Childhood Obesity in the UK

Did you know that the UK has such a terrible problem with obesity that they have a National Obesity Observatory (NOO)? Since 2005, NOO as it is known have been looking at the weighing and measuring of children completed at key times in children’s lives. The name observatory highlights the planetary size of the obesity problem which is fast arising amongst the nation’s children..

It is my opinion that the word observatory is an unfortunate label for this very important establishment. In the world of obese people words can cause harm especially for children. I am sure those in charge meant the meaning to be as those in the English dictionary

1. Place for scientific observations; a building, station, or artificial satellite used for scientific observation of natural phenomena such as astronomical objects, the weather, or earthquakes

or

1. Place for looking at view; a place or building that commands an expansive view

But, I think the word observatory is going to make people think lesser kind thoughts about the every growing in weight children of the UK. The term observatory will be linked to thoughts such as, large, huge, round, enormous etc a link with planets, asteroids, larger than life for example.

Sadly this is what obese children may have to put up with during their childhoods,” fat” jokes and awful connotations at their expense. People might not say it but there will be the thought in some people’s minds. Because, even though it is an ever growing epidemic, seeing a child who is obese is still a relatively surprising jolt to the senses for most people, being hard to grasp, similar to understanding the concept of other planetary bodies, not a usual reality for most people in the UK.

In other countries obesity or being overweight has been a feature for a while, and the rise in children being obese is not just about the loss of innocence and being overweight, being the victim of emotional problems including low self esteem is just one aspect of the nature of childhood obesity across the world. This can rob children of their childhoods, creating problems in the long term which can also affect their weight gain and lead to ill health, emotionally and physically.

Parents and practitioners should familiarise themselves with the evolving language and knowledge about childhood obesity. Here are some of the important points

1. Obesity is a term used to describe somebody who is very overweight with a high degree of body fat – non medical people use phrases such as “he is obese” to describe what people look like
2. Obesity is measured by health professionals using the Body Mass Index – not many people are aware of how the Body Mass Index works. I n children it is very important to use instead of weighing children with scales as the Body Mass Index is a formula using height and weight. This means that as a child grows their weight proportion is more suitably measured with BMI; scales do not take into account growth. Some professional monitor and track trends in BMI not the figures.
3. Obesity is a serious disease with associated symptoms – see number 6 below
4. Morbid Obesity is a measure of when a person becomes double their ideal weight or is more than 100 lbs (44.4 Kg) over their idea weight with a body mass index of 40 or over
5. In Britain children are not normally defined as morbidly obese – instead what is called the 99.6th centile of the UK90 growth reference charts is often used to identify very obese children
6. Even though children are not classified as morbidly obese those that are very obese do risk co-morbid conditions that further seriously puts them at risk – Co Morbid conditions are those that are medical conditions associated with a disease such as obesity, examples are high blood pressure, fatty liver, heart disease and diabetes.
7. NOO states that one in five children in reception is overweight or obese (aged 4 – 5)
8. NOO states that one in three children in year 6 is overweight (aged 10 to 11)
9. The onset of type 2 diabetes is being seen in children who are obese – type 2 diabetes is reversible if children lose weight but the most alarming thing is that type 2 diabetes was always seen as an older persons disease, now children as young as 9 have contracted it and the term being used now is diabesity in adolescent children.
10. Pregnant women who are overweight are said to be more likely to have overweight children – recent research states that obesity for children can start in the womb and pregnant woman should be at an ideal weight to lessen the risk of their children becoming obese during their childhoods.
11. Vitamin D Deficiency Studies in Children – Really important research has being undertaken at the University of Michigan in 2006 and the revered Great Ormond Street Hospital in February 2013 that makes a connection between the lack of the vital vitamin D and obesity. The research proves that children with obesity will prevent vitamin D being made in their bodies. Without vitamin D people get very tired and lack good growth and problems with bones.

But how have children become more and more overweight or obese in this society? With bloggers and chefs such as Jamie Oliver, taking on school dinners and taking the mighty McDonald’s to task over bleached meat unfit for human consumption.

In the UK they have found horse meat in recipes and “fresh” meat products being passed off as beef or lamb on the shelves of major supermarket chains. Public outcry has resulted and rightfully so but does this tell us what is making children progressively over time become overweight or obese?

There are lots of hunches about what is the cause of obesity in children which ranges from not breast feeding, processed foods and low nutrition foods and snacks and lack of parental control. Overall the main agreement is that children who are fed a lot of processed foods tend to also have inactive life styles and that obesity starts within the first 1000 days of life when it gets fully established.

What should Social Workers do about the concerns they have for overweight or obese children? What is making children overweight and what can be done about it? Is this a child protection issue?

Media coverage

• In 2007 in North Tyneside Council’s social services received media attention concerning their intervention with an 8 year old who weighed over 14 stones
• In 200 Cumbria was in the spotlight for taking an obese child into care

Should extremely obese children be taken into care? Asked the BBC in August 2012 A 19-year-old girl was pulled from her house by a crew of fire fighters – not because of a fire, but because she weighed more than 50 stone (318kg).

“The key criteria is whether the harm is significant in terms of the child’s development and whether the harm is due to the parents or care-givers behaviour,” says Colin Green from the Association of Directors of Children’s Services. “You would also be looking to medical colleagues to help you with that assessment as social worker training is not really competent to judge health impact in precise terms,” he adds

Conclusion:

It is felt that obesity cannot be the only cause for child protection intervention, there is a fine line between intervening when someone’s health and development is at risk and when parents are neglecting their children’s wellbeing. There are clear indicators when care givers are not allowing children’s health needs to be met and in obesity cases we need to ensure we do not forget this.

As social workers we rely heavily on health professionals to let us know if children health and development is being impaired however there are strong indicators of need which must always be considered by social workers in their discussions with families and health professionals, social workers have a key role in understanding when differing perspectives are not focused on overall good outcomes for children.

The key is working together and as always learning from research and cases such as SCRs (Serious case reviews). Things should be measured, and plans always reviewed to see if they are working.

In childhood obesity cases, consistent failure to change lifestyle and engage with support is a concern especially when coupled with additional indicators of need such as low school attendance, maternal mental health, marital discord, co- morbidity, neglect, sexual abuse etc concerns with other siblings, deprivation which is everything that we know about child abuse. Then, use professional judgement. However each case is always different.