Responding to Labour analysis of NHS England’s latest figures on obesity, which highlights a lack of progress on childhood obesity, BMA board of science chair Professor Dame Parveen Kumar said: “The childhood obesity crisis shows no signs of slowing due to the lack of inaction by the Government to truly address this. It ultimately places the health of our children at serious risk. This must include a comprehensive 9pm watershed on junk food advertising, mandatory labelling of food and drinks in out of home outlets and regulatory backing for UK wide reformulation targets to reduce calorie, fat, saturated fat, salt and added sugar levels on food products.”
The WHO states “Obesity poses a major risk for serious diet-related noncommunicable diseases, including diabetes mellitus, cardiovascular disease, hypertension and stroke, and certain forms of cancer. Its health consequences range from increased risk of premature death to serious chronic conditions that reduce the overall quality of life.” Obesity is the biggest human generated burden on the economy, after smoking. The NHS spends over £5.1 billion a year treating conditions relating to obesity.
Speaking to Asian Voice, Pediatrician, Dr Prabu Rajendran said, “Obese children are much more likely to be obese adults. So growing up to be overweight or obese is a preventable disadvantage in children. It worsens not just their physical health, but also the mental health, i.e. affecting their self-esteem.”
He stated that the causes of obesity in childhood are multi-faceted, together with genetic and epigenetic factors, there are multiple environmental factors. So when planning an intervention, it is important to consider an approach for the multitude of stakeholders involved, such as parents, children, businesses and social factors. “Being aware of the cultural context, plays a major role and, in particular, to understand the growing inequality in childhood obesity,” he said.
According to figures for 2015/16 from the Royal College of Paediatrics and Child Health, 621 children and young people under the age of 25 received care for Type 2 diabetes from Paediatric Diabetes Units in England and Wales, of which 78.5 per cent were also obese. This number has continued to rise, with 790 being registered in 2018/19.
The latest figures are - almost 1 in 5 children are overweight or obese when they start primary school, figures have shown, that 20% of children are already obese by the time they leave primary school. Dr Rajendran said, “This number alarmingly rises to 1 in 3, when they start secondary school and this is totally unacceptable. This increase is leading to more and more cases of type 2 diabetes, asthma and high blood pressure in children.”
The current concern is that the lockdown measures could exacerbate obesity due to the enforced school closures. He said, “The thinking is that by staying at home, children would miss out on regular physical activities. Alongside, increased screen time is a collateral damage due to the online-classes.” Dr Prabu also shared that the data on Paediatric Intensive Care Unit admissions have shown a higher proportion of those admitted to ITU had a comorbidity, which is worrying. Of those, 20% was obesity and they required mechanical ventilation.
When asked about common mistakes made by Asian parents with obese children, he said, “The first problem is that many parents are ignorant (or don’t want to accept) that their child has a high BMI. Sadly it is considered as a social stigma, as having ‘ puppy fat’ is an entrenched myth in our society of being healthy. It’s not, generally, the lack of understanding about healthy eating, but also the factor that unhealthy food is often cheaper, easier, and quicker to prepare. For most families, working long hours limits the cooking times, in their priority list.”
What is Obesity?
Obesity and being overweight are conditions in which a person has an abnormally high amount of body fat, that may impair health. Children are all different in their shapes and sizes. They continue to grow and develop at their own pace. This constant change and variation makes it hard to know if a child is a healthy weight. Because children are constantly growing, and there is no static benchmark to measure against. A child’s BMI will change from birth to adulthood. Therefore, a child's BMI when plotted on a chart, is compared against the population average, and the child's age, sex and height are taken into account.
How common is diabetes among children and how can it be tackled at a young age?
Children and young people from Black and Minority Ethnic groups are at higher risk of developing diabetes. More girls than boys are being diagnosed with Type 2 diabetes and also living in a socially deprived area is an additional risk factor. For many children, the development of Type 2 diabetes can be prevented with lifestyle changes. Right now, people have limited places to seek advice and get support. So listening to the voices of the children and young people, an Investment in preventative health services, must be prioritised.
Is there counselling for children available at the NHS or groups where they can learn to cope with it mentally at a small age?
It is important that we continue to encourage these bilateral conversations. By doing this, we can also point families earlier to healthy weight programmes, which many families find difficult to access. By explaining why these groups are valuable, and helping families to connect with the right teams, we can make their journey easier i.e. reduced obesogenic environments and widen access to exercises. GP’s can also refer to the local weight loss groups for children such as those run by More Life and MEND. Techniques such as cognitive behavioural therapy (CBT) can be useful.
A five point check-list for parents and children to fight obesity
- Eat 5 portions of fruit and vegetables a day. Have a family fruit bowl for a snack, instead of crisps and sweets.
- Use encouragement instead of nagging. Be firm but offer incentives: 1 treat per week max
- Try to replace the role junk food has in your child’s life with an activity/sports they enjoy.
- When the schools reopen, If you can, get your child to walk to school.
- Reduce the screen time and fix the hours that they can watch TV and play computer games.
