The Problem with Children’s Obesity
During the lockdown, my front door has been the recipient of countless leaflets promoting take-away food of a distinctly dubious nutritional quality. This caused me to write to my local council complaining about high fat, fast food take-aways and the effect they had on obesity. I received a fulsome letter back from the local councillor in charge of health, but it talked only about childhood obesity.
Good cause to worry? UK children are the fattest in Europe and have become fatter since the lockdown according to figures released in autumn 2020 by the National Child Measurement programme.
When children start school more than a fifth of four year olds are classed as overweight and a tenth as obese, meaning they have a BMI of 30 or above. By the time they go to secondary school more than a third of children are overweight and a fifth are obese. Across England, childhood obesity has risen while the gap between the rich and the poor has widened.
The Conservatives pledged to “tackle childhood obesity” in the party’s 2019 manifesto. In 2018 the Tories had committed to halving the problem by 2030.
The campaign is very worthy and well meaning, but there is a more subtle aspect to it. Obesity is a major risk factor for many lifestyle (ie preventable) cancers, so it is important that obesity should be controlled and eliminated.
A number of cancers are caused by obesity: bowel cancer, uterine cancer, oesophageal cancer, breast cancer and others. Indeed, some campaigners are now saying that obesity causes more cancer than smoking. Other lifestyle diseases, such as diabetes or cardiovascular disease are also diseases of the overweight.
However, a characteristic of lifestyle cancers is that they tend to affect the elderly, not the young. For example the average person who gets cancer of the oesophagus is aged 70. The average age of a child is half 18, thus aged 9. So there is a 60 year gap between the cancer itself and the precautionary action being taken. In a sense, you could argue that in the case of cancer of the oesophagus, for example, you have to wait 60 years to know if the child obesity campaign has really been successful. Similar figures would apply to other lifestyle diseases.
No government department works to a 60 year time horizon so why did the Department of Health and Social Care (DHSC) embark on this? The answer is that it is an easy option for them. It is “doable” (Amsterdam has already succeeded), it is measurable, and because children are involved, everybody sees it as a “good thing” rather than part of a so-called nanny state.
Unfortunately, worthy as it is, in my opinion, the campaign against child obesity is also acting as a decoy, a diversionary tactic for what really needs to be tackled, which is adult obesity. It is adult obesity that needs to be tackled now, not in 60 years time. It may be easier and more convenient for the DHSC to turn a battle against “obesity” into a battle against “child obesity” but the two are very different, and the battle against the latter risks sidelining the battle against the former.
After all, the battle against adult obesity would lead you into concepts such as “fat taxes”, finger wagging and concepts alien to a “free society”, whatever that is. It is easier to advocate policies that have already been shown not to work, but apply them to children, where you have more control, and therefore make weak policies seem more successful.
Of course, the assumption is that if you can fix child obesity you will fix adult obesity. I would argue that the logic is the other way around, not to mention that the time horizons are just too long to carry any meaning. Perhaps you can hope that putting emphasis on preventing obesity generally through the child obesity drive will leach through to adult obesity. But I say fix adult obesity first, then you will find child obesity will fix itself.
JMC March 2021