“…Obesity Epidemic is Mass Child Neglect…” By whom? Are we all to blame?

You may have read some of the startling press reports around a recent British Journal of Sports Medicine paper which highlight the following key findings:

  1. Only a third of boys and a quarter of girls in England meet the minimum recommended daily physical activity levels.
  2. One in three youngsters leaving primary education is obese, most of whom will become obese adults.

The journal editorial highlights a lack of leadership from past and present UK governments to sufficiently address this issue:
“…The minimal funding, lack of interest and absence of a child physical activity strategy strongly support the notion that the state is failing to act to prevent harm against children and failing to meet children’s basic physical needs likely to result in the serious impairment of their health and development…this is quite literally indistinguishable from the government’s own definition of child neglect…”
More recently, we have read the harrowing account of a 22 stone schoolgirl aged 10 years old.

obese_child

Sadly, these reports are becoming increasing more frequent but it is important that the key facts are clear so that debates will lead to workable and effective solutions.

1. It needs to be stressed that inactivity and obesity are two separate challenges. In 2009, Sir Liam Donaldson, a former Chief Medical Officer, stated that the costs to health and the economy from a lack of exercise are greater than those caused by alcohol abuse, smoking and obesity combined, because of the number of people affected. Although inactivity and obesity often share common origins and relationships between the two are strong, they should be addressed and treated as separate issues. Preventative measures and intervention strategies should have clearly defined outcomes. Trying to hit inactivity and obesity targets with the same solution often means that both are missed.
2. To combat obesity, the home has a vital role to play and will have a strong influence over whether possible solutions will either succeed or fail. A healthy diet, of suitable portions, over a sustained period of time is how to address the obesity challenge and healthy school dinners is only a small part of this.
3. In terms of losing weight, sport is not the answer as too few children are involved in sport on a regular basis and for long enough periods to be significant. In simple terms of weight loss, healthy eating over an extended period of time is the simple solution.
4. To address inactivity, it is important to draw a distinction between physical education and school sport. Physical Education in schools provides the direction towards an inactivity solution in a way that sport cannot. Over the last twenty years, previous attempts to address this issue through sport have failed. Furthermore, those children who are already sporty are, therefore, also active and are not the real concern.
5. The current Government’s response to this criticism is Primary School PE and Sport funding (also known as “Sport Premium”) which is flawed by its very name and reaches a smaller audience than is needed. Inactivity challenges can be addressed using this new funding but is more competitive sport the solution or the cause of the problem? Should we be looking for alternative physical activity solutions that will engage children who have been reluctant to participate in sport on previous occasions?
6. Schools continue to be dragged into this argument by the virtue of acting in loco parentis for between 30 and 40 hours per week for 39 weeks of the year. The performance of school leaders is ultimately judged by attainment in literacy and numeracy, alongside Ofsted reports. If schools are to be involved in any sensible solution, consideration must be given to how this fits alongside existing provision and performance measures. This will open another debate about whether the current educational system accurately reflects the needs of society today.
This is an area that we are very passionate about and where Project HE:RO originated from, winning an NHS award for innovation. We realise that this is a complex and emotive challenge that society in developed and developing countries around the world are all wrestling with. Our first milestone should be to frame this debate correctly so that proposed solutions take account of all key stakeholders, constraints and opportunities.
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