Is Childhood Obesity A Form Of Neglect?

I found this video to be quite confronting, but I also thought that it was highly effective at promoting the importance of childhood health and nutrition. 

It reminded me of an article I wrote last year on a blog for university. The article received quite a bit of attention and was even tweeted by The Biggest Loser Trainers Michelle Bridges and Commando Steve!

I have attached the article below. This was written in March 2013, so please ignore any older references. I have not edited the article from the publishing last year. My views now are quite similar to what I wrote last year. The answer lies in better nutrition education for both the parent and child. I'm always keen to hear people's thoughts and opinions on matters like this, so feel free to leave a comment or connect via social media.

 

Feeding The Biggest Loser.

I noticed that a new season of The Biggest Loser is currently being promoted on Channel 10. This season is titled “The Next Generation” and features both an overweight parent and child working together to lose weight. I have never been a follower of the show previously, but seeing the promotion for this years season raised a question for me. Is obesity a form of child neglect? And more importantly, why does it happen?

I realise this is a deep and multi-faceted topic, and a complete discussion would require input from experts in the Child Welfare, Nutrition and Dietetics, Exercise Science and Medical fields to name a few. However, it is a well-established and recognised fact that obesity has deleterious health effects and is linked to a broad range of disease states causing reduced life expectancy.

Parents have a responsibility to ensure their child’s health, but have obese children been neglected of this? To a degree, I would say yes. This is due to the fact that obesity is linked to so many disease states and is reasonably easy to detect based on appearance, weight and body mass index. If a parent feeds their a poor diet and does not promote sufficient physical activity, their child’s health is being neglected.

Obviously no loving parent intentionally puts their child at risk, so the question that needs to be answered is why does this occur?

Weight gain and loss is often broken down into an oversimplified equation: energy in (food) – energy out (physical activity) = energy balance ( + or -). Positive energy balance leads to weight gain and negative balance leads to weight loss. While the theory of this equation is logical, its application to real life is rather difficult, and often this isn’t considered when explaining it to people.

In 2012, during a Health, Disease and Exercise tutorial at UC, I took part in an Energy Expenditure session, where I completed a 30 minute continuous resistance training circuit. Three methods were used to calculated my energy expenditure; accelerometry, heat sensing technology and traditional equations. All three methods returned vastly different estimates for my expenditure. If we couldn’t get accurate estimates in a controlled sports science lab, I see how difficult it may be for a parent to estimate their child’s energy expenditure and its contribution to energy balance.

If a child is engaging in regular physical activity, whether it is playing organised sport or incidental activities, their requirements for exercise will likely be met. Most children are generally live a fairly active lifestyle anyway, so neglecting a child’s physical activity requirements would not be my primary concern.

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Diet now becomes the focus. The benefit of monitoring a diet is that kilojoule and nutrient content is available on all food items in Australia, so unlike physical activity, it is much easier to monitor intake. The irony is that they are often overlooked so high kilojoule and low nutrient density foods are overrepresented in too many diets. Fast food and highly processed snacks provide too many kilojoules from carbohydrate and fats while lacking key micronutrients. Soft drinks also contain an alarming sugar content, particularly for young children. Excessive intake of these foods without an increase in physical activity will lead to weight gain and potential obesity.

I don’t think public education is the key to reducing obesity. The 30 minutes of exercise, aiming for 2 fruit and 5 vegetable servings per day and many other healthy living messages are well known by most people. In fact, I think most people could tell you exactly where they could improve their diet but often have excuses as to why they don’t do these things (time, cost, convenience, etc).

A primary reason that parents might overlook their obese child’s condition is that many symptoms do not appear until later life. An obese child won’t have a heart attack while they are young, instead this may strike later in life.

These delayed symptoms give a parent the impression that their child is fine, as they are not demonstrating visible problems. If no symptoms are present, there is no immediate parental feeling to need to intervene. This can continue to develop until the child becomes severely obese and may begin to develop debilitating symptoms requiring more urgent medical intervention. The child’s quality of life may also be impaired.

I certainly don’t think that all parents with obese children are terrible and neglectful parents who should not be allowed to care for children. The main point I want to make is that obesity is well known and preventable health condition and that parents play a role in its development in their children. The importance of a parents role in avoiding obesity should also be emphasised, and treatment of obesity should be like any other medical condition children encounter during their development. I think that this topic should be discussed in the public domain and I would be very interested to read other peoples opinions.

I have attached an interesting article from Time magazine that discusses this very topic, and mentions a British Medical Journal study that states overweight children in foster care do not lose weight significantly faster than other children. There is also a link to a report on ABC’s 7:30 program from last year which I thought to be relevant.

Time Magazine: http://healthland.time.com/2010/07/16/is-childhood-obesity-a-symptom-of-neglect/

The Biggest Loser 2013: http://thebiggestloser.com.au/

7:30 ABC: http://www.abc.net.au/7.30/content/2012/s3544886.htm