Paul Gately: Fighting this epidemic of childhood obesity

It is true that obesity divides opinion and initiates passionate debate about who is responsible; “the parents are to blame”; “schools should do more”; “it’s their own fault”; the list goes on, but the fact is, without support, these children suffer in silence.

Very often, obese children are the victim of bullies and are socially excluded, meaning the issues surrounding obesity actually compound the problem, making it worse.

Many take the view that the solution isn’t rocket science, and they are right. The equation of “fewer calories, more exercise” is, more often than not, true. It does, however, take expertise, hard work, time, money and knowledge to make long-term shifts in attitudes and behaviours to manage the deep-rooted causes of obesity.

There are a great number of children who need help, recognise they need support and are proactively seeking professional assistance; some are lucky, many aren’t. Why? It depends upon where you live.

The postcode lottery approach to our children’s long-term health is failing many vulnerable young people. Access to effective obesity services should be supplied to those who really need it, not decided by the address at which they live.

So why is there such imbalance in the scale of this injustice? It comes down to how different primary care trusts prioritise different health issues. There is no consistency.

While most PCTs identify obesity as a priority, they do not provide the resources to deal appropriately with it. There are, however, some exceptional examples, such as Rotherham PCT, who have made consistent commitments to their obese young people and are seeing fantastic results.

Broadly, I believe the inconsistencies are influenced by the view that fat people get what they deserve. There are numerous stories about denial of healthcare because it’s still seen by some to be that person’s own fault for eating too much.

One of the last acceptable forms of discrimination is against obese people. Even our healthcare service discriminates against them. This is all despite the knowledge that if we effectively treat obesity, the long-term healthcare costs associated with addressing illnesses related to obesity, including diabetes, heart disease, even cancer, are reduced significantly.

Even those that do recognise the seriousness of childhood obesity, and the need to address the epidemic, may not have the right knowledge to make effective funding decisions.

I work at the coalface of childhood obesity. I’ve made it my lifetime’s work to put into practice long-term solutions to help the 2.8 million children in the UK who are clinically obese.

Think about this: 140,000 children in the UK are so overweight that if they were an adult the equivalent size, they would be eligible for surgery. And the cost to our already stretched National Health Service? Estimates suggest in the region of £1.3bn.

During the past five years, the Government has poured £5bn into preventative initiatives to tackle obesity and, comparatively, a mere £30m into treatment.

There is strong evidence to suggest that preventative activities have little or no effect on young people developing into overweight adults but strong evidence to show that treatment is effective and achieves long-term results.

I regularly see young people and their parents struggle to get the support they need and access services and programmes that are proven to not only achieve weight loss, but manage the influences that are the cause of obesity.

I accept that there is less money available within our NHS system. The key issue is that investment is not being made in the direction of these vulnerable children and their families. The huge variability that already exists across the country could also get worse.

The NHS reforms to abolish PCTs in favour of GP consortiums, alongside childhood obesity being addressed by the local authorities (which have not had their budgets protected like the NHS) and the increased emphasis on localism, will mean even less of a standardised approach.

The postcode lottery system will become even worse as your child’s fate won’t rely on an agreed national policy to accessing obesity services but on the knowledge, expertise and, ultimately, sympathy of your local doctor or local children’s commissioner.

As a professional in this area, I see the fantastic results that are achieved by programmes designed and built on robust research, yet I am deeply concerned. Concerned that we are not doing enough; concerned that the subject of childhood obesity is not being taken seriously; and concerned that if we don’t accept we are dealing with an epidemic, we will see a generation of young people die from preventable diseases.

Professor Paul Gately heads Carnegie Weight Managament, based at Leeds Metropolitan University. National Childhood Obesity Week begins on Monday.