimes don’t like the processed flavor, farmers commonly add strawberry-banana flavored Jell-O powder to encourage the animals to eat large quantities.

The result is that the animals eat many more calories. The same effect experienced by humans who eat ultra processed foods! The twelve weeks a chicken once spent growing on a farm has now been reduced to five or six weeks. And that chicken is now three times higher in fat today than it was thirty years ago.

Surely alternative sweeteners are better?

Many people drink diet sodas marketed as “zero calorie” drinks. They tend to think they are making a healthy, or at least calorie-neutral, choice. The current research however indicates that these drinks still lead to weight gain. Perhaps even more weight than if you’d just had the sugary beverage in the first place.

The reasons for this aren’t entirely clear. Scientists have observed that when you drink a drink containing a zero-calorie sweetener, your glucose levels rise, similar to when you ingest sugar. At the same time, the gut bacteria changes, so that it mirrors the bacteria in those individuals who have high blood sugar. One theory is that your brain anticipates the sugar and prepares to metabolize it. However, when no sugar energy actually arrives, your body will trigger you to crave sugary foods so that your body can get the energy it had prepared to receive.

I had three actionable parenting takeaways from Magic Pill. First, ensure kids don’t refuse their regular meals and actively teach them how to manage consuming junk food. Second, focus on developing positive associations with healthy food (avoid negative associations with healthy food). Third, if a child gains weight, make sure they don’t need adult help to handle a stressful event and teach them healthy mechanisms for handling stress.

Let’s assume that the Cheesecake Park experiment, which was performed on rats, has some relevance to humans. If so, I have three takeaways here. First, one regular treat a day for a child may be too much if he learns to reduce intake of healthy calories for that treat. Second, it is better to treat with specific food items than with an unrestricted meal. Third, monitoring a child’s consumption of healthy meals is likely a good marker for whether he is holding out for the junk foods.

One regular treat per day may be too much

The pessimistic takeaway is that once a kid has access to junk food even for a short time, but on a regular schedule, he can learn to wait for it and crave it. The Cheesecake Park study showed access for a short but regular period of time is barely better than full time access. Remember, the rats that consumed the junk food one time per day ultimately refused to go back to a normal diet just the same as the rats that had unlimited access to junk food. And they still managed to obtain 70% of the day’s calories from the junky food, despite only having access to it for an hour.

This leads me to two conclusions. First, if your toddler is not eating, the worst thing you can do to snap him out of it is to finally just offer junk food so that he eats something. By doing that, you are ensuring that he holds out for that junk food going forward as his main source of calories and has even less affinity for the healthy food. This really strikes home for me right now because our toddler boy is nearly impossible to feed right now. He gets one good meal a day if we are lucky.

Treat item-by-item, not with a meal

The second conclusion is that if you are going to give kids some regular access to junk food, don’t let them eat as much as they want of it during the meal. It is better to restrict junk food item by item than by limiting it to a meal where they can eat as much as they like. In other words, let them eat one ice cream or one package of chicken nuggets, but not as much food as they want for lunch at McDonald’s.

At the same time, I think it’s important to teach kids about how to approach junk food, because they will inevitably encounter it in their lives. I don’t want my kids to have unlimited access for the first time in college and then wrestle with this whole new, highly attractive category of food for the first time on their own. I think it is important to demonstrate the concept of limited access to junk foods so that they can learn to manage this themselves one day. They can learn to partake, but only a few, limited items. Maybe involve them in the choice process so that they can take some ownership of the process and internalize it.

Use healthy meals as a marker for dysfunction

The optimistic takeaway from the cheesecake study may be that the cause for concern only creeps in if kids exhibit addictive behavior and start refusing to eat their regular meals of healthy food. Therefore, regularly checking in to see how a kid is eating her healthy meals may be a useful indicator of how big a role the junk foods are playing in their lives. If your child has access to junky food, but still eats a solid breakfast and dinner, it sounds like the junky foods have not become so addictive that your child is no longer recognizing healthy food as food. If the junk food is not impacting calorie intake from the healthy meals, this implies the kid has not developed the addictive feeding habit of the cheesecake park rats.

Personally, rather than actively policing every meal my children have, I’m going to monitor two healthy meals a day to see how well my kids eat at those meals. If they start to refuse to eat well at those meals, then I know a more active policing role is warranted.

Kids will unavoidably develop positive associations with unhealthy foods. Hari cites an internal memo released in 1998 that describes how companies make “a great deal of effort” to focus on children younger than 10, because taste preferences are formed early. These companies focus on children’s movies and TV characters. They donate materials with their logos to schools and contribute food to lunch programs. Hari also delves into his own story, in which his harsh and often critical father would criticize his poor eating habits and try to get him to eat healthy food. This caused him to associate healthy food with shame and discomfort. Meanwhile, his mother and grandmother were very kind to him and would slip him unhealthy foods. This caused him to associate those foods with love and emotional support.

One of the things I’ve learned as a parent, over and over again it seems, is that it just does not work to tell children what not to do. What does have a much higher success rate is encouraging to do one or two specific things at a time. So for this reason, I’m not going to stress too hard about the inevitable exposure of my kids to unhealthy things. I’m just going to try to build positive associations with the healthy stuff.

At least some people use overeating as a coping mechanism for dealing with certain stressors in their lives.

There are two sides to this coin as noted above. The first side is that parents can inadvertently encourage children to eat to cope with stress. Therefore, when my kids are stressed, I’m going to try to remember that a trip to the ice cream shop or eating homemade cookies is probably not the best course of action. Rather, I want to encourage them to move around, whether going for a walk with me or blowing off steam alone, or to pick up a fun book, color. If none of that works, then maybe its time for a bowl of healthy chicken soup.

The second side to the coin is that the weight gain can be an indicator of stress or potential dysfunction. For me personally, this was one of the overlooked reasons why weight matters in childhood. If a child suddenly start to put on weight, this book makes clear that it is probably worthwhile to pay some additional attention to what is going on in the child’s life and mind. Is there a stressful event going on, or something that he or she is avoiding? Is there a deeper problem that the child is struggling with that requires adult intervention? If not, what can I do to help my child cope with the issue in a healthy way?

Johann Hari delves into the processed food industry and the impact these foods have had on our diets. The offending foods clearly include fast food fried chicken, microwave dinners, and candy, but what else? I’ve discovered reading generally on this topic that “processed food” includes more than one might think. Many books suggest avoiding any food that has an ingredient in the label that you don’t recognize. Another book may suggest avoiding any food that requires an ingredient label. So finding a good book discussing what the processed food category includes, and what specifically to avoid for processing concerns, seems like it would come in quite handy here.

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1. Johann Hari, Magic Pill, 99 (2024). ↩︎
2. Id. at 100. ↩︎
3. Id. at 161. ↩︎
4. Id. at 140. ↩︎
5. Id. at 147. ↩︎
6. Id. at 39. ↩︎
7. Id. at 35. ↩︎
8. Id. at 47 ↩︎