TCS Daily

Children and the Fat Police

By John Luik - May 30, 2006 12:00 AM

The news that every UK schoolchild aged four and ten is to be weighed and measured, with the parents of so-called obese children receiving a letter warning of long-term health consequences for their children, represents a new low in the already shocking moral panic about childhood obesity that is gripping both Europe and North America. What makes this newly announced initiative from Britain's Department of Health even more reprehensible is that it flies in the face of a considerable amount of science about obesity, children and health.

First, the government's justification for weighing children is that it wishes to create a national "map" of childhood obesity. But it is not at all clear that there is an epidemic amongst UK children to be mapped.

For instance, the just-published Health Survey for England, 2004, shows a significant variation in the prevalence of overweight and obese children from year to year. Take boys, aged 2-10, who will fall under the ministry's decree, for example. In 2003, 14.7 percent were considered overweight, against 14.2 percent in 2004 -- not even an increase, let alone one qualifying as an epidemic. Or consider obese boys aged 2-10. In 1999, 16.1 percent were considered obese, but in 2000 only 12.2 percent were obese. Again, while 16.1 percent were obese in 1999, 16.2 percent were so in 2004.

Similarly variable patterns that do not support the claim of an obesity epidemic are found in girls, aged 2-10. In 2003 12.5 percent were labeled obese compared with 11.9 percent in 2004 -- suggesting a most peculiar epidemic. Again, the percentage of overweight girls was 13.5 in 1999 but only 11.6 in 2000. Indeed, in their commentary on the survey, the authors note that the increase in mean BMI (Body Mass Index) for both boys and girls in England has not been statistically significant from 1995-2004. Similar findings were reported in a 2003 study which looked at changes in the BMI of adolescent British girls and found "no evidence of an increase in average BMI across the 10 year period of data collection..."

Second, not only is it not obvious -- from the government's own data -- that there is an epidemic of obesity amongst children aged 2-10, it is also not clear that overweight and obese children will, as the government claims, grow up to be overweight and obese adults.

For instance, in the Thousand Families Study (British Medical Journal -- "Implications of childhood obesity for adult health"), which has followed families in Newcastle since 1954, researchers found that there was "little tracking from childhood overweight to adulthood obesity." In the study almost 80 percent of obese 36-year-olds became obese as adults, not as children. As the lead researcher Charlotte Wright writes "... it has been clearly demonstrated in many studies, as well as our own, that most obese adults were not fat children, but this is not generally known and is rarely mentioned when childhood obesity is discussed."

Wright's findings are indeed confirmed in other research. For example Kenneth Ferraro, in a study published in the Journal of Gerontology ("The Life Course of Severe Obesity: Does Childhood Overweight Matter?") found that only children with BMI in excess of 35 were at risk for adult obesity. He also found that being overweight as a child resulted in lower adult mortality for women. Similar results were found by E.P. Whitlock et al who reported that the current evidence shows that a "substantial proportion of children under age 12 or 13, even with BMIs of >95th percentile, will not develop adult obesity" ("Pediatrics Screening and Interventions for Childhood Overweight"). And Serdula et al -- in an analysis that looked at 17 different studies on the question of whether obese children go on to become obese adults -- found that most children become thinner as they get older, not fatter.

Nor is it obvious that these overweight and obese children who carry their weight into adulthood will be unhealthy adults. As Wright noted about the Newcastle children, "We found no evidence that being a thin child is of long term health benefit. We thus argue that efforts to turn the tide of adult obesity will be misdirected if they are directed primarily at turning plump children into thin children." This is true because, as the definitive study from the U.S. Centers for Disease Control noted last year, the people with the best health and who live the longest are not those with so-called normal weights but those who are overweight. In fact according to that study about weight and mortality, normal weight individuals lived no longer than the mildly obese, something that has been repeatedly confirmed in other studies from around the world. Indeed, there is no compelling scientific evidence that supports the government's claim that childhood obesity results in long term health problems and lowers life expectancy.

Finally, despite the fact that Members of Parliament dismissed as "drivel" the worries about the damaging consequences of children being officially labeled as fat, the evidence suggests that these worries are real. The Society for Nutrition Education, for instance, in its "Guidelines for Childhood Obesity Prevention," warns against harping about childhood obesity or labeling children obese. It notes "This can contribute to fear, shame, disturbed eating, social discrimination, and size harassment."

A recent study in Pediatrics ("2000 Childhood Obesity and Self-Esteem") found that obese children had decreasing levels of self-esteem and "demonstrate significantly higher rates of sadness, loneliness, and nervousness and are more likely to engage in high-risk behaviours such as smoking or consuming alcohol." And a study published last year (Archives of Pediatric and Adolescent Medicine, "Associations of Body Mass Index and Perceived Weight With Suicide Ideation and Suicide Attempts Among US High School Students") that looked at 13,601 US students found that perceptions of being overweight were strongly correlated with adolescent suicide attempts. Again, in a study of US fifth and sixth grade children, researchers found an exceptionally strong bias against fat children, a bias that increased with age (Latner and Stunkard Obesity Research, 2003. "Getting Worse: The Stigmatization of Obese Children").

MPs might well dismiss such research as "drivel," but given that it more accurately reflects what many people, including children, think of the obese, one wonders why any responsible politician or civil servant would authorize a program of weighing school children that is certain to result in many being stigmatized as fat. All of this suggests that the Department of Health's plan for weighing UK children is not merely ill-conceived but lacking both a scientific and a moral foundation.

John Luik is writing a book about health policy.


1 Comment

Childhood Obesity
I'm a teacher in a large Canadian city. The provincial government--responsible for education--has decreed that next year ALL classroom teachers will provide 20 minutes of VIGOUROUS physical activity on each day that the kids aren't having gym or swimming. What an utter crock. Have the bureaucrats--wingbats--who came up with this hare-brained idea thought it through? (If their days were micro-managed by dolts, the way teachers' are these days, maybe they'd be more circumspect.) The logistics of this idiocy, space-wise alone, not to mention noise-, sweat- (no showers, in winter, sub zero outdoor temperatures, etc.), behaviour, etc.-wise are mind boggling.

I'm a literacy specialist who's already starved of quality instructional and student pracice time--hey, time, period--with my very challenged kids. I'm going to lose a further 60 MINUTES a week to carry out this pie-in-the-sky Ministry fantasy. (I think a lot of teachers will "run out of time" and not "get to this part of their day" more often than not.) I'm not a gym teacher or the parent of these kids: It's not my job to fill in the gap here. (Oh, yes, I'm required to EVALUATE the activity and provide feedback on the Ministry report card. 1984, anyone?)

If the Ministry's concerned about kids getting more physical activity, hire more gym teachers. I'm mad as hell.

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