We all have a duty of care to fight obesity

Childhood obesity is everybody’s business. It is a problem seen daily by doctors in surgeries and clinics, and is one of those areas where a marriage of health, social care, education and leisure services is central to the success of tackling the problem.

The facts speak for themselves. We have good data both from the National Child Measurement Programme and the National Obesity Observatory on the way the problem is intensifying: 28 per cent of those aged two to 10 in England are overweight or obese; this rises to 34 per cent among 11- to 15-year-olds. We are already seeing the results of this in greater demands on health services, growing levels of type 2 diabetes and high blood pressure and, in the case of adults, lost productivity through time off work.

Children of all ages are exposed to a large amount of unhealthy food and drink advertising. This is made worse by the endorsement of fizzy drinks and fast-food outlets by major sporting figures such as David Beckham, and by the kind of sponsorship that has underpinned the London Olympics. Research suggests that young children in particular are unable to distinguish between ads and other television content. The result is that these products are normalised, so they become part of their mainstream diet. It is within this context that moves such as the 2007 restrictions on “junk food” advertising during children’s programmes were introduced. This, however, represents a small drop in the ocean, although it is at least an explicit recognition in policy terms of “pester power”. Indeed, broadcast regulator Ofcom found that these restrictions reduced younger children’s exposure to such advertising by only 37 per cent, and for older children (10- to 15-year-olds) by just 22 per cent. Only a ban on junk-food advertising before the nine o’clock watershed would prevent children from viewing unhealthy content during family-oriented programmes.

As with alcohol and drug abuse, there needs to be intervention at a national and governmental level to constrain advertising, monitor supermarkets and regulate the food and drinks industries. It is totally unrealistic to expect self-regulation. You only need to look at the ill-fated efforts of the Portman Group to promote the responsible marketing of alcohol from within the industry to realise how little effect such self-policing really has.

But there is much more that health and social care can do jointly. This is why the Royal College of Paediatrics and Child Health is part of a campaign involving other health professionals. The campaign has received written evidence from a range of stakeholders – from the Design Council and British Retail Consortium to Weight Watchers and the National Institute for Health and Clinical Excellence. It has run a series of oral evidence sessions and public and patient questionnaires.

Local services now have a major role to play on three fronts. First, the new Health and Social Care Act creates extra opportunities for social care and children’s services to address obesity. Undoubtedly, there will be a vital role for the health and wellbeing boards as the public health aspects of obesity pass back into local authority control. On the one hand, there are understandable nerves that with the thumbscrews applied to local authority budgets, what qualifies as “public health” may become extremely fuzzy. However, the move over to local authorities might present opportunities for genuine co-operation between education, social care and those leisure facilities that local authorities still run.

Second, there is also a vital part to be played by social care settings. So ensuring high nutritional standards in family centres, nurseries, residential and daycare settings is essential – not just providing good food, but also educating users with nutritional advice.

Third is the specific role local authorities and voluntary organisations play in relation to their looked-after population of young people. All providers have a responsibility to work with foster carers, potential adoptive parents and those who provide food to young people to ensure that the important lessons of good nutrition are clearly conveyed. Taking on corporate parenthood also means a duty of care towards the growing dangers of obesity.

Chris Hanvey is chief executive of the Royal College of Paediatrics and Child Health