It appears that in the UK we have become so politically correct that accurate biological terminology can't be applied even when highly appropriate and in perfect context. We have to swerve around precise, quantifiable and descriptive words and replace them with ineffectual euphemisms.
I refer of course to handling of the data from the National Child Measurement Programme (NCMP) where each year school nursing teams write letters to the parents of tens of thousands of five and ten years old. For those whose children have crossed the 91st centile on the child growth charts, they are notified that their children are classified as overweight. It is only when the children cross the 98th centile that the authorities shrink from their responsibilities and rather than correctly stating their child has been measured and categorised as obese, they apologetically refer to the child as being very overweight.
As the American Medical Association has just passed a motion declaring obesity a disease, they ought to also pop a get well card in with the NCMP letter, which would be the politically correct thing to do. Equally we should be expecting to see more sick notes with the words:
Dear Miss Brown, I'm sorry but Chardonnay cannot come to school today as her obesity has flared up again over the weekend". Also, would it be ok for her to have few years off PE until her conditions settles down a bit?
Whilst we are at it - that is weighing and measuring 94% of kids in England of this age - I also wonder whether or not it would be a good idea at this point for the authorities to send out letters to notify the parents of the many underweight children that are identified by the programme that "your child is a tad on the lean side". I'd suggest that sending these families a cake at this point would be the proper thing to do.
Which brings me on to the 6% of children that opt out of being weighed and measured. Well it isn't actually the kids that opt out it is their parents. I am reliably informed by the school nursing teams that the opt-outs are actually the heaviest kids in the school. Not only does this nullify the data but it validates the position that you can bring your child up to be super obese and the authorities will turn a blind eye - in order to be politically correct of course.
After receiving just such a letter, a mother asked me how she should refer to the issue with her 11 year old daughter when they discussed her weight. I asked the mother what she felt her options were to which she said she was vacillating between, chubby or plump (her daughter had a BMI of 34 making her seriously obese). I suggested that she explain to her daughter the concept of being too fat, and what this was likely to mean for the future if they did not work together to make better choices and reduce the amount of bodyfat she was carrying. She recoiled at the very thought of using the F word, and I could hear the eggshells creaking as she departed.
The term overweight refers to a state where the body is carrying too much fat. It is normally stored under the skin (subcutaneous) and spawns the classic love handles or bingo wings. However if we gather far too much, it starts to accumulate inside your organ cavity creating a bulging waistline. This type of fat accumulation is dangerous as fats collecting close to the viscera start to infiltrate the organs. Disease markers such as elevated blood pressure and high cholesterol act to warn you that something sinister is lurking around the corner. Unless you clear your organ cavity of fat, you can pretty soon expect one of the rising stars of the chronic lifestyle diseases such as heart disease, diabetes or stroke to knock at the door of your corpulent physique.
Actually the thing that is most pertinent to children is not the pathological components of being too fat, but the social penalties that will surely come once they become an adolescent; and these will be truly devastating for the youngster. I've seen too many desperately unhappy young teenagers weeping inconsolably and in utter despair because of their weight and the wretched effects it is having upon them at a time that they should be enjoying some of the best years of their lives. It is an absolute tragedy it really is; mainly because it is totally avoidable.
Personally I think a good starting point would be to use the correct terminology around the condition of obesity, and a more liberal use of the word fat would also help. Educating young people about the consequences of gathering too much bodyfat (the psychosocial as well as the health effects) would be a major step forward.
Young people don't know this stuff and it is our responsibility to teach them about it. It can be too late once they are sixteen and the obesity is established both behaviourally and biologically; it's simply not fair at this stage to say "well you're an adult now, so sort yourself out!" A fat lot of good that would do!
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 personal trainers and health practitioners.