Last November Sagicor published a photo in the Guardian of a young girl, as an ad for their long-term investment Education Plan for families. Presumably, the picture represented, at least in the minds of the advertising company, a healthy child. It was not. It was a photo of an obese nine or ten-year-old. It is simply stunning that nobody picked this up and the reason is that the overweight child is now considered the norm in T&T.
You see them everywhere except, of course, in the streets and parks. Walk into any mall, movie theatre or fast food place. Paediatricians have become accustomed to parents coming into their offices with fat children and expressing surprise that the kid is 20 pounds overweight. “He build just like his father!” And they are correct. Both overweight. But what did the father look like 30 years ago when he was ten? Overweight rates in children and adults have insidiously trebled since 2000 much to the delight of fast food corporations who look on with pleasure at the expanding faces, waistlines and of course, bank accounts.
Problem is, overweight is the underlying problem for non-communicable diseases. It’s the foundation on which diabetes and cardiovascular disease in adults are built. And the treatment of NCDs costs us just over $6 billion (TT) a year. One in every ten dollars government spends, is on treating the complications of overweight. Is that sustainable? And increasing.
What’s to be done? Obesity is a lifestyle disease. It begins in childhood. How many people are going to change their children’s lifestyle today to prevent diabetes in 30 years? Who thinks that far? This is a seven-day wonder country, at best, “nex year Carnival"! To complicate matters, overweight is almost untreatable. The only fairly successful treatment is surgery, essentially reducing the size of the stomach so the person simply cannot overeat. That treatment is reserved for morbidly obese adults or people with money.
In 2016 the American Academy of Child & Adolescent Psychiatry observed that: “Obesity in children is among the easiest medical condition to recognise but most difficult to treat.” It’s illustrative that that statement comes from a children’s psychiatric association. It shows that the treatment of obesity is not a simple matter of caloric intake and output, of food and exercise. Better clinical care of NCDs requires a focus on the social and psychological determinants of disease. Business lunches, personal ego, social media, advertisements, family habits, and tradition and how we were fed as children are some of the factors that play into the equation.
It’s now clear that weight control programmes do not work. They don’t work with adults. They don’t work with children. That was true a generation ago. It is true today despite all the three-month TV motivational programmes, complete with obsessive-compulsive trainers, highly skilled nutritionists and tailored dietary and exercise programmes run under the eye of the all-seeing television cameras and millions of couch potatoes urging the participants on. Within a year, it’s back to the old habits. The occasional success is held up as an example of discipline. Most successes are weirdos who depend on the admiration of others to maintain their egos.
Weight control programme teams for children, including paediatricians, nurse practitioners, dieticians, physical instructors, behavioural therapists, and social workers in addition to a motivational team of parents, caretakers, teachers, and policymakers have also failed, all over the globe, to make children lose weight.
Weight control programmes don’t work!
If the treatment does not work, the only solution is prevention.
Can overweight be prevented?
Yes, it can. Prevention is always better than cure. But it’s not sexy. It’s not immediate. It takes long. It requires foresight, maturity, confidence and a social and psychological milieu that rewards discipline. You think we have this in a country where obese people with diabetes refuse to go for a free flu vaccine and then complain when they get sick? And most people think that’s fine.