Writes Professor Donal O' Shea, Consultant Endocrinologist and Physician, St Vincent's University Hospital and St Columcilles Hospital
After 20 years involved in the treatment of obesity in adults, I am more convinced than ever that the majority of the effort in the obesity area needs to focus on preventing the current generation of babies becoming overweight and obese adolescents. Next week, I will have the chance to address delegations from the Departments of Health in the EU. I will be making this point as plainly as I can to the Ministers for Health themselves – many of whom will be present.
Having returned to Ireland in the 1990s, I sought in vain over five years to bring this issue to the attention of the authorities and to explain my views on the seriousness of obesity. Therefore, the opportunity being afforded to me at this informal Ministerial meeting is one I want to maximise.
Obesity related illnesses now claim at least more than at 5 times the number of lives lost to suicide and road traffic accidents combined.
The opening 3 hours of Monday’s session is being dedicated to the issue of Childhood Obesity. I consider this an acknowledgement that childhood obesity is now amongst the biggest challenges - if not the biggest - to the future health and economy of the developed world. The statistics are stark - we know enough. We know that 25% of children are overweight or obese in most EU member states with socio-economic separation apparent at least as early as 3 years of age. We know that childhood weight tracks strongly to adulthood with an obese 12 year old having an 82% likelihood of being an obese adult and we know that the younger a child gains weight, the bigger their final adult weight will be. We don’t need anymore “knows”.
It is now established and not the subject of dispute that obesity in adulthood drives the development and worsens the outcome of chronic diseases including cancer, type 2 diabetes and dementia. Obesity-related illnesses now claim at least more than 5 times the number of lives lost to suicide and road traffic accidents combined. In terms of health costs death is relatively cheap, it is the years with chronic illness and disability that are already crippling our health economics. Up to 80% of this illness burden is preventable primarily through a physically active and healthy eating lifestyle.
A normal weight, physically active child carries the minimum risk into adulthood of developing lifestyle-related diseases. As the vast majority of children do not smoke or consume alcohol, this allows a targeted focus on healthy eating and active living - the main modifiable determinants of weight - for this group.
The concept that individual responsibility is the main key to reversing this epidemic is simply too simple – and in children does not apply at all. When it comes to children their job is to be irresponsible – certainly up to the age of 12. Individual responsibility is of course a factor, but an individual cannot totally influence the activity environment, food production, labelling and marketing alone. These are areas that can only be influenced by a co-ordinated ‘multi-stakeholder’ approach. The capacity to address these determinants of childhood weight lie at a societal level.
This is the first time the EU will have officially devoted a large part of a health programme to childhood obesity and is a very important step. My hope for the informal meeting next week in Dublin Castle is that the Ministers and their officials will see fit to place the issue of childhood obesity as a major theme in health promotion across the EU. This will involve a commitment to targeted education in areas for individual responsibility and focussed regulation (with legislation where needed) around the areas that are outside of individual control. Minister Reilly’s decision to establish a special action group on obesity when he took office has given some momentum back to the battle against childhood obesity in Ireland. This is reflected in the priority being given to it at this meeting and is the most positive step in the fight against obesity since the taskforce was set up in 2004. The pace of progress since then has been painfully slow for many reasons. This meeting needs to be a wake-up call for not just Ireland but the EU. We know the statistics, we know where they are leading – we know enough to act now with renewed urgency.
As published in the Sunday Business Post on the 3rd March 2013.