Sunday, 28 April 2019

In denial about childhood 'obesity'

The European Congress on Obesity kicks off today. It traditionally produces plenty of media-friendly stories based on unpublished research and eccentric opinions. Last year, for example, one of the speakers recommended that fat people be allowed to start work later than everybody else. It also produces a reliable stream of unreliable obesity forecasts.

The first big press release for this year's event led to news stories like this...

Parents are 'in denial' over childhood obesity with 54% underestimating how overweight their boys and girls are

Scientists have accused parents of being 'in denial' over their child's obesity as fresh evidence suggests that more than half underestimate their offspring's weight issues.

But doctors and even the child itself are also guilty of misjudging whether they are overweight, the research found.

This is not really news. You can find similar results if you dig into the tables of the Health Survey for England. If you ask the mothers of 'obese' children, 47 per cent of them will tell you that they are 'about the right weight'. This rises to a whopping 90 per cent when it comes to children who are classified as 'overweight'.

The figures are similar for fathers. Only 46 per cent of them think their 'obese' children are 'too heavy' and only 13 per cent believe that their 'overweight' child is overweight.

The Health Survey for England doesn't ask children for their opinion but it used to. And, when it did, it found that only around a third of 'obese' kids thought that they were too heavy and only 15 per cent of 'overweight' kids thought they were overweight.

We are supposed to believe that all these parents and children are deluded. Even doctors, it seems, cannot identify an obese child. Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, says:

'This study shows how underestimation is prevalent across the board - including amongst healthcare professionals - and highlights the importance of taking accurate measurements, so that appropriate and consistent interventions can be implemented to support a child to lose weight and live a healthier lifestyle.'

But it's not a question of taking 'accurate measurements'. The question is about how those measurements are used. As I have explained time and again, the justification for setting the threshold for child obesity at the 98th percentile is very shaky. The justification for dropping it to the 95th percentile when gathering national statistics is non-existent. It creates millions of false positives.

Parents and doctors have an advantage over researchers who only look at obesity through spreadsheets. They have actually seen these children in the flesh and there is a simple reason why they do not think that many of them are obese. It's because they are not obese.

The facts that healthcare professionals would not diagnose large numbers of 'obese' kids as obese is a giveaway. You can imagine some parents having a rose-tinted view of their children, but not clinicians. Doctors use the 98th percentile because that is the clinical definition. The people at the European Congress on Obesity use the 95th percentile, presumably because it produces a bigger number. They also use the truly ludicrous 85th percentile to define 'overweight'. Neither measure has any scientific credibility.

It is a sham and these people have got some nerve accusing parents and clinicians of being 'in denial' when all they are doing is seeing things as they are.

Tam Fry, chairman of the National Obesity Forum, said: 'Millions of parents are in denial about their own and their children's weight and they are doing their kids no favours at all since, as the researchers point out, they are denied the help to prevent them spiralling into becoming seriously overweight or obese.'

There's only one group of people who are in denial here, Mr Fry.

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