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Childhood Obesity Ads Stir Anger

Aired January 17, 2012 - 21:00   ET


DR. DREW PINSKY, HOST: Tonight, a controversial anti-obesity campaign in Georgia. What is it supposed to do? Inform? Shame? Or make fat kids thin? I want to deal with the real problem behind the obesity epidemic.

Plus, concussions and what they do to the brain. It`s a serious problem on and off the football field. Dr. Sanjay Gupta is here to help me sort it all out.

So let`s get started.


Tonight, childhood obesity. As a country, it`s a problem we have got to face and do so in a way that is honest and real, and gets at the problem.

Here is how some are trying to combat the problem in one southern state. Watch this.


JADEN, STOP CHILDHOOD OBESITY AD: My video games is what I like to do by myself. I don`t have to be around other kids, because all they want to do is pick on me.

PINSKY (voice-over): Jaden`s commercial is part of a massive anti-obesity campaign in Georgia. One million children in that state are overweight. Research reveals that 75 percent of their parents don`t recognize it as a problem.

The ads have generated controversy just as these billboards did months ago as they put fat kids, their families, and maybe an entire state in a position of being mocked. Here is the ad about Tamika.

UNIDENTIFIED FEMALE: Being thick runs in our family. As her mom, I never notice Tamika eating differently than the rest of us. She likes junk food. But what kid doesn`t.

PINSKY: The Shape Act passed by Georgia lawmakers requires some children to be weighed and measured. The results reported to parents and the state. Question is will this $50 million push help solve the obesity epidemic or is the focus on the wrong thing.

UNIDENTIFIED FEMALE: When the doctor said she had type 2 diabetes, I never thought what we ate made her sick. I just always thought she was thick like her Mama.


PINSKY: Obviously well intentioned, these ads are, but do they help anyone?

We have three guests who have something to say about this. Bob Greene, he was a frequent contributor to "The Oprah Winfrey Show." He`s the author of "The Life You Want." He is joining me via Skype. Steve Perry, CNN Education Contributor. And Mark Wulkan, he is the children`s - represents the Children`s Healthcare of Atlanta, the organization behind the ad campaign.

Mark, first to you, I watch these ads, and I`m not sure what we should be learning from them. What do you think?

DR. MARK WULKAN, PEDIATRIC SURGEON: Well, you said it earlier, that 75 percent of these kids` parents don`t know that they`re obese, so the intent of this ad campaign is to raise awareness in Georgia. Let them understand that we have a problem.

We are number two in the nation with childhood obesity, that`s a top 10 that we want to get out of. And the only way to get out of is to first admit you have a problem. The process for any change begins with awareness and acceptance that there is a problem that needs to be solved.

PINSKY: Steve Perry, amongst all of us here, you`re the one who`s dealing with adolescents and young people on a day in, day out basis. You`ve seen a little bit of these ads. You saw the clips we just played. Do you think it`s going to have the intended effect?

STEVE PERRY, CNN EDUCATION CONTRIBUTOR: I hope so. I remember when I was in middle school, the campaign was about trying to get kids to not smoke. So they showed us the lung of a smoker in class and it frightened us.

So obesity is a lethal disease that is curable. And especially when I go to visit schools in the south, I see some really (INAUDIBLE), some pretty large children who I don`t think their parents really see them as large. I think the parents accept that they are just built that way, and many times you hear children - parents say they`re just big boned. Well, they`re no big skeletons. There`s big meat on those bones and they need to see that.

PINSKY: Dr. Wulkan, is it just an issue of how kids are eating and what`s going on at the dinner table? Or the fact that there is no longer a family dinner table?

WULKAN: Well, it`s multi-factorial. You know, if you look at the obesity epidemic, it started in the `80s. There`s a genetic component. There are some people in some groups that are more predisposed to becoming overweight.

But it`s really a cultural milieu that we live in. And right now the culture here in Georgia and throughout the nation it`s such that we have a terrible obesity epidemic that is leading to health problems in kids that we used to only see in adults.

I`m a pediatric surgeon and a surgeon in chief at Children`s, and, you know, we see these kids every day. And we see high blood pressure, heart disease, diabetes. Again, diseases that you only saw on adults than kids. We need to do something about this.

PINSKY: Now, Bob Greene, this is something you`ve been addressing for quite some time. How do you see all this?

BOB GREENE, AUTHOR, "THE LIFE YOU WANT": Well, I think no question something needs to be done. The health consequences are dire.

However, I look at someone struggling, in particular a child, with their weight, it`s never about just they`re eating too much, there`s almost always issues behind it. And the root of this is usually the way the child feels about themselves.

So in some ways to put a spotlight on that child may be a disservice, quite honestly. It`s going a level deeper if the child is insecure about their life or anything going on in their life, to have some public ridicule or the potential for that only inflames the situation.

PINSKY: Well, Bob, I want to dig into that a little bit because - I`ll let the other guests ring in in just a second, but I first want to dig in with you, Bob. Because this is something I see this all the time.

Obviously I deal with a population that`s been highly traumatized. And think of this from an evolutionary perspective. From an evolutionary perspective, if there is trauma to a young animal or young human, it makes sense if a human is entering a traumatic environment that they would want to quickly accumulate as much calories as they could, with the sort of adaptive idea that they - this is a hard thing to explain, but the idea that the environment may not allow them to eat in the future because it`s a very dangerous, traumatizing environment.

The problem is that after trauma in our culture, they enter an environment where there`s nothing but gratifying, fatty, fast foods, and so obesity ensues, and then obesity becomes a strategy for keeping people away. If you`re a trauma survivor, you kind of want people at a distance. Do you find that, too, Bob?

GREENE: I really have to agree with that. And there are levels of trauma, even say a parent or a teacher who says why did you get a C on your report card, why are you wearing that, why are you wearing your hair that way. That actually over time reinforces the fact that you`re unworthy of certain things, happiness, to be a certain size.

And these are the problems that are very subtle. And you take that all the way up to, say, a situation where a child has experienced abuse, you`re upping the odds that there`s going to be a coping mechanism, and that`s either drugs, that`s either alcohol, and most common would be food. It`s a subtle kind of way to say I`m OK. I feel good about myself, and it tends to be more socially acceptable than alcohol or drugs.

PINSKY: And this was a sort of light went on in Oprah`s head under your guidance - in her head, is it not? She understood that she started eating for emotional reasons, is that accurate, Bob?

GREENE: Yes. She`ll be the first to tell you that eating can be part of a coping mechanism when you`re happy, when you`re sad, when you`re bored, when you`re stressed. It`s the easiest one and you`re not necessarily hurting anyone else, but, again, we know it`s a subtle way, has very similar health consequences. It may not be as immediate as someone addicted to drugs or alcohol, but they`re significant.

PINSKY: I`ll turn to my other guests now. We`re going to have a whole other segment after the break with you guys, but who wants to ring on this, Steve or Dr. Wulkan? Steve.

PERRY: Well, I think for sure some - some obesity is of course a symptom of other things, but in many cases it is the result of a family`s eating style and inactivity of a child. I think that schools have had the traditional gym class in which you have to take a certain amount of hours per week in order to fulfill your gym requirement.

When we look at some of the prep schools, what we see is that they don`t have traditional gym. What they have is that the children have to participate in two varsity sports which can get them up to 2,000 hours of physical activity which more importantly builds a healthy child and as you know builds muscle memory.

So you don`t have to worry about eating as much as another child does because you`re constantly in season. You build better eating habits and you create in the child the opportunity for them to see themselves as an athlete and improve their self esteem.

PINSKY: Steve, well said. I think the point is this is a complicated multi-factorial issue. We don`t want to leave any of these factors out.

Let me add another one. We don`t all sit down at the dinner table and have moms or dads sort of portion out the food for us and tell us what we can and can`t eat. It`s sort of people are catch as catch can.

I know Dr. Wulkan, you`ll have more to say about this, too. We`re going to talk more after the break.

So what can we all do? What is the solution? We`ll hopefully have some more answers after the break.



UNIDENTIFIED FEMALE: I don`t like going to school because all the other kids pick on me. It hurts my feelings.


PINSKY: We are talking about childhood obesity, looking into the cause of this very complicated issue. It`s complex, as complicated at each and every one of our kids.

Joining me though now is actor Sean Kanan. You know him as Deacon from "The Young and the Restless." He also is the author of "The Modern Gentleman." And what some people might not know, Sean is - you were an overweight kid and you were bullied. And so you have an opinion about all of this.

SEAN KANAN, AUTHOR, "THE MODERN GENTLEMAN": I was. You know, I grew up in Western Pennsylvania and I was - I was an overweight kid. And around the time that I was 12 years old, I said to my parents, I`m going to Weight Watchers and I`m going to - I`m going to do something about it.

And I really - I really went through sort of a metamorphosis. You know, I lost about 20, 25 pounds. I got contact lenses. And for me, it was a very catalytic time in my life, because, you know, especially now I really feel like I understand what it`s like to be on both sides.

You know, now working in Hollywood, which is obviously a very -

PINSKY: Well, let me ask you this because I think for people who are at home watching this, they want to know what can I do to help my kid.

KANAN: Right.

PINSKY: Is there something that led to that transformation?

KANAN: Well, I think that, you know, I was really uncomfortable in my own skin, like a lot of kids were.

PINSKY: Did somebody support you in some way? Were you getting through some traumatic issues? Did you have something that you successfully sort of negotiated emotionally and suddenly you`re able to take care of yourself properly?

KANAN: I think I have to attribute a lot of it to my parents. I mean, they were really receptive when I said to them, you know, I don`t feel good about me and I don`t feel good about the way that I`m being perceived by other kids and I want to - I want to do something about it.

And so I think the support I got from my parents and the fact that they recognized that, you know, I needed a little help really was what helped me.

PINSKY: Which is really I guess the ultimate goal of this ad campaign -

KANAN: Right.

PINSKY: -- is to bring awareness to the parents.

Dr. Mark Wulkan is a pediatric surgeon at Children`s Healthcare of Atlanta. I didn`t give you a chance to respond in that last segment where we were talking about all these other factors that were coming to bear on the obesity epidemic. Do you have a response to all of that?

WULKAN: Well, you know, again, it`s multi-factorial. I think everybody hit upon the points.

But, you know, the ad campaign is really part of our Strong for Life movement which has many more facets to it, including a provider program. We`ve trained nearly a thousand pediatric healthcare providers in how to manage overweight kids. And we`ve also partnered with daycare centers. We`ve partnered with schools and community groups. And we use social media to attract, to target our audience to really start teaching people healthy habits.

You know, we didn`t get here overnight. The obesity epidemic, again, has been going on since the `80s. It`s the cultural milieu we live in. And you can`t - there is no quick fix. There`s no diet. Diets don`t work, they have a beginning and end. You need to establish healthy habits, like less screen time, except for Dr. Drew.

PINSKY: But Dr. Wulkan, I want to say, though, and I think a lot of people don`t realize that when physicians approach a pediatric patient, certainly an adolescent patient, they`re talking about the child and the parents. That`s - the patient is the entire group.

And I want - and Steve is nodding his head vigorously. Sean has sort of set us off down that discussion I think appropriately. Steve, go ahead.

PERRY: One of the things that we see is that the children are simply a representation of their parents, and many of these parents that I work with have very bad eating habits and they pass them onto their children. And when their children do them -

I mean, there are times where I`ve had had female basketball players come in with donuts, a bagel, and orange soda that the parent brought them in with. And I say that`s not training food. What are you eating? And the parents sort of laugh it off and they say how they had bacon earlier in the day.

Many times the parents are challenged to know what it is that they should be doing, and sometimes seeing the truth as it is in these commercials is going to help a lot of parents to say I might be helping my children and I didn`t mean to.

PINSKY: And let`s be fair, too, this is a time of great financial stress for a lot of families, and that high calorie food is probably cheaper.

Bob Greene, do you have an opinion on what we`re talking about here, the fact that it is the unit is the child and the parents, is that not true?

GREENE: No question, the solution is with the parent, starting with the parent. It trickles down to the student, the child, and the school needs to be involved.

We look at the states. Obviously we`re talking about Georgia tonight. But the vast majority of states pulled activity, physical education out of the curriculum, and it is not mandatory in most of the states now.

Also, what`s on the menu in the schools is enormously important, and while some states are aggressively changing menus, that would be - the first stop is putting activity back in the schools, number one, and number two, changing in part of the education is the importance of that.

So it`s one thing, the commercials we`re probably going to be split on are they effective. But I think this is an emotional issue more than anything else, and you have to appeal to the emotions, not of just the student, but for sure the parents.

PINSKY: Sean, I feel you bursting with a comment here. Go ahead.

KANAN: Well, you know, I think the economics of obesity is really an important issue. And if I have any criticism of these ads, I don`t find that they`re particularly solution oriented.

You know, one thing - one solution that I have is let`s - let`s initiate a sin tax for the food that is making America obese. Let`s take the money from that sin tax and use that to subsidize foods that are healthy. You know, one of the biggest complaints is that people who are economically challenged don`t have access to some of the better, more expensive foods that are -

PINSKY: Fresh, organic vegetables.

KANAN: -- fresh organic fruits and vegetables. Why don`t we take the crap these kids are eating, tax it if the parents want to give it to them and create subsidies so that they have more availability for the healthier foods.

PINSKY: Dr. Wulkan, it`s an interesting idea. It sort of look at the nasty food the way we look at cigarettes. It`s an idea.

WULKAN: It`s an idea, but I`m not - I don`t know if that`s really the way to go about it. I think you need to educate the parents. And so everybody said that you have to treat the family unit, and there`s a lot of - I mean, that rings true with any pediatric healthcare. But -

PINSKY: But let`s go all the way with that. We have sick families in this country. We`re not - our families are not healthy generally, and if you look at almost any issue, whether it`s social or physical health, whatever it might be, that`s a - that`s a core issue we`ve got to deal with. Would you agree?


PINSKY: Yes. Steve, how about you?

PERRY: Yes, absolutely. One of the reasons why I keep bringing up the issue of sports is because it allows children also to be part of a group. One of the challenges that many kids have is they feel like they`re an outsider. By putting them in an in group, whatever that in group is, and by giving them some sense of confidence that comes from feeling like I`m working out a little bit more, I feel better about myself, you can see in children their lives change.

I can tell you real quickly, Dr. Drew, we`ve had children who are almost suicidal, but because of their connection to their coach and their team, they were able to pull back. And that`s where we find most of these issues with the children. When children feel disconnected, they do very bad things to themselves and others.

PINSKY: Steve, no - you`re absolutely right.

PERRY: Making them a part of something.

PINSKY: Steve, this is something for everybody out there. We`re trying to talk about solutions here.

When you look at kids that come from distressed backgrounds, you would think they would have all kinds of psychological and psychiatric problems, you actually find that there`s less than you had predict. And when you look at kids that don`t manifest problems, what you find is a single sustained quality relationship with an adult outside the home.

One of us can make all the difference that can prevent a kid from becoming obese, becoming a drug addict, becoming a criminal. It`s incumbent upon us - all of us to really look at this problem.

Thank you a lot, you guys. Sean, I`ll give you the last words.

KANAN: Well, you know, I just think that in 1980, we had about seven percent obesity. Now we currently have about 20 percent. There`s a lot of reasons why and we have to look at that.

You know, parents are allowing their kids to play six or eight hours of video games a day. I think the doctor had a great point, get the kids out there, exercising and it builds self esteem. And when you have high self esteem, you`re not turning to food as a - as aw comfort, as a coping mechanism.

PINSKY: Yes, absolutely. So, thank you, Sean, Steve, Bob, Dr. Wulkan.

It`s an important topic, and, listen, I actually - hats off to Georgia for doing something. I hope it doesn`t have any unintended consequences, but it`s clearly something we all need to be aware of and try to tackle, it`s us, the adults that are the issue.

Next, what are your concerns about childhood obesity? The "On Call" segment is coming up.

And later, Dr. Sanjay Gupta is here to talk about concussions. They just - they happen to many people, not only football players, and is a very serious issue.


PINSKY: And welcome back.

We`ve been discussing Georgia`s new anti-obesity campaign. A million children in that state are obese, and many of their parents are not aware that it`s a problem.

You have questions and comments about this. I will do my best to address them. Let`s go first to the phones. We`ve got Stacy in Pennsylvania. Go ahead, Stacy.

STACY, PITTSBURGH, PENNSYLVANIA (via telephone): Hi, Dr. Drew.

PINSKY: Hi, Stacy.

STACY: I just wanted to say that I think those ads in Georgia do more harm than good, especially because it will encourage bullying in school, don`t you think?

PINSKY: Well, that`s actually a really great point, Stacy. It`s one of the concerns I have is that not only bullying, but also it has implications upon body image issue, something we`ve been talking about.

The question is what lengths are we willing to go to address this problem and what risks are worth it. And Georgia feels it is worth it.

Michelle on Facebook writes, "The ads are awful, kids are too young to fully understand what this is all about. It will lower their self esteem if they are overweight."

It certainly would be a problem for kids who are actually in the ads. I think they are going to be subject to bullying. I believe this thing is primarily directed at parents, but you`re right, it could create a culture of antagonism towards kids who are overweight rather than a deeper understanding of what`s behind it.

Tim writes, "Do you agree with using the BMI scale for this project?" The Body Mass Index scale.

It`s one of the concerns I have actually because by the BMI standards, I`m obese. And so if you are athletic or you work out, lift weights, you can sort of shift outside of that scale or change the way that scale works. So it`s something that I`m not sure all parents are equipped to interpret for kids that are particularly on the margin, so that is one of my concerns as well.

Jill writes, "Why do you think so many parents sugar coat the whole child obesity issue?"

I`m not sure they do. I think they overlook it, and I think so many - this is like with every issue, it`s transgenerational, that so many parents that aren`t on top of it are themselves overweight and have terrible dietary habits.

Chris writes, "I think the obesity ads are appropriate. Any parent who would help their kid with other unhealthy habits like smoking or drugs would help them with this type of unhealthy habit."

I think that`s a great point. I think that right there sort of encapsulates the philosophy they`re trying to capture. But as we were talking about in the last segments, it`s a complicated issue. It`s a complicated issue, this sort of the emotional dynamics behind why kids get so overweight is something that is generally left out of this conversation.

And finally, Felicia writes, "The real message shouldn`t be about being skinny or smaller size, but about eating healthy and being physically active. Wouldn`t you agree?"

Yes. But it`s absolutely impossible to disagree with that. And, you know, the basic aphorism, folks, if you`re wondering what to do is eat less, move more. That`s the basic thing. And, you know, less calories, less fat, less carbohydrates, those are all simple things you can do. It`s as simple as paying attention. And start out slow, but do something.

The best exercise is the exercise that you will do, the one you`ll actually do every day. Make a commitment to that. It`s a new year now, guys. Let`s make a commitment to our kids and to yourself.

When we come back, moms, dads, boys and girls, you will want to hear this. How any sport can cause concussions, head injuries, sub-concussions, and perhaps even more serious injuries?

More information about this or any story we`re talking about tonight, go to And I will be joined by Dr. Sanjay Gupta after this.


PINSKY: And welcome back.

Tonight we`re talking about football and concussions and horrific collisions and not just the pros on game day, but kids across the country who is having concussions and perhaps not getting back up. We are tackling the concussion debate head on.

CNN`s Dr. Sanjay Gupta is here. His upcoming documentary "big hits, broken dreams" premiers on CNN, Sunday, January 29th, 8:00 p.m. Take a look at this.


UNIDENTIFIED MALE: Football in North Carolina is really big.

UNIDENTIFIED MALE: If you`re from this area, you know J.H. Rose, 4-A State champion.

UNIDENTIFIED MALE: Pumped up, excited. Ready to go. That`s all I thought, every single day. Football, football, football.

UNIDENTIFIED MALE: Football is a tough sport. It isn`t for everybody. There are collisions in this sport.

UNIDENTIFIED MALE: He is my little brother, he is not moving. He needs help breathing. I mean, I just lost it.

UNIDENTIFIED MALE: He was tackled, went to the sidelines and collapsed.

UNIDENTIFIED FEMALE: Friday night`s death of Jaquan Waller being --

UNIDENTIFIED MALE: It is tough for the whole community. I remember getting hit hard. That rang my bell.

UNIDENTIFIED MALE: First three weeks was a constant headache.

UNIDENTIFIED MALE: The trainer was asking questions, I was answering them wrong.

UNIDENTIFIED MALE: There are a small percentage of impacts that simulate that car crash.

UNIDENTIFIED FEMALE: He does have symptoms of a concussion.

UNIDENTIFIED MALE: Parent came to you, said coach, my kid wants to play football, but I want you to tell me he`s going to be safe.

UNIDENTIFIED MALE: I can`t guarantee that.

UNIDENTIFIED MALE: It is a violent game. That`s always going to be there. Can you make this game safer?


PINSKY: Neurosurgeon and chief medical correspondent, Dr. Sanjay Gupta joins me now. Sanjay, you have been covering this more than a year. What made you want to focus on this topic?

DOCTOR SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Well, you know, I think it`s obviously as a neurosurgeon and reporter, there were some overlap in terms of what I do. What I thought was interesting was, there was a lot more knowledge coming out about what the concussions do to the brain. And I think a lot it have been anecdotal prior.

And now there`s new research coming out looking specifically at these brains, imaging, looking at what`s happening in the brain after something like this happens. And also this idea that you follow along a team, in this case we followed along a single high school football team who suffered tragedies, they had lost players. Players lost their lives in the past because of head injuries, and seeing what they can do now to try and make football safer.

PINSKY: You said players, how many?

GUPTA: Well, there were two players in North Carolina in 2008 who both died. There`s no specific laws or mandates for high schools at that point in terms of what they should be doing. They really had no knowledge, Drew. Most people couldn`t define what a concussion was.

PINSKY: Do that for us. What is a concussion?

GUPTA: Well, concussion, first of all, is a type of brain injury. It`s not -- doesn`t necessarily mean someone was knocked out. But, typically what happens is, connections in the brain, the synaptic connections have become jarred for one reason or another. A person has obvious symptoms. They may be confused, they may have blurriness of vision, then they have headache, and all those types of symptoms are significant because it means the brain is not healed. It means the brain is still trying to repair itself.

PINSKY: Would you say altered sensorial, meaning some level of confusion or abnormal function of the brain, cognitive function?

GUPTA: Right, almost always. And people would describe it as I got my bell rung. For example, you heard that. And the reason I specifically don`t say that is because I learned part of the investigation that people use those terms trying to minimize it.

PINSKY: Right.

GUPTA: And this is a brain injury.

PINSKY: That`s right. The kids don`t you - they don`t want to be taken out.

GUPTA: That`s right.

PINSKY: Isn`t the rule of thumb, three, class three concussions, and you`re out. Your career is over? You prefer that anyway.

GUPTA: You prefer that. But, you know, as you know, I mean, at the highest levels of this game, there are players that have had many concussions and told get right back in there. That culture is starting to change a little bit. There`s some good news in there. But, you know, it is amazing how that filtered to high school and younger than that.

PINSKY: Now, many young athletes don`t grasp the severity of what it means. As we pointed out, their brains are developing. These injuries can have long term, persistent effect. Check this out, Sanjay`s special.


GUPTA: Even after two concussions, he wants to play. You don`t worry about that? Why not?

UNIDENTIFIED MALE: I don`t play the game scared I guess.

GUPTA: Your brain we`re talking about.

UNIDENTIFIED MALE: I know. I mean, it`s a sport. There`s a lot of risk in everything really.


PINSKY: So, is the adolescent brain more at risk than an adult brain?

GUPTA: It is. And this is I think surprising to some people. Because in so many things, we get older, it becomes tougher to repair our bodies.

PINSKY: Yes. Especially our brains.

GUPTA: Especially our brains, right. But, with the kids` brains, because they`re still developing, what they have found, and again this is real objective evidence that it has actually a harder time recovering from some of these, and if there`s some long term injury. So, you get the change associated with concussion to the brain. The brain has a hard time repairing from that as well. So, you can see, you know, sort of what happens to the brain when you look at some of the images.

PINSKY: We are looking at images here of probably recurrent head injury? Would you say, yes for that?

GUPTA: That`s right. And what you find, Drew, this is frightening, but the changes you would see in someone with Alzheimer`s, for example, classic brain findings, they`re starting to see these in very young brains as well, brains that had lots of blows to head over time.

PINSKY: So, let`s -- people get very confused about varying different aspects of head injury. I see we are showing a brain there. Looked like a brain swelling, which can sometimes happen after concussion.

There`s concussion which we have defined which is, let`s just call it altered sensorial, change in your awareness. There are catastrophes that happen in the brain, which is what kills people. And those are primarily bleeding into the brain, epidural bleed, (inaudible). I had to resuscitate a kid with an epidural bleed. We`ll talk about that in the next segment. And then recurrent head injury which is really I think more the more concerned because that what we`re all worried about.

GUPTA: And the best way I can sort lay that out is a concussion is exactly what you say altered sensorium. But it is also an injury to the brain.

PINSKY: it is usually a counter co-injury.

GUPTA: Yes, exactly. You think of the brain sort, think of a beach ball in a swimming pool, for example.

PINSKY: Or a pickle in a jar. Shake the jar, the pickle moves around.

GUPTA: Back and forth. If you were to throw that jar and it would suddenly stop, the pickle would what, smash into the jar front and back. And that`s what happens to your brain. And even if contained with a helmet, it`s moving back and forth in the skull which kind a makes the point that no matter how good the helmet, you can`t stop that movement of the brain back and forth.

PINSKY: What are people doing to make it a safer game?

GUPTA: Well, you know, it is interesting that people are focusing on helmets, and to some degree that will help. But I think what we find is that the vast majority of hits to the head first of all as a starting occur during practice.

PINSKY: Surprising.

GUPTA: Yes, surprising, when you practice a lot more than you actually playing the game. So trying to like really prevent helmet to helmet hit certainly during practice. Even doing a lot of practicing without helmets, you starting to see that in more high schools, getting rid of three point stance in most situations, so, in the two point stance, how are you like me to tackle if you are the two point stance? Tip of the sphere --


GUPTA: Right. And so, you tackle like this, with the hands and body, not with the head, moving the kickoff line a little further forward. Why? Ball goes into the end zone.

PINSKY: I like to talk no head to head, or intentional head to head which is the worst thing.

GUPTA: People do and that culture starts young. The head is the most protective thing. That`s what people try to use to their advantage.

PINSKY: you mentioned the full disclosure. I played football, my sons played football. And I started them early because I wanted them -- I said get your head out of the game, use the shoulders, use your body, so you can get the head away. But, I have a son that was knocked out of playing football because of three concussions. Went to a neurologist, and he said son, you can`t play anymore, he went OK. And the neurologist went good, because he is used to the parents or the kids getting angry. My son said I don`t want to harm myself. And the neurologist practically applauded him.

GUPTA: Your son is a good example. But, so many players not only that they want to continue playing, they want to go right back in even though they`re not with it.

PINSKY: Well, then I have another son that`s going to play in college, high school was an accomplished player, and he kind of admitted that maybe he had some bell ringing a couple times.

GUPTA: Is that right?

PINSKY: So again, I had the experience of kids minimizing or even not telling you when he had a concussion.

GUPTA: I have an anxious see what Dr. Drew says to his son in that situation.


PINSKY: You know, I don`t believe - if I believe he had actually three concussions, he would be out. So, I will be watching him very carefully.

Sanjay`s documentary, "Big Hits, Broken Dream," that views on CNN, Sunday, January 29th. 8:00 p.m. We`re going to keep this conversation going. And I`m going to tell you about a kid I had to see on the sideline who was dead and I had to work on him there. Stay with us.


PINSKY: Welcome back. We have been talking football and traumatic head injuries. Last year interviewed Allison Duerson. She is the widow of former NFL player, Dave Duerson, who took his own life. There were many unanswered questions about why Dave killed himself. Here is a clip from that interview.


ALLISON DUERSON, WIDOW OF NFL PLAYER: Dave really didn`t know what was going on with him. You have to remember, he was fine, and then maybe like the last five or six years of his life started to change. So everything was gradually going down. So I don`t think he understood towards the end of his life that maybe something was wrong from the concussions.


PINSKY: Chris, you have the brain tissue, is that right?


PINSKY: Have you had a chance to examine it?

NOWINSKI: Mr. Duerson`s brain is with (inaudible) at the brain bank at VA in Massachusetts.

PINSKY: So, they`re going to examine it.


PINSKY: Dr. Sanjay Gupta is here. His documentary "Big Hits, Broken Dreams" debut on CNN on Sunday, January 29th, 8:00 p.m.

Joining is Chris Nowinski. He is the co-founder and president of the Sports Legacy Institute. Chris now, since that interview, you have studied Dave Duerson`s brain. What did you find?

PINSKY: We found Mr. Duerson was suffering from moderately severe chronic encephalopathy.

PINSKY: And Sanjay, define that for our viewers.

GUPTA: Well, the best way to describe it, these are changes in the brain we most often see in patients that have Alzheimer`s disease. They call they can plaques and tangles. The name is not that important. But they see these in people that are far younger than you expect. You think of someone in Alzheimer`s in their 70s and 80s, and they`re seeing these changes in people in their 30s, 40s and 50s.

PINSKY: And Chris, this particular case was presenting which cognitive changes but with prominent depressive symptoms. Did it surprise you, that what you found here?

NOWINSKI: No. Unfortunately doesn`t surprise us at all. I mean, 17 of 18 cases of NFL players we completed had the disease. And with Dave Duerson`s symptoms, it seemed like the most likely scenario.

PINSKY: Thirty one states require students and parents to sign a waiver acknowledging risk of concussion and head injury in football. But understanding those risks don`t prevent the worst of them, of course. Take a look at one family whose tragedy is a lesson for us all.


GUPTA: In the last game of the season right after half time, Nathan went down.

UNIDENTIFIED FEMALE: He collapsed on the sideline, and the coaches were telling me to try to wake him up. And he didn`t. Then I heard him say he`s seizuring, and that was it. Took him in the ambulance, we waited for life flight. And everything went bad from there, from bad to worse.

GUPTA: After hours of surgery, doctors stopped the bleeding in Nathan`s brain. By then, his lungs and heart were too week, to keep him alive. Nathan died. The cause, second impact syndrome.


PINSKY: And Sanjay, I actually had an experience and Chris, you`ll be interested to know, living through something like this. A friend of my son`s was found on the sideline posturing. So, we call it when you had a severe injury, they posture, that means the brain is severely injured, agonal, meaning he wasn`t breathing. I saw kids panicking. I ran over, started breathing for this kid. I begged for a helicopter for ten minutes while people stood around crying.

He -- I hyperventilated him a little bit, posturing got better. An ER doctor, Dr. Lewis, thank you, who joined me and took over, and he worked at a hospital about five minutes away. By then, paramedics had arrived. We had a neurosurgical team was waiting for the young man by the time we got him down the hill. How do you think that turned out?

GUPTA: I am hoping it turned out all right. That`s a long time to wait.

PINSKY: it was a good half hour before he got in the neurosurgical suite, 30 minutes; probably 15 minutes on the field, he was back in chemistry class three months later which is unbelievable. It`s unheard of.

Yes, Chris is saying wow. And I understand you actually have Nathan`s brain, the family requested you to look at that. And I imagine you saw a giant (inaudible) epidural bleed, is that right?

NOWINSKI: It was studied by Dr. Mckey but she did see signs of second impact syndrome as well as signs of early CTE.

PINSKY: And again, it was a massive bleed this kid had, is that correct?

NOWINSKI: That is correct.

PINSKY: Because now we talk about chronic traumatic encephalopathy, we talked about concussions and now we talk about the worst. When you see somebody -- whenever somebody goes down on a football field, and you see the stretchers come out, you and I worry about this injury or something like this. So, tell people what that is.

GUPTA: Well, what we are talking about here is someone that had a concussion, and the brain has been damaged. You get an injury as a result to the brain from that blow. What we know is there is a vulnerable period. The brain is -- think about it as an inflamed brain. That`s the best way to describe it. That brain can heal. But it has to heal.

That means lots of different things. Let`s not putting any stress on the brain whatsoever. If on the other hand the brain is hit again during that time period, a second impact syndrome Chris is talking about, that`s the worst possible outcome, one concussion bad, Drew, second concussion on top of that, exponentially worse.

PINSKY: And that`s what the bleeding can --.

GUPTA: Yes. You can get --

PINSKY: And when bleeding happens inside the skull, it is a closed space. It`s like a jar, like what you have been saying, and it crushes the brain when there`s bleeding.

GUPTA: There`s nowhere for it to go. Bleeding in the belly is different, here it is different.

PINSKY: That`s where it is an advantage to have an adolescent brain. Because you can recover from some of that stuff as my patient found out. You and I, not so much, not so good for us.

GUPTA: We`re getting older, right.

PINSKY: Now, the sub-concussive hit, that`s a bigger issue now, is it not?

GUPTA: This is fascinating to me, Drew. Some of what we`re talking about is brand new knowledge. But on average, football start with this high school players take 650 sub-concussive hits to the head.

PINSKY: So, not enough to create change in sensorium, we call it the concussion, but a big whack on the head.

GUPTA: Yes. You hear it sometime on the sideline, but the guy gets up, he is fine. What we are finding now in Chris`s work and Dr. Mckey`s work is that those concussive hits can lead to these changes in the brain. And in fact, in Nathan styles` brain, you know, you see his parents there, they saw their son`s brain, and what they found were these changes in the brain, 17-year-old kid, changes in the brain that were consistent with somebody that had Alzheimer`s disease. They`re seeing it that young. And Dr. Mckey is convinced that`s from those blows to the head that Nathan had.

PINSKY: Chris says it explains why I have memory problems. But, tell us what you found in Nathan`s tissue.

NOWINSKI: Well, Nathan is now the youngest case of CTE. So, what we found or what Dr. Mckey found were neurofibrillaurie (ph) tangles, and a lot of other changes as Dr. Gupta said, that is more common with Alzheimer`s.

But, we are now finding in more and more athletes where structures of the axons are actually falling apart. We don`t exactly why it is happening. It probably has something to do with inflammation acutely, but cells really can`t send signals to other cells. And so the function of the brain is starting to change, especially these areas where you see that acute damage.

PINSKY: And so, Neuro-fibulatori (ph) tangles changes are things we used to talk about in Alzheimer`s and plaques.

GUPTA: And they see patients develop a real classic triad of symptoms. Dave Duerson had this. Many others, they have anger, they have depression, and they have memory loss. These are young people, 30s, 40s, retired from football, and they have no idea why. I mean, these players literally would say to me. I interviewed lots of them that are still alive, and they say look at me in the face, say look, I have no idea why I am losing my memory at such a young age.

PINSKY: You know, there is -- I don`t want to out the NFL, but there`s data on social functioning of NFL players after they retire, and it`s not good. Do you think this has a lot of contributory factors in?

GUPTA: Probably, there is no question. I mean, that the data that Chris and Dr. Mckey have been collecting are making that point. Up until the last year, this has been anecdotal. We speculated.

PINSKY: You got it.

GUPTA: Now the data is pretty compelling.

PINSKY: Chris, I am going to let you go after the - before the break. Last word to you. I would like you to address the social function, ability to function in the world after you have been hit in the head so many times. Do you guys have concerns about that?

NOWINSKI: I have huge concerns about that. Imagine if your brain starts falling apart at some point in your teenage years or 20s. The future will not be so bright. I see it in former athletes with real problems with impulse control, real problems with memory, real problems achieving.

And so, to see this disease in someone like Nathan styles, I mean, it is like a double whammy. You have the tragedy of second impact syndrome, mismanaged concussion, then the additional tragedy that even if he survives, his future was probably not so bright. And that`s - it`s really frightening.

PINSKY: Thank you, Chris.

Now next, It was Muhammad Ali`s 70th birthday yesterday. I`m going to tell you how he perhaps figures into this conversation, when we come back.



PINSKY: Welcome back. An American hero and boxing legend celebrated his birthday this week. Muhammad Ali is 70 years old. And tonight, we have been discussing the effects of concussion on young athletes and what parents, players and coaches need to know to better protect themselves.

Sanjay, Muhammad Ali took many head whacks, and to my eye, that movement disorder, Parkinson`s and perhaps cognitive problems all to be related to the boxing.

GUPTA: His doctors certainly thought so, and they thought so for a long time. You know, when he was 42 years old, almost 30 years ago, he himself sort of realized it, talked about it pretty openly. He was already starting to have at that age some of those cognitive problems, and beginnings of tremor. And so, you know, it`s hard to believe through that for 28 years now, we have been talking about his tremor. They used to call it punch drunk syndrome or pugilistic dementia. That same sort of thing can also have these Parkinson-like symptoms.

PINSKY: If I develop any kind of cognitive decline, just call them I have a pugilistic dementia (inaudible).

Let`s take a quick question from facebook.

Marcy writes. "Why do guys feel they have to lie about head injuries?"

This is a good question. I will ask my son when I get home. Because they want to play, they want to succeed. It`s hard -- unless you play football, you`re a fan of football, it is hard to understand the mindset of a football player. They literally are trained to put themselves in harm`s way.

GUPTA: Right. And some of these guys want to keep playing, and in order to do that, if they`re not on the field instead of on the bench, they`re obviously not going to get their chance. The culture trickles down as well.

PINSKY: From the NFL.

GUPTA: Yes. I talked to Kurt Warner about this and he retired, obviously but he had been MVP. He talked openly about the fact he had a concussion, he was not right, and then get back in the game. You know, Kurt Warner, he`s --

PINSKY: They need him to win.

GUPTA: So - but that culture is starting to change again. There are some bright spots in that.

PINSKY: Let` take quick phone call. We have Matt in California. Go ahead there, Matt.

MATT, CALLER, CALIFORNIA: Hi, Dr. Drew. I just wanted to say with all of the advances in medical science, is it possible for guys to make a full recovery that suffered brain trauma due to football? And if so, how long can therapy take?

PINSKY: So, I think he`s asking are there treatments for concussion, and time is basically that treatment.

GUPTA: It is time. But it means putting the brain to rest. And I found this fascinating as well. They put the brain to rest, that means you are really not doing anything for several days, maybe even a couple of weeks. No texting, no screen time.

PINSKY: it means no activity of the brain. Not just lying quietly, it actually means not using your brain.

GUPTA: Yes. Not just -- not playing football, that`s obvious. But if you want the brain to heal completely, what you can do.

PINSKY: That`s new information. I thought you want to lay low, not get re-injured.

GUPTA: Right. And some of this is new information. But really letting the brain heal is a mantra at the high school level and starting to trickle up.

PINSKY: And how long, a week?

GUPTA: It depends. You know, one of the players we followed on the documentary took over a week to heal. And they would not let him play. Every day he was begging to get back in. But his brain was just not healed completely.

PINSKY: By doing serial examinations?

GUPTA: That`s right. They would do baseline test beginning of the season. And said I`m fine now. They said, alright. Let`s test you again. Turns out he wasn`t fine. They waited until his test scores came back up. And his brain was completely healed before he came in.

GUPTA: Thanks Sanjay, important information. I really appreciate you being here.

Remember the documentary is "Big Hits, Broken Dreams." It debuts on CNN Sunday, January 29th, 8:00 p.m. You do not want to miss this. TiVo it or watch it. You need to for your kids. Check out for all the must see, must share stories you have seen tonight.

And more, Nancy Grace is next. See you next time.