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Who Cares About a Few Fat Kids?

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Apparently not many do, and I'd like to tell you why. As a weight management practitioner and obesity lecturer of 20 years I have made up my mind on a number of weight-related matters, however they are unlikely to draw any gasps or change the course of history. For instance, I'm pretty certain that the global obesity pandemic is driven primarily by the increasing consumption of omnipresent energy dense highly processed edible products. No kidding Sherlock!

A further viewpoint that I have reached is that child obesity is completely unnecessary and actually unacceptable. I consider that child obesity is little different and perhaps even worse that malnourishing a child. It is interesting to note that humans cope well with malnutrition and recover well from it (millions of years of evolving in frugal environments and exposure to cyclical famines have programmed us to cope well with meagre amounts of food). However, over nourish humans for a long period and things don't tend to work out that well.

Most people are surprised to know that a six year old child with arms aloft should expose ribs front and rear. This would be typical of a child on the 50th centile of the growth charts with a body mass index (BMI) of around 13 (at which point an adult would probably perish). The point being that children are designed to be lean. As weight increases in childhood, so too does the number of fat cells and they don't simply disappear in adulthood. The body does not cope at all well with continued weight gain and as fat accumulates it overspills from the safe confines of the adipocyte and infiltrates organs causing mayhem. Half of obese children have at least one clinical disease marker such as elevated blood pressure or raised blood sugars. When one considers that one third of the child population in the UK is overweight or obese, we have to ask the question: "Do we really care?"

Perhaps the biggest problem is a failure by both parents and society to acknowledge that these children are in fact overweight or obese in the first place. In one study in 2009 less than one third of parents whose children were clinically obese recognised that their child had a weight problem.

"It is just a bit of puppy fat; right?" Wrong, puppy fat belongs on puppies.

A further hurdle is that even when parents are made aware of their child's weight status, they still don't see it as a problem. They simply don't connect with the enormous health and quality of life challenges that the child will face over time. Most parents wrongly believe that their child will grow out of their weight, when all of the evidence points to the child growing into their weight. Increased bodyfat becomes established over time and this relationship is both behavioural and biological. Sadly, the obese children of today are the most severely overweight people in society tomorrow.

So a few fat kids, why is it such a big deal? Why don't those pious, nannying, control freak health practitioners (such as me) just leave people alone and let them get on with it? Well, through my specs it looks a little different. Perhaps this is because I feel the pain of Louise, a 14-year-old girl that recently tried to take her life due to her weight. Louise weighs 152kgs (335ibs) and is three times as heavy as a normal weight 14-year-old of the same height. She is confined to her bedroom living her life through social media channels and pretending to be someone else because she is so ashamed of her body. She is on anti-depressant medication and also the register for bariatric surgery. With few friends, constant taunting and ridicule, zero motivation to be successful in a career and a near pathological fear and loathing of boys, she is in a very dark place.

From the age of two Louise has been overweight and the root cause is the same as in pretty much all instances of child obesity that I see: overfeeding by the parent(s)! Tragically Louise blames herself for this predicament, exacerbating her chronic low self-esteem. Louise is not alone, my organisation works with hundreds of children like her, week in week out.

What will it take to see that children, like adults are simply not equipped to deal with the highly palatable, energy dense, nutrient deficient, artificial edible products that are ubiquitous in our lives today? We evolved on foods that are approximately 125kcal per 100g, they were energy sparse and contained abundant fibre, water and micronutrients. Chocolate, cakes and biscuits are around 500kcal per 100g and fries, crisps and biscuits are around 400, with little or no fibre, water or micronutrients. At up to five times the energy per bite of real foods, our brains, digestive systems and appetites, are simply overwhelmed.

Sugary drinks bypass the natural appetite system and are simply extra empty calories. You could drink five litres of cola (2,200kcal) yet won't compensate for it in calorific terms at the next meal as the brain cannot detect the energy in fluids (unless it's milk). As adults we can't cope with these products and so how on earth do we expect infants and children to?

There is now good evidence that high sugar and fat combinations are addictive and switch people off traditional foods, instead craving the more highly calorific artificial forms. A further conclusion of mine is that addiction to junk food is at the heart of weight problems for very many people; children are not spared this rotten snare.

So why does it matter? Well, I believe that if parents could see the distress and abject misery that awaits most obese children when they reach puberty, I am convinced they would do things differently. If I had a pound for every parent that has told me they wish they could turn back the clock and start again, I could afford to open my own KFC franchise!

I would ask all parents of young children that are reading this article to take 20 seconds to show some empathy with Louise. Slip off your shoes and step into hers for just one minute. What does the world look and feel like? Where are your aspirations, hopes and dreams? What will your world look like 20 years from now? I would ask you now to think of your own child and galvanise your plans to ensure they have a better chance than Louise. Please take a fresh look at food and don't become another parent wishing you could turn back the hands of time.

Alan Jackson is the lead practitioner and researcher for Weight Management Centre in London and Discovery Learning an educational organisation dedicated to health, fitness and personal wellness for fitness instructors and health practitioners

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