Work in Progress

Bias That Leaves Children Without Options

You might think that childhood obesity is a subject that draws a lot of sympathy from the public. You would be wrong. Today at the 26th European Congress on Obesity, we presented new data on a huge gap in the public understanding of severe obesity in young children. Even in young children, our data shows that most people chalk it up to bad habits.

What about the physiology and genetics of obesity? Not important, say most people in four different countries – the U.S., U.K., France, and Italy.

Blaming the Kids

We found that roughly half of respondents in the U.K., U.S., and France say that bad habits are the primary cause of obesity when it occurs in young children. Among Italians, that number was a bit lower at 33 percent. Italian respondents placed slightly, but not significantly, more blame on excessive junk food marketing. Thirty-five percent of Italian adults said that was the main problem.

We found fewer respondents blaming parents than we expected. No more than 27 percent of respondents chose poor parenting as the reason for severe childhood obesity.

Between 6 and 16 percent of respondents named genetics and physiology as important causes. This observation contrasts sharply with scientific evidence that puts the heritability of obesity at about 70 percent. Especially in young children, it’s hard to explain obesity as a simple matter of bad habits.

A Bias with a Harsh Impact

But this is where public opinion lies. And the result is that health plans face little pressure to provide adequate care for kids with severe obesity. Access to bariatric surgery for teens that might benefit is severely restricted. Only about 35 stage four childhood obesity treatment centers exist in the U.S. to meet the needs of approximately five million kids with severe obesity.

The situation is no better in the U.K., where Professor Paul Gately tells us there is no national provision to provide care for 450,000 children with severe obesity.

Without help for dealing with severe obesity, future health is at risk. In the short term, bullying and mental health issues can take an even bigger toll.

Before this situation can change, two things must happen first. We need a better public understanding of the truth about obesity. Moralistic judgments and bias simply get in the way. And perhaps most important, kids and families will have to speak up about the travesty of this denial of care for a condition that, untreated, will have profound effects on a child’s prospects for life.

Click here for our presentation. Click here, here, here, and here for more information on options for treating severe obesity in children and adolescents.

Work in Progress, photograph © Smadar Shilo-Marcus / flickr

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April 30, 2019