Wednesday, 31 August 2016

UK Childhood Obesity Plan - A Bit Thin?

The UK Government has recently published its long-awaited Childhood Obesity Strategy. It’s unusual for a policy document because it’s very short and to the point. It explains concisely what is planned to be done to combat the very real health threat emerging from young people being overweight and obese – this puts them at risk of Type 2 diabetes, cardiovascular disease and many other conditions. It has even been said (although not in the strategy) that this generation of young people may even be at risk of dying before their parents, due to the health risks of overweight, obesity and inactivity. A very serious situation

The overall target stated in the strategy is to reduce ‘significantly’ the number of obese children by 2020. It doesn’t explicitly state what ‘significantly’ means in actual numbers, however it does say, close to the start of the strategy, that the publication of this ‘plan for action’ represents the beginning of a conversation, rather than the final word. This must mean that further details will follow

So, what does this ‘conversation opener’ include? A number of high profile plans, some of which have been the matter of discussion in the press for many months, namely:

A tax on soft, sugary drinks – due for legislation in February 2017. Interestingly, the policy seems to suggest this will not be paid by consumers, but by producers and importers;

A 20% reduction in the sugar content of the 9 highest consumed products by children – including yoghurt, cereal and sweet spreads. This is an initial list of products, more will apparently, follow later;

Helping all children have an hour of physical activity every day. This intention includes working with schools to identify key times of inactivity and work on making them more active. Schools will be responsible for providing at least 30 minutes of activity, parents and carers the other 30 minutes;

Other aims include focusing on healthy school meals, providing breakfast clubs and making the contents of vending machines healthier, thereby creating a healthy eating environment wherever young people are

So far, so good. These are all admirable plans and there is some degree of joined up working between, for example, schools, the Department of Health, Public Health and private companies, such as leisure centres. We wish these initiatives well, as every step definitely matters

However, we’re concerned about aspects that aren’t on the list – perhaps yet, we hope. Here’s our wish list for additions:

Something more than acknowledgement that eating behaviour arises not just from the amount and content of food provided, but from an emotional context, too. Children learn their eating habits from their early experiences, and food is often used as a surrogate for expressing emotions within families. Sadly, too, food can become a comfort for children who aren’t experiencing unconditional love and nurturing that plays an important part in shaping their view of themselves, others and the world. The strategy says nothing about the psychology of eating in young people who are overweight and obese, choosing instead to focus on equalizing the energy in/out balance to gain a healthy weight;

An emphasis on how young people can identify the link between their eating and their feelings and get help, both emotionally and physically. True, the NHS is mentioned, particularly the role of health visitors and school nurses in helping families to start good habits early. However, mention of skills training in dealing with ‘difficult conversations’ seems to be limited (perhaps to online courses?) and reviewing the content of existing materials, plus bigging up the ‘making every contact count’ initiative. NHS professionals are urged to ask families about eating behaviours at every opportunity, which could become counter productive if people feel ‘nagged’, or more importantly, if there is insufficient time, insight or skills to deal with the ‘difficult’ answers they might give;.

More focused, detailed training and a proper resource list of emotional and psychological support for eating behaviours – which could be for families as well as individual young people, not to mention health professionals themselves – would be very helpful. This could include mental health, eating disorder and young peoples’ charities, as well as statutory agencies;

Finally, what of the money that will be raised through the ‘soft drinks industry levy’ – known popularly as the ‘sugar tax’? Most of it seems to be committed to schools, with increase in the primary PE and sport premium and the investment in breakfast clubs. Could some of it be used for wider support as we have suggested? Schools are important, but not more important than families and emotional health for the future. Wider application of the finances raised is much needed. A further question is what happens when the money runs out? Is there a longer term plan to maintain these young peoples’ health throughout their lives?

Since schools are so much mentioned in the policies, and there is much to commend the efforts it describes, we’d offer the Government 7/10 so far….but wait expectantly to see if their plans for reducing weight will be fattened up

HM Government. Childhood Obesity: A Plan for Action. London 2016

1 comment:

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