Such a Shame About Severe Childhood Obesity

Such a Shame About Severe Childhood Obesity

Today we have another round of headlines, clucking about childhood obesity. Unfortunately, the UK is setting new records for severe childhood obesity. It’s such a shame, they say. Obesity is entirely preventable, said Max Davie to reporters. Davie is the officer for health promotion in the Royal College of Paediatrics and Child Health.

A Ten-Fold Increase in Three Decades

Public Health England published a new report today, focusing on children with severe obesity. By the time they are 11 years old, four percent of children in England have severe obesity. For boys, the rates were higher – five percent. The chief nutritionist for Public Health England, Alison Tedstone commented:

The rise in severe obesity and widening health inequalities highlight why bold measures are needed to tackle this threat to our children’s health.

These trends are extremely worrying and have been decades in the making – reversing them will not happen overnight.

Any Concern for the Children?

But amid all the clucking, we can’t find much concern for the children and families affected. After all, four percent of our precious children with a severe health condition is actually quite a big number. In the U.S., we have six million children with severe childhood obesity.

After reading all these reports, we could find only one mention of doing anything for the families affected. Schools and the NHS will send letters home with children, advising parent and child that they’re too fat. But no mention of help for the families to improve their health. Just a sharp finger pointed in their direction when the authorities detect excess weight.

That finger pointing does nothing to reverse severe childhood obesity. It does plenty to raise the level of stigma. Further measures, like menu labeling, are unlikely to help either. Even the most intensive behavioral programs yield modest results.

More sugar taxes and food marketing regulation might eventually have an effect. For all the effort going into such efforts, we certainly hope so.

But is it too much to hope for some concern about the children and families already severely affected? Telling them to make better choices isn’t good enough. They never signed up for this.

Click here for more from The Times and here for more from the BBC. For the UK government’s view, click here.

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July 24, 2018

4 Responses to “Such a Shame About Severe Childhood Obesity”

July 24, 2018 at 11:25 am, Angela Meadows said:

Hi Ted,

I agree that the response to childhood weight surveillance is less than ideal (partly because it was never intended as a means to a health intervention but only as an epidemiological surveillance issue).

But as you know, terminology and definition used by the obesity-as-disease camp is a bugbear of mine. We have discussed this several times and you insist that your definition of ‘obesity’ is a level of ‘excess adiposity’ associated with ill health, and that ‘obesity’ is therefore a disease.

Notwithstanding the circular logic here, the definitions used by PHE, the Royal Colleges, and the National Childhood Measurement Programme in the UK are all entirely based on body size.

You may argue that these children are at increased risk of certain health conditions (which I would not disagree with), but you yourself claim that body size and health are not necessarily equivalent. In the present article, you do not make this distinction, equating being heavier with being inherently unhealthy. I just wanted to mention this in case you wished to adjust the wording used in future blogs on the topic.
- July 25, 2018 at 7:50 am, Ted said:
  
  Thanks for reading and sharing your thoughtful comments, Angela.
  
  I agree with you many UK authorities are using the wrong definition for obesity – focusing on size, rather than health and body composition. What can I say? They’re wrong. And my only mention of weight (“a sharp finger pointed in their direction when the authorities detect excess weight”) is intended as criticism of such thinking. I’m sorry that’s not clear enough.
  
  Regarding the circular definition of obesity, I guess we just see this differently. And that’s OK. In my view, the circular logic you dislike would be true for any disease. If it doesn’t impair health, it isn’t a disease. Obesity is defined by excess adiposity. It’s not about size or weight. It’s all about body composition. What defines “excess”? Enough to impair health.
July 27, 2018 at 12:52 pm, Angela Meadows said:

You know, I was thinking about this after I posted the comment. Really, any and all epidemiological statistics about the prevalence of obesity, anywhere in the world, where it is on the rise, how many kids are affected etc, are relying on anthropometric definitions entirely. Perhaps we should stop reporting these statistics uncritically. Adding “… by BMI standards” would probably make it clearer where we all stand on this point.
- July 27, 2018 at 3:30 pm, Ted said:
  
  I think that’s perfectly reasonable, Angela. These are, indeed, just estimates. Different conditions have different caveats linked to estimating their prevalence. When crusaders promote stigma, they make reliable estimates of prevalence even harder. But then, that’s just one of many problems that stigma and bias cause.