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Put families at heart of helping obese children

Doctors and social care must address the obesity ‘time bomb’

Louise Prime

Wednesday, 23 October 2013

Families should be at the heart of tackling the problem of obesity in children and young people, NICE said this morning. It said that parents and carers should be helped to recognise that their child is overweight or obese and the importance of addressing the problem.

In its new guidance, the National Institute for Health and Care Excellence urges health professionals – as well as local authorities and providers of community-based lifestyle weight management services – “to do more to help families address the obesity time-bomb in children and young people” and ensure that they understand the challenges faced by families of overweight children in their area.

It recommends that they should encourage overweight children’s parents and carers to help children to change their behaviour, and promote lifestyle weight management programmes that focus on making long-term behavioural changes.

But NICE also points out the importance of helping parents to recognise in the first place that their child is overweight or obese, and how addressing their weight will bring benefits. Overall, about 30% of 2-15 year olds are now overweight or obese; in the 2011-12 school year, about 23% of children in reception and 34% of those in year 6 were either overweight or obese. And few children grow out of it – 79% of early teens who are obese remain so as adults. This puts them at considerably raised risk of type 2 diabetes, as well as at greater risk of other problems including coronary heart disease, asthma and sleep apnoea.

NICE says lifestyle weight management programmes should include certain ‘core components’, including:

  • behaviour-change techniques to increase motivation and confidence in the ability to change, including strategies to help the family implement and sustain changes at home
  • positive parenting skills training, including problem-solving skills, to support changes in behaviour
  • an emphasis on the importance of encouraging all family members to eat healthily and to be physically active, regardless of their weight
  • a tailored, individual plan appropriate to the child’s age, sex, ethnicity, cultural background, economic and family circumstances, any special needs and how obese or overweight they are
  • help to master skills in, for example, how to interpret nutritional labelling and how to modify culturally appropriate recipes on a budget
  • help to identify opportunities to become less sedentary and to build activity that children enjoy (such as games, dancing and aerobics) into their daily life.

Professor Mike Kelly, director of NICE’s centre for public health, said: “Parents should not have to face the challenge of obesity on their own … Local commissioners – including local authorities – need to make sure that the right services are available when families need them. They also need to be convenient and easy to access – so parents and their children can stick with them.”

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