Combating Childhood Obesity
April 23rd, 2018
Author Dr Eilish Yarham
Dr Venita Patel is a Community Paediatrician with extra training in Nutrition & Lifestyle Medicine and lead doctor for Childhood Nutrition and Obesity, as part of the Evelina Hospital.
She talked to us about her work to help combat the obesity epidemic.
“Childhood obesity is a complex issue with many drivers, including behaviour, environment, genetics and culture, and I believe it requires a multi-faceted collaborative approach.
In the UK, almost a third of children aged between 2 and 15 are overweight or obese, with younger generations becoming obese at earlier ages and remaining obese for longer. The rates are highest for children from the most deprived areas. At age 5, children from the poorest income groups are twice as likely to be obese compared to their most well-off counterparts, and this rises to three times by age 11. Obesity prevalence is also higher in urban than rural areas.
The effects of being overweight as a child include development of type 2 diabetes, reduced activity levels and lower school attendance. The mental health sequelae include depression and the effects of bullying.
Particularly for children, physical activity is importantly associated with not only maintenance of a healthy weight, but numerous health benefits: improved muscle and bone strength, health and cardiovascular fitness, and quality of sleep. There is evidence that physical activity and participation in organised sports and after school clubs is linked to better academic performance, and the associated social contact improves mental wellbeing.”
Lambeth Specialist Healthy Weight Project:
“In Lambeth we previously had some of the highest rates of childhood obesity in the country, and we have been running this Community Paediatrics Tier 3 Specialist Healthy Weight Project since 2014. It is based on NICE Guidelines and aims to create a supportive environment to help children and their families make necessary lifestyle changes. Children referred to our project have a BMI above the 98th centile, and a level of complexity such as learning difficulties. The team consists of myself as the Paediatrician, a Dietitian, a fitness specialist and a family therapist.
We therefore take a truly holistic family approach, including the psychosocial aspect, working closely with mental health services and social care. Members of the team will initially see families every fortnight and make home and school visits to create individual care plans. As a team, we make 3-monthly assessments to review progress, health issues and psychosocial issues. Families have up to 12 months to work with our project.
We include a variety of elements such as mindfulness, art therapy, parenting and behaviour support. The nutrition and dietetics support often involves returning to traditional diets for families of different cultures, as in Lambeth we have an enormously diverse population, for which the ‘Eat Well Guide’ has little relevance.
The overall emphasis of this project is on the child’s mental wellbeing, fitness and balanced nutrition, rather than a focus on BMI and weight changes. As a result, we have seen long-term improvements across the board in mental health scores, activity level measures and diet quality as well as BMI.”
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