Child obesity: don’t believe the hype

One group of children for which there is no sign of any respite from bullying is those who are overweight. While all children are being coerced into “healthy eating” and fitness training, fat children face public weigh-ins (together with waist measurements), intensive lunchbox surveillance and “fat-laps” to burn off the excess adipose tissue.

Now that the crusade against childhood obesity has been enthusiastically endorsed by the government and the medical establishment, fat children are certain to experience new levels of ridicule, harassment and discrimination.

Like all crusades, this one trumpets apocalyptic rhetoric: we are in the grip of an epidemic a timebomb is ticking towards a nightmare scenario of disabling disease and premature death. While politicians proclaim a “wake-up call” to the nation, journalists scour the thesaurus for metaphors of disgust (deployed against people who are obese and their parents) and outrage (against purveyors of junk food).

The crusade against obesity is a triumph of prejudice over evidence, propaganda over science. It is based on assumptions such as fat children eating too much of the wrong sorts of food and watching too much television. Yet a dispassionate survey of the scientific research (much of it of poor quality) shows that these assumptions cannot be supported by evidence.

There is a popular notion that we once lived in a happy era in which children thrived on fruit and vegetables and gambolled freely in sunny meadows. This is linked to the idea that we have now fallen into a state of decadence in which children have become couch potatoes, scoffing junk food in front of TVs or computer screens, in anticipation of a life of smoking, drinking and antisocial behaviour. Like all such golden age stories, this is a myth that reveals more about the pessimism and despair of contemporary adulthood than it does about childhood past or present.

The greatest delusion of the obesity crusade is the notion that telling children (or adults) to eat more healthy food and take more exercise will result in them losing weight. The one clear conclusion that emerges from more than half a century of research around such interventions in the US is that this approach simply does not work.

In the very week that the government announced its latest initiatives in this area, a major study of a school-based obesity prevention programme in the UK confirmed that the modest improvement achieved at 12 months was not sustained two years later.

The good news from the US is that, although people have been getting bigger and heavier for the past century, they have also been living longer and healthier lives – apparently despite their pursuit of what are regarded as “unhealthy” lifestyles.

Instead of a crusade that will inflict anxiety and misery on children (as well as provoking conflict with parents, teachers and doctors), we need less rhetoric and propaganda and more serious scientific study of obesity.

Dr Michael Fitzpatrick is a GP in the London Borough of Hackney

This article appeared in the 22 November issue under the headline “Obesity crusade is a triumph of prejudice over evidence”

 

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