Quick: What is the biggest health threat for school kids today? Smoking? Suicide? Drug and alcohol use? Guess again.

Kids' greatest health threat is eating too much and moving too little.

One in three New Mexico children is overweight or obese. In some communities that number is one in two. Most of these kids will carry their extra weight into adulthood, joining the ranks of the three in five adults who are now overweight or obese.

Obesity, defined as having a body mass index of over 30, is poised to overtake smoking as this country's leading cause of preventable death. It is linked to a growing number of chronic illnesses, including heart disease, stroke, diabetes and cancer. Aside from obesity's personal cost, the burden it imposes on an already stressed health care system is nothing short of staggering. Obesity-related illness now account for one out of every five dollars spent on health care in the United States.

I work with these kids in my clinical practice as a social worker and see each day another price they pay. Overweight children are at increased risk of depression, anxiety disorders and low self-esteem. They perform less well academically and are at greater risk for attention deficit disorders. They are disproportionately targets of schoolyard bullying and gossip. They are more likely than other kids to develop eating disorders, such as binging and bulimia, and more likely to commit suicide.

Unfortunately, many of these social and psychological costs appear to be reciprocally related to obesity. Depressed kids are more likely to eat too much. These children find themselves caught up in a perfect storm of causality and illness. Distressed, they seek comfort in calorically dense, nutritionally poor food. The weight gain this diet produces increases their physical, social and emotional distress.

What is the way out? Across the state a number of initiatives are addressing this epidemic. Last year, a group of New Mexico doctors and social workers received a three-year National Institutes of Health grant to develop and test a mindfulness-based eating intervention for overweight 14- to 17-year-olds and their families. We are currently recruiting participants and expect to have preliminary data early next year.

How might this approach help?

Every person has an innate system for monitoring hunger and satiety. This complex interconnection of organ systems, hormones and neurotransmitters gives us real-time information about our caloric condition. Normal-weight kids make food choices based on this information, eating to address their bodies' energy needs.

Overweight kids tend to ignore their bodies' signaling system and respond instead to emotional and environmental cues. They eat when they feel bored, depressed or isolated. They see a billboard and immediately want a hamburger. Over time, their caloric intake exceeds their metabolic needs, and the excess calories get stored in their bodies as fat.

Our mindfulness-based approach refocuses participants on their own inherent signaling systems. It also increases awareness of emotional states and environmental cues that may be triggers for eating. We hope the result reconnects kids with their own physical selves, so they can leave behind dysfunctional eating behaviors and set off on the road to better health.