Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

A Prevention Partnership

Can I have some?


Obesity is a complex disease that can be hard to treat. Promoting healthy lifestyles while preserving and honoring cultural and family traditions can start with newborns.    

A mother brought her two-day-old infant in for a check-up. I learned that the mother had gestational diabetes, and several of her family members had Type II diabetes and obesity. She said, “I really want him to eat well, but I want to do everything possible for him to not be overweight. I don’t want him to have all the health problems my family has.” She went on to tell me that her family’s way to celebrate is to eat together, and she never wants him to miss out on that, but she does want him to be healthy.  

Obesity is a complex chronic disease with numerous comorbidities and it’s so hard to treat. Children are growing up in an incredibly toxic food environment of calorie-rich, nutrient-poor food that’s marketed to systemically disadvantaged communities and is sadly more affordable than healthier options. As a clinician, I was honored to be asked for help at the front end of this chronic illness.  

I know what mom meant about family celebration and grandparent-doting. Food is love in just about every culture, and that’s a beautiful thing. “Don’t worry,” I said. “We’ll make sure that he eats well, and that the good food of your culture will be celebratory and valued.”  

By helping her breastfeed, she could promote a process that probably allows for a more diverse palate, reduces overfeeding, and is cheaper than formula. By teaching the mother-infant dyad hunger and satiety cues (ways he shows her when he wants more food and ways he shows her he wants less food). How often do I wish I could truly eat when I’m hungry and stop when I’m full? How often I wish that I didn’t look at the clock to determine whether it’s mealtime or not, instead of listening to my body. Later, I planned to work with the mother on feeding him healthy, instead of super-sized, portions. By not feeding him sugar-sweetened beverages, he would be less likely to develop a sweet tooth, and the wonder of water as the best thirst-quenching beverage would continue to please him throughout his life. By allowing the baby tummy-time and not always strapping him into the numerous devices available, he could explore, play, and learn the joy of physical activity. By keeping him away from screens, she could teach him to engage with the world around him instead of mindless media.  

None of this requires giving up delicious foods at family gatherings or abandoning important traditions. With this incredibly thoughtful question, this mother invited me to a partnership grounded on the promise of prevention, a partnership we should strive to make with all our patients. 








This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.