Stories to help obese children

Unlike the obese children often pictured when weight problems are discussed, ordinary chubby children can be much harder to spot as having a problem. Evidence shows that parents, teachers and even health professionals can struggle to identify the children whose body mass index puts them at risk of weight-related illness. This is presenting something of a problem in Scotland, where a government programme is requiring every health board to get a certain number of overweight children into treatment programmes.

The first year of a three-year programme should already be under way, but some health boards have not yet decided how they are going to identify children with problems or how to “treat” them. There are worries that the new money – £6m, which is part of a bigger £52m anti-obesity drive by the Scottish government – could simply be swallowed up without any effect on the population, which is currently the world’s second fattest after the US.

Ross Finnie, health spokesman for the Lib Dems, calls the project “chaotic” and thinks money should have come with guidance. He says it is “concerning” that several of Scotland’s 15 health boards are unclear about how to use it.

Professor of medical psychology at Leeds University, Andrew Hill, who specialises in this issue, remains positive. “I really welcome this and I would love to see something similar in England. We need to target resources specifically on children who have a problem. I think a project like this will reward areas which are already thinking about this, but it will also expose weaknesses in other areas.”

Community child health professor Charlotte Wright, of Glasgow University, says: “I am not saying that we can make these children slim. We probably can’t. The target is to slow down the rate at which they gain weight. Even a small improvement can make them happier and increase their life chances in every way.”

Glasgow Health Board is going to write to every family. “There are plenty of families out there who are crying out for help and who are motivated to change, and that is where we will start.”

The Scottish government is already targeting resources on education measures, healthy eating initiatives, cookery clubs and increasing children’s activity. So far there has been little apparent success. The previous administration got egg on its face after a healthy eating advice line, which was advertised with a poster campaign showing people trying to eat the telephone and urging them to call for healthier suggestions, received no calls.

But storyteller “Mrs Mash”, Marie Louise Cochrane, who works with early years children telling tales revolving around the making of oatcakes or soup, argues that changing children’s attitudes to food is key. “One woman told me that after her granddaughter heard my soup story she came home asking for vegetable soup, which she wouldn’t normally eat. I think sometimes it isn’t seen as normal to give children soup, it seems more normal to give them chicken nuggets, and we need to change that.”

Paediatric obesity expert Professor John Reilly, also of Glasgow, says a pilot project targeted on fat families is showing good effects. “The families are taught to monitor what they are eating and how long they are sitting in front of a screen. We ask them to talk about what lifestyle changes they think they could make and why they want to make them. It sounds a bit touchy feely, and when we started it people were saying, it is too Californian, families in Glasgow won’t go for that. But they do. I would say some of the families who come forward are pretty desperate. In some cases, they don’t know where to turn.”

Dr Alan Mordue, of the Borders, says local school nurses will be asked to refer based on their existing knowledge of the children. “There have been guidelines recently asking us to reduce the number of times we weigh and measure children. Also we need to be sensitive to the fact that we don’t want to draw attention to these children in a negative way. But in most cases the school nurses will already be aware of them. The whole family will be asked to come into the school for a meeting. They will need to show a level of commitment. If that is there, they will be referred to the programme.”

Several areas, including Fife and Shetland, plan to weigh and measure schoolchildren to provide a baseline assessment. Lothian children will be invited on to the programme when they are spotted in routine health checks by GPs and others.

The Guardian
Tuesday May 27, 2008