Childhood obesity, a father’s view: ‘Having been in the system, it doesn’t feel like we treat obesity as a complex condition – meanwhile our child feels harassed’
Dealing with the multi-faceted disease, one father gives his view and suggests system changes that need to happen in health, policy, education and even town planning to tackle the increase in cases
Another month, another publication from the World Health Organization (WHO), announcing that Ireland needs to get a grip on childhood obesity. We rank nine out of 53 countries for obesity among five to nine-year-olds, and tenth for 10 to 19-year-olds.
The WHO has pointed out that obesity is a multifactorial disease requiring policy interventions to help tackle the environmental factors which can be the catalyst for those predisposed to obesity to gain weight.
Despite the State’s recent efforts, being the parent of a child with obesity feels like being left out in the cold. My child is in danger of developing serious complications as the result of the condition of obesity and for all of the State’s good intentions, we’re still struggling to get adequate support.
Convenience stores offer whole aisles of confectionery and fizzy drinks
What treatments are available?
Obesity is a complex condition. I see that every day. My child is fit and active but, I believe, there are some as-yet undiagnosed issues with mental health. There is, I think, depression and anxiety, possibly behavioural issues and, in addition, an addiction, or at least a compulsion to eat unhealthy food.
We’ve tried as a family to find treatment for the mental health aspect but frankly, we’ve been bounced around from waiting list to waiting list and appointment to appointment. Every time there’s a new clinician, we have to start from scratch detailing our history — something no teenager wants to do.
Partly because clinicians, I believe, are now afraid to treat obesity, particularly amongst teenagers, we don’t speak about how poor mental health might lead into obesity, which in turn can create worse mental health outcomes and all manner of other physical conditions.
Having been in the system, it doesn’t feel like we treat obesity as a unique condition with varied constituent parts.
Rather, healthcare becomes siloed — mental health in one column, respiratory health in another and obesity in yet another. And for families like ours, that means hours of appointments, miles to cover between them, lost work time and lost family time with our other children.
Meanwhile, our child with obesity feels harassed. We are always telling children with obesity that it’s not their fault, but shipping them from pillar to post to get help makes them feel like they’re a problem. And actually, this is not the fault of the healthcare system. All of the doctors, barring a few I have dealt with, have been kind, patient, and sincere. They are working in a straitened system in which it feels like they are still battling for funding to treat obesity.
Furthermore, the environment outside thwarts them at every turn. Take my town for example. It is your standard Irish town with a population upwards of around 10,000.
What I want to know is when policy interventions are going to arrive at a town like mine. The Government wants children to take more exercise and yet, down the road from me, a school was built with no footpath going to it. When I was a child, everyone walked or cycled to school. Now the roads are busier and parents insist on driving and we wonder why. This seems like fundamental town planning and yet it’s still happening.
So where else can your teenager with obesity exercise?
Not at school, where PE mostly means team sports which many children with obesity will hate. Learning how your body works and doing exercises for flexibility, mobility and strength would greatly benefit children with obesity. It also means they can do these exercises at home.
Not in the gym, because under-16s can rarely use gyms after 6 or even 5pm, a time when most teenagers are just in from school. There is no outdoor gym in my area. Walking as an exercise is an option, but teenagers, regardless of their weight, tend to be self-conscious.
For teenagers with obesity, this is only magnified. There is a fear of being seen trying to lose weight. Bullying on social media makes this worse. Sometimes I feel for this generation, almost unable to escape the judgment of others. We tend to go to other places to exercise and enjoy it, so we’re not looking over our shoulders.
In winter, it is too cold and dark for children to be out alone walking and we are at work until late in the evening. So often, we have to forego exercise until the weekend. Two new food outlets opened over the last while. An ice-cream parlour and a pizza place. There’s only one restaurant left in the town, the rest are chippers and takeaways. Now, you’ll find the only place you’ll get a “proper” dinner is in a pub but you don’t want to take the kids to the pub. So families are getting takeaways. Kids are getting takeaways on their way home.
That’s another issue — I can’t tell what my child is buying. My child has a debit card linked to my account. This is hugely helpful but it would be really useful for providers to itemise the spend on child-linked accounts. There is a big difference between €5 spent in a shop on fizzy drinks and crisps, and €5 spent on water and a sandwich. All of these issues mount up when you have a child with obesity. You do your very best for them — cooking them healthy, filling meals and helping them understand nutritional value. But once they leave the house, they are at the mercy of fast-food and junk-food companies who see them as prey.
Convenience supermarkets are the worst. Wall to wall of fizzy drinks, jumbo bags of sweets, ‘sharing’ bags of crisps that never get shared. As a parent, your steady advice and good habits compete with such temptations every day.
What can parents of children with obesity do?
We need to teach children about nutrition and good eating habits in primary school. By the time they reach secondary school, bad habits are too hard to break. Eating right, choosing fresh food, teaching them how to cook for themselves are life skills we owe our children.
Sometimes we shirk from conversations about good and bad food — we can be too squeamish about these matters — but this is a generation who have top-of-the-range iPhones and we won’t talk to them about calories? These double standards make no sense.
The basics of home economics should be taught in primary school. By secondary, some will be getting their own dinner. They should know how to cook safely and if they’re making a food choice outside of the home — which most are — we should give them the knowledge to do that wisely.
We need to teach them how to budget and what to buy. It must be so easy for a child to get sidetracked in the supermarket on the sweet aisles. I know plenty of adults who do the same. At home, I teach the basics of good cooking. Carrots, peas and broccoli, sweetcorn and cabbage, chicken breasts, potatoes. You’re always trying to get as much fresh vegetables and fruit in as possible, and to make everyone at the table happy.
I’ve almost stopped using shop-bought sauces now because they just contain too much sugar. There is no junk food in the house and, thanks to remote working, there is always someone here to cook. I can’t imagine how stressful it is for single parents of children with obesity.
What can the Government do?
Take food policy in hand. Parents are being blamed for children with obesity and yet, if you walk down any of our main streets in the country, it’s obvious that our food culture has become blighted with fast-food and junk-food.
In many towns that we parents speak of, family-run restaurants are closing down in favour of high-calorie takeaways. Could we not incentivise more healthy restaurants or healthy takeaways or at least have a set limit on the number of takeaways any single town can have?
Surely this can be a function of town planning. Exercise is imperative for children with obesity but there is no joined-up thinking on this. Every school must have footpaths so that children can walk to and from school safely. These should be well-maintained and well-lit by town councils.
Children with obesity should be given access to gyms, if this is through a municipal local gym or by giving vouchers to private gyms. It is too hard for children to get exercise. Teaching nutrition needs to happen at a much younger age.
The sugar tax needs to be implemented more ardently. Everything from cereals to sauces are laden with sugar. It is impossible for a normal family to police this. Highly processed products containing large amounts of sugar need labels like cigarettes.
I am all in favour of choice, but we must know the risks. Some people think that obesity is a result of laziness. If only this was the case. In my family it has cost us thousands of euro, months of missed work, weeks of sleepless nights.
Having a child with obesity means you worry endlessly for their future. I hope other families don’t have to go through what mine has needlessly. No parent wakes up and says, ‘Today I’m going to make my child obese.’
