Why it’s a parent’s duty to tell their child they’re FAT

From a top obesity expert, an uncompromising warning

THE situation is as commonplace as it is frustrating. At 5ft tall, Josh weighs a hefty 15st and wheezes as he moves. Shockingly, he is only 12. Already his weight has resulted in the kind of bullying that makes him skip school. He has become quiet and withdrawn, rarely venturing from his shell.

There’s no denying the devastating impact of obesity on Josh’s childhood — not to mention his future. Yet his mother, who is also seriously obese, is adamant that her son eats ‘healthily’ and that his imposing frame ‘isn’t a problem’.

Here we have a classic case of parental denial. And as the head of a weight management centre in London, I — along with my colleagues — see hundreds of such deluded families every week.

In this case, no one has faced up to the fact that Josh is fat. No one dares use that ‘F’ word any more. Parents can’t say it, health professionals can’t say it, teachers most definitely can’t say it. But, I think it’s time we all did.

In the UK, a third of children are overweight or obese — another banned term. In some inner cities, this rises to almost 50 per cent. By cloaking the problem in evasive language, we are failing these children. We need to jolt parents into action — and bald terms help with this.

Many fail to acknowledge their child is overweight in the first place: ‘It’s just a bit of puppy fat, right?’ Wrong. Puppy fat belongs on puppies. If you tell parents their child is ‘clinically obese’, they’re more likely to take the problem seriously.

A further hurdle is that even when parents are made aware of their child’s weight, some fail to see it as an issue.

We’re encouraged to think ‘as long as he’s happy’; there’s even the cliche ‘fat and happy’ to back this up.

But these parents are refusing to face up to the enormous health and quality of life challenges that the child will face over time — particularly with puberty and all the emotions that brings.

What’s worse is that the government colludes in our sensitivity to the issue. As part of the National Child Measurement Programme (NCMP), all children across the country are weighed at the age of five and then again at ten — unless their parents opt out (about 6 per cent refuse to take part).

The school nurses who take the measurements indicate it is often the heaviest children whose parents are opting out — but we are too politically correct to even gather robust data in order to fix the problem.

EVEN in t he offi cial letters we send out to warn of obesity, we’re not allowed to use that word because it’s considered too emotive. Instead, schools notify parents their children are ‘ overweight’ or ‘very overweight’. They will then be invited to bring the child to a weight management clinic like ours.

As an independent organisation commissioned by health service professionals, we offer onetoone counselling and healthy eating advice to obese young people.

Our programme is successful for the 90 per cent of children who complete it. But such is our collective denial that of the several thousand NCMP letters we might send out, typically only 20 parents will put their children on the programme.

And about ten will phone my office to hurl abuse: ‘ How dare you call my child fat?’

Why such hostility to something that will help their family and may make the difference of a lifetime to their child? It’s something I’ll never understand.

People complain that calling a child ‘fat’ or ‘ obese’ stigmatises them, but this is nonsense. It’s not the labelling that stigmatises the child, it’s being overweight that sets them apart. Society judges the obese very harshly.

I’ve been working with families of obese children for 20 years. And I have to say I think we are no nearer coming to terms with the problem, either as individuals or as a society.

Some put the child obesity epidemic down to an increasing lack of discipline: modern parents are more likely to give in to requests for sweet snacks and fast food.

People of my generation (fiftysomethings) remember that if we turned down healthy food, we would be offered no alternatives and would go to bed hungry. We learned to like the stews, the greens and the porridge because they were infinitely preferable to a growling, empty stomach.

This is inconceivable now. Many parents today will supplant the r ej ected f ood with a crisp sandwich or somet hing equally appealing to a child’s palate, thinking ‘ at least he’s eating’.

But it’s also worth noting that when I was a child, there wasn’t the huge array of unhealthy foods on offer.

Today we have less time, more stress and it is considered unsafe if kids stray beyond their garden fence, let alone spend the day outside, burning off energy gallivanting around as we would have done.

What I do know is that nourishing a child is the most important job any of us will ever do. That’s what we’re here for, after all. Healthy eating habits start with babies. I know only too well how tough it can be, but you have to push on through. Acknowledging that it will be tricky is the first step.

The elder of my two children, Sophie, is nine. When she was a tiny baby we’d just liquidise whatever we were eating — fish, olives, liver — and she’d wolf it down.

I’d wonder what all the fuss was about because it all seemed so easy. Then Sophie turned 14 months and started spitting out her usual food. Sound familiar? The key is to understand that this period will be difficult, and all children go through it. But by the age of three or four, they will start to grow out of it — but not if they are allowed to stay in their sugarcoated worlds. However stressed or lacking in time we are, there’s no good outcome from taking the line of least resistance. If you pander to a ‘fussy eater’ you are handing the child instant power.

It’s the first thing children learn: in an environment where everything is decided for them, the one thing they can control is what they put in their mouths. But you have to resist the urge to appease them. Otherwise you will have to win the power back, which is far more difficult. Our weight man agement programme starts at 24 months, and frankly I’d start earlier if we had the chance. We are now inclined to work with midwives to try to get the message across before birth.

It is very sad to witness obese toddlers already lagging behind their peers as they lose the coordination, balance, motor skills, fitness and confidence to develop and prepare them for a physically active and fulfilling life.

AS FOR older children, most people are surprised to know that a six year old with arms aloft should expose ribs front and rear.

This would be typical of a child on the 50th centile (ie average) of the growth charts with a healthy body mass index (BMI) of around 15 (at which point an adult would probably perish). The point being that children are designed to be lean.

When we see overweight children of this age, you’ll always get more truth from them than their parents, because they have no notion of the stigma of being overweight.

Ask their mother or father why this child is fat and they’ll shrug and say they don’t know, or blame school lunches, or their friends — anyone except themselves.

Ask the child and they’ll tell you it’s because they eat too many sweets or drink too much cola.

Our job is to teach families that it’s not too late. Although the earlier the intervention the better — when children reach their early teens, it’s far harder for parents to have an impact on their diet.

The body does not handle continued weightgain well and, as fat accumulates, it overspills from the safe confines of the fat cell and infiltrates organs, causing longterm consequences.

That’s not to mention the psychological impact. One 14yearold girl I work with recently tried to take her life due to her weight. At 152kg (23.9st), Louise is three times as heavy as a normal weight 14yearold of the same height.

She is confined to her bedroom, living her life through social media channels and pretending to be someone else because she is so ashamed of her body. She is on antidepressant medication and is waiting for bariatric surgery.

With few friends, constant taunting and ridicule, zero motivation to be successful in a career and a near pathological fear and loathing of boys, she is in a very dark place.

Louise has been overweight from the age of two and the root cause is the same as in pretty much all instances of child obesity that I see: overfeeding by the parents.

It’s not necessarily that such parents care any less; they don’t understand the likely consequences.

Tragically, Louise blames herself for her own predicament, exacerbating her chronic low selfesteem. And she is not alone; my organisation works with many children like her, week in week out.

I believe if parents could see the distress and abject misery that awaits most obese children when they reach puberty, they would do things differently.

So, think of your own child and make sure they have a better chance than Louise. Don’t be fearful of fat; tackle it head on.

AlAn JACKson is the lead practitioner and researcher for Weight Management Centre in london and Discovery learning (www.discovery.uk.com).