The past four decades have seen a tenfold increase in childhood obesity and this has been further exacerbated by the pandemic. Global childhood obesity has increased from less than 1% in 1975 to nearly 6% in girls and nearly 8% in boys by 2016. The pandemic has added fuel to the fire.
For adults, the new weight loss drug, Wegovy, recently approved for use in Ireland, offers real hope for significant weight loss and health gain for those who use it over the long term. But it won’t address the underlying problem: the obesogenic environment.
Results from the UK’s National Child Measurement Program for the 2020/2021 school year estimate that the prevalence of obesity has increased from 9.9% to 14.4%. There have been no official studies in Ireland, but there is reason to fear that similar trends exist here.
Grace O’Malley, clinical director at the Child and Adolescent Obesity Service at Temple St Children’s Hospital, confirms that the upheaval in children’s routines of bedtime, sleep time, mealtime, and schedules snacks were overturned led to an increase in obesity among children. She said there is likely to be a clear divide in terms of social inequality, with families from low-income groups suffering the most.
We know the drivers of this: the profit-driven market flood with cheap, energy-dense, nutrient-poor food and drink, along with cityscapes that promote sitting staring at screens or driving vehicles.
If we know what the problem is, why are we hesitating to solve it? Here are some key steps we can take to address the obesogenic environment.
The Obesity Policy and Action Plan 2016-2025 recommends the “development of guidelines and support materials for those working in the development of the built environment for urban development and planning in relation to reducing the obesogenic environment “.
This recommendation would be more effective if it specifically aimed at introducing robust legislation to limit fast food planning near (within 400m) of schools.
The obesity action plans also recommend “the development of a code of conduct for food and beverage promotion, marketing, sponsorship and product placement.”
For this to be effective, it must be supported by legislation. A voluntary code is not competitive and has minimal effects. An involuntary code would equal the playing field for the food industry to change the way food is marketed, sponsored and promoted.
Britain plans to introduce robust legislation in October 2022 to restrict advertising for high-fat, salt and sugar-rich foods shown on TV before 9pm and in paid online advertising, as well as restricting food promotions. unhealthy in stores and online.
In June 2020, the newly elected government pledged to tackle obesity in Ireland with a public health (Obesity) law, including limiting the marketing of unhealthy foods to children.
This legislation is likely to be fiercely opposed by the food industry as it has in the UK, but it has the potential to have an impact and is lagging behind, with the ability to give parents and children the opportunity to have a “fair chance” to make the healthy choice “.
One approach that has proven useful is to tackle obesity in the early years. “Right from the Start with HENRY” is a UK program delivered by qualified facilitators to small groups of parents over eight weekly sessions.
HENRY (Health, Exercise and Nutrition for the Really Young) is designed to equip parents of infants and preschoolers with the skills, knowledge and confidence needed for a healthy home lifestyle.
Evaluation of the program showed an increase in family lifestyle healthiness, improvements in parenting and emotional well-being, an increase in fruit and vegetable consumption between parents and children, as well as significant reductions in the consumption of foods high in fat and sugar. There were also positive changes in children’s eating behaviors, physical activity, and screen time.
If this all sounds too good to be true, Leeds became the first city in the UK to report a decline in childhood obesity after introducing the HENRY program in 2009, helping parents set boundaries for children to say no to children. sweets and junk food.
Only a few other cities in Europe, especially Amsterdam, have achieved this and, like Amsterdam, the decline is more marked in families living in the most deprived areas where the problem is worse and more difficult to deal with.
In four years in Leeds from 2013 to 2017, obesity fell from 11.5% to 10.5%. Among the wealthiest families, obesity levels also fell from 6.8% to 6.0%. The biggest drop was in the host class at the age of four. From 2016 to 2017, 625 fewer children in the reception class were obese.
These changes came after the introduction of HENRY in 2009, focusing on younger children and the poorest families. HENRY helps parents set boundaries for their children and take a firm stand on issues ranging from healthy eating to bedtime.
The program encourages authoritative rather than authoritative parenting. Authoritarian parenting is when children are told what to eat and do, compared to permissive parenting where children are asked what they want to do.
HENRY encourages authoritative parenting, where parents make it clear that they are responsible but also respond to their children. Instead of asking what vegetables they want for dinner, children may be asked if they want carrots or broccoli. Instead of being told to go to bed, they are asked which bedtime story they would like. Instead of being told to stop watching television, he is asked if she would like to turn it off or if the parent is doing it.
Similar programs, such as Parents Plus, operate in Ireland. The goal is to deliver educational workshops in schools, community services and primary care, supporting parents to make positive lifestyle changes for their families.
The state has a mandate to protect the health and well-being of children that is not respected. This need has been accelerated by the pandemic, where there are clear indications that obesity levels have risen substantially.
There is evidence that community development programs that support authoritative parenting around healthy lifestyles can play a role. Equally important is solid legislation to guide changes in the food environment if it is to become healthier, so that cinemas, recreation and activity centers, supermarkets and food outlets offer and promote tasty and healthy choices for all, but especially for the children.
The key to success is recognizing that the obesity crisis is much less a problem of individual behavior and lack of willpower and much more of the environment around us.
- Dr Catherine Conlon is Senior Medical Officer in the Department of Public Health, St Finbarr’s Hospital in Cork and former Director of Human Health and Nutrition, Safefood. Her book was released by Veritas in 2020.