When the weight falls on the children
A new report warns that obese children are in danger of having a shorterlifespan than their parents. But ditching the 'eat less, exercise more' mantra may be the best way to help them, writes Kate Hilpern
Alarming numbers of children are obese. We've heard this before, but now there's a macabre twist. The latest warning - delivered last week by Andrew Prentice, professor of international nutrition at the London School of Hygiene and Tropical Medicine - is that parents might soon be outliving their children.
"Seriously obese children are losing up to nine years on average through diseases that were not as common among their parents," he says. As nearly 8 per cent of boys and 7 per cent of girls are now officially obese, this is cause for concern.
The usual advice for parents with overweight children is simple - get them to eat less and exercise more. But now, the word from the child-obesity professionals is that the best solution to childhood obesity is to ditch the "eat less, exercise more" mantra altogether.
"All it does is make the parents anxious," says Susie Orbach, psychotherapist and author of Fat is a Feminist Issue and Susie Orbach on Eating. "They end up transmitting this anxiety to their kids, making eating a loaded thing rather than a pleasurable and biological encounter. The key is to stop making food an issue.
"Quite often, the parents feel inadequate in dealing with their children's distress about bullying at school, falling over or even boredom, and they offer them comfort in the form of ice cream or chocolate. But all this does is give a message that food makes everything OK. It's important to offer real forms of comfort instead."
Contrary to popular opinion, Orbach believes that parents should resist telling their children to avoid certain foods. "We know that telling young people not to eat junk food will make them even more drawn to it," she says. "Providing a wide range of food, along with the junk food, if that's what they eat, is the answer."
Researchers have discovered that telling children what to eat doesn't work. Jane Wardle, professor of clinical psychology at University College London and a co-founder of the charity, Weight Concern, says: "Our study found that if you offer a novel food a child hasn't tasted before, along with a health message, they rate it as less nice than exactly the same food that they weren't told is especially healthy. This suggests health messages can be counter-productive.
"That's not to say that children aren't interested in health messages. Indeed, in the long term, we know that it will start to influence their food choice. The problem is that when they're young, they realise you only bring up this health issue when they're about to not eat something. So they learn an association with health and something they don't want to eat. One solution is to point out that something they do like is good for them."
Daniel Smith, 11, was so unhappy about weighing 15 stone that he stopped going to school for three months. His mother, Jan, noted that when he felt down, he ate, which made him feel more down. When they went to the doctor, Daniel was given antidepressants and half an hour with a dietitian, who handed him a list of foods he could and couldn't eat.
"There was no back-up, so it didn't work," Jan says.
"Putting obese children on a calorie- controlled diet is very common - after all, it seems the most obvious solution," confirms Paul Gately, principal lecturer in physical activity, exercise and health at Leeds Metropolitan University. "But it doesn't work."
A surprising view, perhaps, for the co-founder of Carnegie International Camp, Britain's first "fat camp" based in Yorkshire. But, as Gately explains, "American fat camps, together with most of the more traditional intervention programmes in the UK, are based on the assumption that if kids lose weight and exercise more, they'll stop being overweight."
And, at first glance, the results are spectacular. Some kids lose huge amounts of weight. The problem is, it doesn't stay lost.Year on year, many actually gain weight.
Gately's approach is to understand what makes these young people want to eat more and not exercise and, armed with that information, encourage them to manage their weight themselves. "For example, it's not about saying you can't eat chocolate," he says. "It's about saying here is a range of chocolate desserts, as well as non-chocolate desserts, some much higher fat than others. After that, they are given the choice."
Likewise, the children - who attend the Carnegie for six weeks - are encouraged to join in sports for fun. "Many have had bad experiences of sport at school, but we ensure the children enjoy the sports they play here. You use up lots of calories running, but what's the point if you never do it again? However, if a child really enjoys playing basketball and plays it for the next 20 years, that might keep the weight off them."
THE camp also helps children deal with the psychological side-effects of their weight, including advice on how to deal with bullying. "So much of the work with obese children - whether it comes from parents directly or indirectly by sending them on a camp like this - needs to be about giving them their confidence back. It's incredibly common for children to eat because they feel bad about themselves," says Gately.
If a child is to lose weight permanently, it's crucial that the whole family is involved, rather than it being the child's "problem", he adds. "I don't subscribe to the view that parents are wholly to blame for obese children, but no child can diet without support. Parents need to know the basics of nutrition and to agree to assist in simple ways like emptying the snack drawer and filling up the fruit bowl. Essentially, they need to change their habits, too, because if a child is to stop being obese, they need a whole new outlook on life."
Leading by example applies equally to physical exercise, says Hugo Crombie, a public health adviser to the Health Development Agency. "It is counter-productive to encourage children to exercise if you're not doing any yourself," he says.
Going to the gym isn't necessarily the answer. "Family exercise-based activities, such as going to the park, ice-skating and swimming, can be an alternative to the cinema or McDonald's. If a child doesn't excel at sport, it's about staying clear of competitive sports and not asking questions like 'Did you win?'"
A worrying number of under-fives - one in 10 of whom are overweight - don't even realise that walking is a form of transport, says Crombie. "With this age group, encouraging activity should be more about establishing lifetime habits than formal exercise. And it should be about fun and joining in."
Giles Platt, physical education co-ordinator at Perry Hall primary school, Orpington, Kent, believes the same should be true in school. "School sports should be child- centred and wide-ranging and, where possible, parents should get involved in extra-curricular clubs."
The first step to helping your child lose weight, then, is to get off the couch yourself.
- Guardian Service