Listen to the article.

Childhood obesity is a growing global health crisis. What is causing it? What are factors driving the rise of childhood obesity? What are the immediate, medium, and long-term consequences? What can be done to first stop the rate of obesity increasing and then to help return our young citizens to a healthy weight? 

The scale of the problem

By the time they start reception classes (age four to five years), just under 10% of UK children are overweight or obese. Forward wind six years, and 23% of 10 to 11-year-olds in the UK carry too much body fat. With age, the problem continues to grow (please excuse the pun); 64% of UK adults are currently overweight or obese. 

In 2021, the Royal Society for Public Health (RSPH) found that childhood obesity was costing the UK around £4,200,000,000, or 2.5% of the NHS yearly budget. The problem is expected to expand to £10,000,000,000 by 2050.

That’s just in the UK. We could take almost any developed country and show similarly alarming figures. Childhood obesity has swollen into a major world health problem. The causes are multi-factorial, and the consequences are multi-generational. 

Large numbers of our children are eating themselves to illness and a premature death, one bite at a time. 

What causes childhood obesity?

The simple answer is: eating too much, eating the wrong ‘foods,’ and getting too little exercise. 

Let’s flesh out the detail.

• Energy consumption. Children who consume more energy than they expend over the long haul will become overweight, then obese, then morbidly obese. The more processed foods, the more sugary drinks, and the more high-fat content a child consumes, the more likely they are to be obese and to develop life-threatening and life-long illnesses.
• Nutritionally deficient “foods”. If children are not provided with a diet with sufficient nutrients and minerals, they will tend to be driven to eat more in an unconscious attempt to feed their bodies what they need.
• Too much food. When children eat too much food, even if it is nutritionally sound, they will become overweight and eventually obese, or worse.
• “Immobility causes morbidity.” There are few health professionals who do not know that phrase: “Immobility causes morbidity.” Why? Because it is true. Health thinkers have known for millennia that lack of movement is very harmful to health. Currently we have a greater understanding of the reasons, but even today, the precise biochemical mechanisms that cause our health to deteriorate with lack of mobility are still not fully understood. Understanding or not, we know that children who move least are the most likely to be obese and suffer serious health problems.
• Sedentary lifestyle. It may be that as the population as a whole has an increasing sedentary lifestyle, children too are spending large amounts of time in front of screens and, as such, move much less than previous generations.
• Exercise facilities. In the UK, many schools no longer have proper exercise and physical education facilities. Some local areas have limited exercise options and few green spaces or playgrounds. Both of those factors contribute to reduced childhood mobility and therefore increased childhood obesity.
• Social and economic factors, too, play a part. When parents have limited knowledge of healthy eating, are themselves obese, or do not have the funds to provide their children with a healthy, balanced diet, it is more likely that those children will be obese. Poor communication, inadequate social skills, poverty, and problematic emotional and physical health in parent are strongly linked to childhood obesity. It could be that the stress created by such adverse social environments also leads children to eat more, or eat more unhealthily, as “comfort food”.
• Genetic factors. These are often blamed for childhood obesity. Alas, while that is convenient and makes obese people feel “It is not my fault,” it is, alas, not the whole picture. Genetics can make people more susceptible to becoming obese, but that susceptibility only becomes reality if they also eat too much and don’t get enough exercise and do both over a prolonged period.
• Belief structure. Children tend to pick up the belief structure of their parents and peers. If the belief structure is obesogenic, then it is nearly inevitable they will become obese. For more information on the role of beliefs in diet, see The Belief Diet.
• Influence and persuasion. Every day, children are subjected to around 15 advertising events for food, drink, and snacks. Many of those are for high-sugar, high-fat, ultra-processed “substances” that no health-conscious adult would want anything to do with.
• Poor parental role models for food and eating habits. If a child grows up in a household with negative role models, their chances of becoming obese are much higher. How do such poor role models behave? They are themselves obese. They have no or limited healthy eating awareness. They take no or little self-responsibility for healthy eating. Their children have easy and instant access to high taste, high calorie but low-nutrition substances (“foods”), any time they wish. In such an environment, childhood obesity is nearly inevitable.
• Education. In educational settings where physical exercise is not encouraged, possible, or valued, obesity is much more likely. The policies of any given school regarding food availability and the types of edibles available can also impact childhood obesity.

What is the health impact of childhood obesity?

Childhood obesity has a negative impact on both physical and mental health.

The same physical consequences that await many obese adults can and do also afflict obese children. Such as type 2 diabetes mellitus, cardiac disease, high blood pressure, stroke, and certain types of cancer. Childhood obesity leads to a higher incidence of the following cancers, each of which is related to eating habits: stomach, kidney, liver, colorectal, gall bladder, pancreas, and oesophageal. 

Childhood obesity can also cause sleep apnoea, which disrupts sleep. Sleep disruption is known to cause a wide range of health problems, not least of which is depression. 

Joints and bones of obese children are also damaged. They are more likely to develop skeletal misalignment, such as spinal curvature problems like scoliosis or lumbar lordosis and are at higher risk of bone fractures caused by reduced bone density and excess load. The risk of premature joint problems in feet, ankles, knees, and hips is also greater under the strain of excess weight. Expressed simplistically, if a child is 10kg overweight and they walk 5,000 steps a day, that means every joint in both legs has been subjected to a total extra daily load of 50,000kg. With that extra weight, every day, it is little wonder they end up with serious joint problems.

• Psychological consequences also follow childhood obesity, such as low self-esteem, depression, and anxiety. Those mental health problems can be caused by the stigma and discrimination that obese children are subjected to, or they can be self-induced from awareness of their obesity.
• The long-term consequences are pretty horrible. Around 85% of all type 2 diabetes cases are caused by obesity, as are many cases of asthma. Cardiac problems and the incidence of strokes increase dramatically the more obese a person becomes. And that is an abbreviated list.

With such nearly inevitable and severe consequences, what can be done to help children reach and maintain a healthy weight?

The biggest predictor of any human behaviour is the belief system of the person concerned. If we can help develop healthy, self-empowered beliefs in children about their nutrition and exercise and then encourage those beliefs when manifested in behaviours, children are much more likely to act in self-responsible ways.

How can we develop such healthy beliefs?

• Provide healthy role models. Those adults encouraging children to be fit and healthy should be practising what they preach, or at very least be actively on the same journey to health.
• Make physical activity fun and enjoyable, and integrate movement into daily life.
• Set an example by showing children that there is a wonderfully exciting life away from electronic screens.
• Provide useful knowledge of foods and nutrition.
• Provide healthy foods and drinks and a balanced diet as a normal part of their lives.
• Provide family-wide education to create the right support environment.
• Governments can choose to appoint healthy people to head any and all health campaigns to set a powerful governmental role-modelling example.

Theory informs action, but is no substitute for it

If you are a young person struggling with obesity, what will you do right now to start your journey to health?

If you have children who are obese or at risk of becoming so, what will you do today to help them reach and maintain a healthy weight?

Professor Nigel MacLennan runs the performance coaching practice PsyPerform.