Obese children become paradoxical problem

Obese children become paradoxical problem

Posted: 18 August 2007

From The Age, 4 August 2007

By Jill Stark

It is a perverse paradox. Children starving themselves to death under the same roof as those who are eating their way to an early grave.

While the Royal Children's Hospital struggles to cope with rising admissions for anorexia, it is also dealing with unprecedented demand at its obesity management clinic.

Matt Sabin, one of the doctors who runs the outpatient service, says that 11-year-olds weighing 130 kilograms are common at the clinic.

"We used to see type 2 diabetes in overweight people in their 40s and 50s and now we're seeing it in children as young as 12," he says. "Even young children are showing high blood pressure and abnormal fat levels in their blood which are long-term risk factors for heart disease."

Dr Sabin cautions against a "knee-jerk reaction" to claims that a focus on obesity could be driving a rise in eating disorders. He says with clinic waiting lists of up to four months, the epidemic shows no signs of slowing.

"We're seeing considerably more patients than we've seen before. We have expanded the service, we're at full capacity, but there is no shortage of severely obese children who require intensive management," he says.

One of Australia's leading obesity experts, Deakin University Professor Boyd Swinburn, says the debate around weight is too important to shield from children.

"It's a bit like saying we shouldn't talk about sexuality with teenagers because then they just go off and get pregnant. We can't let the fear of creating disordered eating patterns paralyse us against doing anything. Childhood obesity is a very real problem," he says.

But there could be a common solution to problems: "If we can make healthier food available, if we can reduce the risk of kids gaining unhealthy weight, if there's more opportunity for physical activity, then there's every chance that you could deal with both of the issues."

While parents are often blamed for allowing children to become overweight, VicHealth researcher and nutritionist Dr Karen Campbell says many are simply unaware that their children are fat.

"Most parents don't worry that their children eat too much but that their children eat too little," she says.

Schools and sports clubs should also shoulder some of the responsibility for the "hidden calories" children consume daily.

Rick Kausman, a weight management specialist who is treating a rising number of teenagers distressed by their weight, blames a clash of cultures for the rise in disordered eating.

"We have a culture of less moving, lots of high-fat, high-sugar foods available and marketed at every opportunity, and at the same time the culture saying: 'Thinner, thinner, thinner', where it becomes almost impossible to feel settled and calm around food and eating," Dr Kausman said.

"Some kids respond to that by eating more high-fat, high-sugar foods and some say: 'I'd better restrict my intake or go on a diet', which significantly increases the change of developing an eating disorder."

Nutritionist Jenny O'Dea says being overweight or obese does not necessarily confer ill health. "If they're having a healthy diet, a bit of daily physical activity, no family health risk and a reasonably healthy lifestyle then they are simply fat," she says.

"We have to stop telling people that their life is over until they lose weight. It's a ridiculous, nasty, pernicious, unhelpful message and we need to stop being prejudiced against fat people and fat kids."