Temple Street hospital team warns politicians on childhood obesity

Clinically obese Irish children are waiting 2½ years for specialist treatment and “urgently require” more timely access, doctors have said.

The W82GO! weight management service at Temple Street Children’s Hospital in Dublin has treated about 4,000 children since 2014.

Addressing an Oireachtas committee on children and youth affairs, team members said a more detailed implementation of services was needed to fight a health problem that can lead to severe physical and psychological problems.

Nicola Sheridan, clinical specialist physiotherapist in paediatrics, said whereas the average nine-year-old weighs about 34kg, those attending the clinic were at about 55kg.

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The team said some progress had been made on the issue of childhood obesity in recent years. But they were concerned over a lack of “definite signals” on whether the new children’s hospital would provide the same level of service available at Temple Street.

In 2017, half of W82GO patients were under 10 years of age, 29 per cent between 11 and 13 and 22 per cent 14 or older.

Ms Sheridan said that in the last month the clinic had seen five children who had been homeless over the last three to four years.

“These parents were working parents and they had no access to cooking facilities. The children develop habits – hoarding food, hiding food because they don’t feel secure,” she said.

Mental health

There is also an issue that children do not feel safe to go outside due to the threat of violence or intimidation in their area, she told the committee. “There has to be safe places for children to play.”

The W82GO service is delivered by a part-time multidisciplinary team, the only one in Ireland, made up of specialists in paediatric dietetics, physiotherapy, clinical psychology and specialist nursing.

In its submission to the committee it said 40 per cent of clinically obese children already showed risk factors of heart disease. Seventeen per cent meet the criteria for metabolic syndrome – a cluster of weight-related conditions – and 40 per cent have significant and severe mental health problems.

Of those treated at Temple Street, 75 per cent have experienced bullying with 11 per cent describing it as severe.

“Unfortunately a number of the children seen have a history of self-harm or suicidal intent,” said Ms Sheridan.

“Over 40 per cent are from deprived to severely deprived areas and the rates of homelessness have become more common. As such, we are seeing first-hand the effects of inequality on health outcomes.”

The estimated number of primary school children with clinical obesity and morbid obesity stands at about 6.5 per cent, or about 80,000 children and adolescents.

Rates of clinical and morbid obesity are nearly double in schools serving disadvantaged areas, the committee was told. The Temple Street team said 60 per cent of those with clinical and morbid obesity report psychological difficulties such as poor self-esteem and depression.

It appealed for the development of an implementation plan for obesity services, including efforts to secure sufficient funding.

Political response

In her submission Dr Grace O’Malley, chartered physiotherapist and clinical lead on the team said the UN Convention on the Rights of the Child “demand” that those already obese have access to early treatment.

“The children of Ireland urgently require timely access to treatment in primary, secondary and tertiary care,” she said.

On the issue of stigma, Fine Gael Senator Catherine Noone said it was important for policymakers to be aware of the complexity of the issue.

“I am tired of listening to colleagues in the Seanad and elsewhere saying ‘they’re just fat’ and ‘if they eat less they won’t be fat’,” she said.

Addressing stigma, Dr O’Malley said there was a need for a stronger social response to the bullying of people because of weight.

“We have rules and laws around gender, race, sexual preference but nothing around shape,” she said.