Every GP who has signed up to treat children under-six is required to measure and weigh them when they come into the clinic. It can be depressing. Many of the kids clutch bags of crisps and sugary drinks during the process.
We expect about one in four to be overweight or obese. We pop them on the scales, get their height and then check the charts. Sure enough, many of them are well above the limits, often dangerously so.
So, often, are the parents, and they do not see a problem with that. You try to be sensitive. Overweight kids are prone to depression and eating disorders. You also try to be practical.
Difficult to treat
Childhood obesity is notoriously difficult to treat. The causes are often complex, and the aim is to keep the weight the same as the child grows. If you reduce calorific intake and increase the amount of exercise the fat should reduce.
The difficulty lies in getting the message across effectively and forming a plan. What can you do when presented with an overweight child or adult? Only the dramatically obese can get access to paediatrics or dieticians. We are told that brief interventions – some quick, opportunistic advice – can achieve a lot in the surgery. Apart from that, we are largely on our own.
Today's obese children will be obese adults in 2025, when we are expected to be the fattest people in Europe. Seeing a plump child on the scales today, the GP sees their future: diabetes, sleep apnoea, heart problems, high blood pressure, joint disease and low self-esteem.
No resources
The child’s life expectancy will be shorter than that of her parents. Doctors have neither the time nor the resources to cope. Children and parents are subject to a deluge of advertising for fast, unhealthy, sugar-rich food.
If the GP could access a national programme for diet and exercise, if the problem could be addressed in schools and in a national campaign that helped to change behaviour, then that same doctor would not feel so helpless.
If there were recognition of the need for change, we would not feel so alone. People are starving elsewhere, yet more than half of the world’s population shorten their lives by overeating.
The problems caused by obesity are mainly addressed first in doctors' clinics. Even though everyone from the World Health Organisation to the HSE agrees that obesity is a major threat and is likely to get worse, little is being done.
We are collapsing in fat but short on public health muscle.
