Limited success tackling childhood obesity
LETICIA Martinez Gaytán’s life changed dramatically eight years ago when her parents separated. She gradually gained weight, eating to cope with her emotions. In January, at 15, she was admitted to a childhood obesity clinic, classified as morbidly obese.
“I used to come home from school, eat and go to sleep – no exercise,” the friendly teenager told Health-e News last month from her home in Mexico City.
“I ate because I felt bad. I suffered when my father went away.”
Mexico has some of the world’s highest obesity rates and experts warn South Africa is headed the same way if urgent action is not taken.
A report released by the UN in April found that 74% of women and 70% of men were overweight or obese in Mexico.
In South Africa, two-thirds of women are overweight or obese, as are a third of men, according to the latest demographics and health survey.
Dr Jesus Felipe Gonzalez, director-general at the Mexican Health Ministry, said that in his country one in three preschoolers, schoolchildren and adolescents was overweight or obese.
He said the obesity crisis, which was the main contributor to soaring diabetes rates, emerged from a decades-long trend towards “unhealthy lifestyles and eating habits” as well as a sedentary culture in which exercise was not prioritised.
One innovative solution Mexico has come up with to deal with the situation is to establish a childhood obesity clinic because “early intervention” can deliver the best results, according to the clinic’s Dr Salvador Villalpando.
The clinic, called Hospital Infantil de Mexico Clinic, in Mexico City, admits about 300 patients a year between six and 16. Each receives individual intervention over six months, including diet and exercise plans.
Mental health is also an important factor. Children receive therapy from the facility’s psychologist.
A relative is mandated to come with because entire households might have to change their eating habits to ensure the success of a child’s treatment.
“We have kids who eat because they are anxious or their parents don’t pay them attention. If we don’t work on all these problems, the child can’t stick to the treatment,” said Villalpando.
The clinic is partly financed by the government to allow low-income children access, often the most vulnerable, but patients are still expected to pay about half of their consulting fees.
Even with all these targeted interventions and specialised resources, Villalpando said there was only a 30% success rate after six months – defined as patients achieving the goals agreed with a team of health workers.
“We’ve been going for 14 years and the success rate has improved drastically, but there is still a 70% failure rate. Obesity is such a complex problem, which is why prevention is so important,” he said.
Whether it is a cost-effective model other developing countries like South Africa can follow is unclear, but Villalpando said research was being finalised and the outcome would be published this year.
Gaytán has dropped from 87kg to 76kg by sticking to a healthy eating plan, dancing and taking swimming classes, as well as drinking water instead of fizzy drinks every day.
In 2014 Mexico introduced a 10% tax on sugary beverages, similar to the tax being debated in South Africa, and within two years sales of these drinks dropped by almost an equivalent 10%.
Parliament’s standing committee on finance has just voted for the bill to progress to the National Assembly. The legislation is expected to be introduced next year, despite heavy opposition from the beverages industry.
Besides not drinking fizzy drinks and juice, which are high in sugar and low in nutrition, Gaytán’s goal is to lose more weight gradually by sticking to her new lifestyle and routines.
But her self-proclaimed “outgoing” nature might be a crucial reason for her success.
For Gaytán, eating out with friends is not a problem because “I’m not shy”, she said.
Teresa Siliceo Bernardi, who heads the clinic, said bullying was also a major factor in childhood obesity, but, through sessions with the facility’s psychologist, youngsters could develop coping skills.
That’s something Gaytán said she had down to a fine art.
She said: “There are some people who say I’m ugly and fat, but I usually just say something sarcastic back and that shuts them up.” – Health-e News