Calories cause obesity and while everyone wants a magic solution to eating too much for a prolonged period of time, those with the means can make it reality in the form of surgery.

COVID-19 set off a panic in much of culture. Schools were closed, people were ostracized if they didn't think flipping masks up and down between sips of water was clinically valid, but decisions were being made in real-time so a lot of things that once again seem silly in hindsight were the Precautionary Principle in all its glorious flawed reasoning.

Some people like me chew gum or go for a walk to relieve stress, others exercise, but some reduce stress by eating and, just like hermits who know they won't see anyone don't bother to shave, not seeing people may mean eating a lot more. If you have good health insurance and the money for the deductible and saw your child get fat, the magic bullet was more often bariatric surgery in 2021 compared to previous years.

Childhood obesity has gone up a lot this century, with the largest increase among Hispanic youth (4.1 percent in 2000 to 10.7 percent in 2018) followed by Black youth (6.7 percent to 10.2 percent, respectively) and White youth (2.6 percent to 4 percent, respectively) and since obesity is a risk factor for various co-morbidities, including COVID-19, controlling it early remains key.

Less DoorDash meals is one way to consume fewer calories but during the pandemic far more people ordered takeout. It is easy to eat 1,000 more calories per day but losing weight means eating 1,000 calories less for the same amount of time as kids ate in excess, or exercising much more. Behavioral change is hard for some parents to adopt or their kids wouldn't be obese and the quick solution is drastic but effective; bariatric surgery.

Though the pandemic is still not over by some on Twitter even in 2023, by 2021 it was over enough that the authors were able to look at data of over 1.3 million people and find that 19 percent more kids had the surgery in 2021 than 2020. Some of that may be relative, as in delayed. It is an elective surgery so when the rest of us were told not to leave the house, if rich parents were getting hospital space for this, they're just terrible human beings, the way wealthy Manhattan women once got autism diagnoses for their kids so they could skip the line at Disney World. 

Yet 2021 surgeries were up from 2019 also.  

The authors think the increase is a good thing, they don't seem to believe that behavioral changes, like a sensible diet and exercise, i.e. being a parent, are effective, and they may have a point. American agriculture produces affordable food two generations after progressive Doomsday Prophets like Paul Ehrlich and John Holdren said the planet was going to starve unless we had mandatory sterilization. Human history was filled with cycles of feast and famine, 'you never know when your next meal will come' thinking was ingrained.

Defying the consensus from the 1960s and '70s, this basic necessity is now so bountiful that for the first time ever poor people can afford to be fat. Overcoming that takes what I call 'cultural maturity.' Just like a new iPhone was once a big deal but now it is a commodity, eventually we will not binge eat because 'kids are starving in Africa', we will again treat excess food as the thing we do in a communal experience, and not have an episode of "Succession" be a reason for a feast.

Until then, more wealth means more surgery, but it's not a bad idea to just stop buying so many treats too.