Take away the junk or we take away your kids

It would be nice to think that last year’s case of eight-year-old Connor McCreaddie, who weighed over 14 stone and whose mother was threatened with having Connor placed on a child protection register, was an aberration. In today’s anti-obesity crusade, however, it appears that the state-sanctioned seizure of fat children from their parents’ care is becoming the norm.

The Scotsman reports this week that a Dundee family was told that three of their children (a 12-year-old boy weighing 16 stone, an 11-year-old girl weighing 12 stone, and a three-year-old girl weighing four stone) could be taken into care if they fail to lose weight over the next three months. According to the parents, child protection officers ordered them to send their children to dance and football lessons to lose weight, and warned that, eventually, all six of their children could be taken into care.

The suggestion is that parents are placing their children at risk by allowing them to be fat just as much as if they were providing their kids with alcohol, cigarettes or drugs. Last year, then secretary of state for health, Patricia Hewitt, justified the threat to remove Connor from his parents by arguing: ‘We have got a boy whose life and health have already been shockingly damaged because he is quite clearly eating the wrong food, and not able to take enough exercise.’

Is any of this true? Are fat kids shockingly damaging their health? Is it simply a matter of taking these children away from their parents, changing their diet, and increasing their amount of exercise before they become thin?

A resounding ‘no’ is the answer to all three questions. The health hysteria that has overtaken the government, the public health establishment and much of the media has obscured the facts about fat children. If one peaks behind the obesity crusade’s rhetoric, one finds little scientific support for any of these claims.

To begin with, the entire idea of fat children is more a cultural construct than a scientific one. A century ago, today’s penchant for thin children would have been considered a shocking instance of child neglect. The idea that children weighing over a certain amount are fat or obese has no scientific foundation, as the statistical dividing line between fat and normal is purely arbitrary. It represents nothing more than someone’s idea of where ‘normal’ ends and where ‘fat’ begins. So says the very someone who came up with the government’s numbers. ‘I’ve taken a graph and drawn a line on it’, says Tim Cole, professor of medical statistics at the Institute of Child Health. ‘The idea that these numbers are cast in stone is absolute nonsense.’

Furthermore, it is not at all clear that being a fat child carries significant health risks or increases one’s risk of being a fat adult. Dundee’s child protection service need look no farther afield than an Aberdeen study that looked at the health outcomes of children born in the 1950s. That study found that the body mass index (BMI) of children was not associated with increased risk for stroke and heart attack in later life.

There is also the study that has followed 1,000 Newcastle families since 1954 in an effort to track the effects of childhood obesity on adult health. The study found that there ‘was little tracking from childhood overweight to adulthood obesity’. Similarly, the best evidence indicates that a substantial proportion of children under age 12 or 13, even those with BMIs in the top five per cent for their age group, will not develop adult obesity.

Nor is it fair to say that these children are simply gluttonous. Data from the US, for example, has shown that fat children generally consume no more food, nor are less physically active, than those of normal weight. Multiple studies have failed to find a link in children between physical activity levels, food intake and obesity. A review of studies from France, the UK, Spain, Australia and the US concluded that there is little evidence to support a relationship between energy intake in children and their weight.

There is little evidence to support the cure proposed for the Dundee children, as it is not clear that increased physical activity actually prevents or reverses age-related weight gain. In fact, recent research suggests that physical activity in children is regulated biologically rather than environmentally. Regardless of how much physical activity schools provide to children, their overall activity levels are unchanged.

Blaming either these children or their parents for being fat contradicts much of the accumulating evidence on how small a contribution to obesity is made by the factors that anyone can control. For example, a new study found that environmental factors account for only 10 per cent of why a child is overweight or obese.

Once the obesity crusade’s veil of rhetoric is rent, it is clear that the state-sanctioned seizure of fat children is built on a scientific house of sand.

Patrick Basham and John Luik are co-authors, with Gio Gori, of Diet Nation: Exposing the Obesity Crusade, a Social Affairs Unit book. (Buy this book from Amazon(UK).)

Sources:

‘Your children are too fat. Either they lose weight or we’ll take them away’, Scotsman, 24 March 2008

‘Physical Activity in the Prevention of Obesity: Current Evidence and Research Issues’, L. DiPietro, Medicine and Science in Sports and Exercise (1999) 31.

‘Association of BMI and Obesity Measured in the Early Childhood with Risk of Coronary Heart Disease and Stroke in Middle Age’, D. Lawlor et al., Circulation (2005) 112.

‘Is Childhood Obesity Associated with High-fat Foods and Low Physical Activity?’,L. Meucke et al., Journal of School Health (1992) 62.

‘Nutrition’, M. Rolland-Cachera and F. Bellisle, in Child and Adolescent Obesity: Causes and Consequences, Prevention and Management, Cambridge: Cambridge University Press, 2002.

The Truth about Obesity, BBC News, 22 November 2007.

‘Evidence for a Strong Genetic Influence on Childhood Adiposity Despite the Force of the Obesogenic Environment’, J. Wardle, American Journal of Clinical Nutrition (2008) 87.

‘Screening and Interventions for Childhood Overweight’, E. Whitlock et al.,Pediatrics (2000) 105.

‘Variation in Physical Activity Lies with the Child, not His Environment’, T. Wilkin, International Journal of Obesity (2006) 30.

‘Implications of Childhood Obesity for Adult Health: Findings from Thousand Families Cohort Study’, C. Wright et al.,British Medical Journal (2201) 323.