Fighting Fati

Definition: Childhood obesity is a condition where excess body fat negatively affects a child's health or wellbeing.

Six out of ten children will be obese by 2020, a report warns. Becky Thurston reports on how Sheffield is tackling the supersize problem.

Obliterating ObesityBreast milk, free fruit and extra sports activity could prove vital weapons in the struggle against a fat pandemic, Becky Thurston reports

It is a little known fact that today’s obese children could be the first generation in 100 years to die before

their parents. In Sheffield, obesity among children

is a growing concern. With new Government initiatives being released, it is the job of Sheffield City Council to implement the means to an end.

Councillor Andrew Sangar, Cabinet Member for Children’s Services and Lifelong Learning, is competent on reaching the new obesity targets.

“With the issue of smoking having taken a back seat, it’s full steam ahead on reducing obesity. Like smoking, it will take a lot of convincing that tackling the problem is the right thing to do but with enough support, it can be achieved, slowly but surely,” he said.

According to Government statistics, one in three children in the UK is obese. In 1996, 15% of children were classified obese. This means that the level of obesity has virtually doubled during the past 13 years. If nothing is done to obliterate the situation, a pandemic could be on the cards, and the level of obesity in a further 13 years could affect 60% of children.

But what has the city council been doing in the past few years to try and reduce the level of obesity in our city?

“We have always been thinking of ways to make schools more healthy, mainly

concentrating on food. We’ve introduced a free fruit scheme into primary schools across the city, and plan to extend this right to year seven pupils in secondary schools, although this idea has not

yet been approved and implemented. There has also been changes made in the school tuck shops, so that only healthy snacks are available. There is the ‘Home2School’ transport campaign currently in place, encouraging pupils to walk or cycle to school as

opposed to getting a lift, which is aimed at increasing exercise. Not forgetting P.E. which has been increased on the

curriculum, by the Government on a national scale, making kids do more sport.”

Within Sheffield, the city council has a close relationship with Activity Sheffield, who have increased their programme of events in recent years so there is a wider variety of activities for children and their families to participate in during the school holidays. This inevitably means that children are being provided with ample opportunity to exercise outside of their P.E lessons, which is great for eliminating obesity.

Healthy Towns

Last year, the British Government set out to devise a way of preventing obesity destroying our country. A new pilot programme to be tried and tested in nine

areas across the UK was announced. Sheffield City Council pushed for

selection, and finally made the final nine. Other successful areas include Manchester, Calderdale, Portsmouth and Dudley.

“There are Government initiatives in place to stop the

situation spiralling out of control. Sheffield has been selected to take

part in an experimental programme, which was originally used in France and has a high success rate. A

model of the ‘EPODE’ strategy has been adapted for our city.”The Healthy Towns programme

will work across the whole city to promote healthier lifestyles amongst children and young people. Improving children’s health is a key priority of the council and can be identified in the ‘City of Opportunity’ scheme set by members of

“Sheffield has been selected to take part in an experimental programme”

Obliterating Obesity

Aims of the Healthy Towns programme- Making Sheffield a breastfeeding friendly city. Breastfeeding has been linked to a reduced risk of developing obesity later in life. There will be increased support for breastfeeding in our communities, public places and workplaces.

- Parents as positive role models for healthy eating. Parenting skills, particularly around child feeding, have been shown to play a key role in the development of child obesity. The programme intends to build the capacity of parents to improve their children’s wellbeing and be positive models for healthy living.

- Schools being the heart of healthy communities. The National Healthy Schools programme will be the key delivery mechanism for reducing obesity. The city council intends to provide opportunity for practical school cookery and food growing, as well as increased P.E and educating children about obesity and the effects it has on the human body.

- Living neighbourhoods. This will create local environments that promote wellbeing. The Community Assemblies will play a large role in facilitating this.

- Healthy open spaces. This area of the programme will enable children and families to enjoy safe, active and healthy recreation in the city’s parks and open spaces. Encouraging use of community facilities for physical activity is a key focus of a number of obesity prevention initiatives.

- Change4Life. This strand focuses on families that are more at risk of developing obesity, such as pregnant women, parents of toddlers and two to 11 year olds.

- Community health champions. Individuals are far more receptive to health messages delivered by their peers within their own community. The programme will establish a network of volunteers to support people in their communities to live healthier lives, increase physical activity and improve nutrition and diet.

- Cross sector innovation. This strand is about the programme building new partnerships, to maximise the success of the programme in terms of reducing obesity. A partnership with the Chamber of Commerce will support opportunities for partnerships with the private sector.

the city council.£5million will be injected into Sheffield, in order for the programme to get going.

“Certain areas of the city are more susceptible to obesity. The programme has been tailored to give more focus to these areas in order to prevent the onset on obesity in people surrounded by obese types. The overall aim of the programme is to provide all children and families in Sheffield with the opportunity to maintain a healthy weight and remove any barriers which may prevent them from doing so.”

As a first step towards achieving this ambition, in May 2008 Sheffield City Council and NHS Sheffield jointly commissioned the development of a five year initiative to tackle childhood obesity in children and families. Andrew Sanger is on the panel working towards the ten year target. He says that the nation is in dire straits if nothing is done. “This is a national issue. We could potentially see the first generation of children dying before their parents in 100 years. Being obese could result in 15 to 20 years being taken off a person’s life expectancy through being morbidly overweight. It has overtaken smoking in terms of national health issues.” He said.

The programme will provide real opportunities for parents, children and their families. They will benefit from safer play and activity areas, improved park facilities, increased physical activities in schools and communities and improved access to healthier food options.

According to Councillor Sanger, school children are weighed at two intervals throughout their primary years. “The children are weighed in the reception year (approximately four years of age) and later in year six (approximately 11 years of age.) However, we are unable to achieve an accurate reading across the nation, because the weigh-in requires parental consent, so not every single child is weighed and their weight recorded. Teachers often find that overweight children are saved by their parents from the embarrassment of being weighed, which means that it is more difficult to determine the level of obesity in the country, ” he said.

“In recent years, approximately 17% of year six pupils weighed are obese and a further 13% are overweight. These are the latest results from a ten year rising

trend.” Councillor Sanger told me that obesity

has become a huge strain on the NHS in recent years, due to the cost of treating the health complications that arise in many patients suffering from the condition.

“Heart disease, strokes, diabetes, cancers and mental health are all associated with being overweight and these are not treated cheaply. It really is a case of learning to look after yourself, so that you are at a reduced risk of contracting these obesity-related illnesses.”

“The new programme will hopefully make a big difference to the problem that we as a society are facing.

Sheffield Hallam University will be evaluating the results as we go along, to measure which aspects have made the most difference. It won’t be a quick fix though. Societies have been designed to become overweight with the ease of public transport, cheap cost of take-away food, computer gaming on the up and increased food advertising. I just hope that we can change our society’s attitude towards obesity.” He said.

CommentKath Sharman(SHINE leader)

“I think the Healthy Towns programme is a big step forward in the drive to reduce obesity within our city. The city council are doing the right thing by targeting pregnant women and young families.But I’m concerned the already obese people among us are being sidelined. It’s important not to forget the existing obese population and although prevention is better than cure, they’re still there, needing help.”

It’s time for change

In January 2009, the Department of Health launched a national campaign, in a bid to reduce the

levels of obesity that are beginning to dominate the UK.

The Government has worked extensively to involve thousands of local organizations and charities which will help families to eat well, move more and live longer. This is an attempt to grab the nation’s attention and make them aware that change needs to happen.

Through Change4Life, the Government is aiming to reduce the number of people who are obese or overweight and prevent the problem escalating to a point where the experts say it is likely to cost the NHS an estimated £50 billion by 2050.

Obesity is currently the biggest health challenge that the country is facing. It is essential that families work together to change their lifestyles, so that generations of children can be saved from reduced life expectancies.

At the launch of the campaign, Health Secretary Alan Johnson said "It's

unprecedented for supermarkets to join the Government and pledge to cut prices on healthy food. But this isn't an exclusive club. Anyone who promises to help families to be healthier can join. I am today challenging every CEO of every company who can influence what we eat and how we exercise to come forward and tell us how they are going to help beat this national epidemic. Obesity affects us all so everyone must get involved."

Tesco and Asda are two of the key players involved in bringing about the change that is so desperately needed. They intend to reduce the cost of healthy foods, and support and sponsor sports campaigns such as Bike4Life, which encourages cycling as a healthy activity. Other major companies which have jumped on the band-wagon are ITV, Kelloggs, PepsiCo, to name but a few.

Many local businesses have also got involved. This really is a case of a national challenge, so communities

need to pull together for it to work.Change4Life means that families

will start to see new local initiatives providing support, help and advice to help them live more healthily. For example, there will be healthy food promotions and recipes in supermarkets,

walking campaigns, cycling groups and free swimming

for under 16s .

Tracey Williams lives with her five year old son, Ryan, on Sheffield’s Manor estate. As a single mother living on benefits, she tells me of her struggle to afford nutritious meals.

“I got made redundant earlier this year and had to sign on. You aren’t given alot when

you’ve got a five year-old to feed. It definitely doesn’t put healthy meals on the table.I’ve had to sell my car, so now I can’t get to good quality supermarkets. This means that the food that is conveniently available to me is expensive, and sometimes I have to make sacrifices.Without a Tesco or Asda nearby,

I find that I buy frozen foods like chicken nuggets, pizzas and fish fingers, which I know, just aren’t healthy. I really wish I could provide better meals for Ryan, but healthy food is just too expensive. It’d really help me if I lived near a Tesco, as the food there is much cheaper and there’s more choice. I know that he’s overweight but I don’t see what I can do.”

The Government’s national campaign, Change4Life, aims to combat obesity by communities pulling together to make a difference

‘We really are dealing with a global epidemic’

In the seventies, the level of child obesity in the UK sat at 6-7%. These days, the figure is 25-30%. If we

continue with the considerable rise, then by 2050, our population will inevitably be dominated by obesity. However, if we’re careful with what we do now, then you could arguably say this would be an over-exaggeration.

There are currently both interventional and preventative strategies in place, which are trying to alleviate this problem, although we have to realise as a society that it won’t be a quick fix.” He said.

Dr Dimitri believes that the modern lifestyle has a lot to do with the problem. There are a number of factors which are quoted widely as contributors to obesity over the last 10-15 years.

“Food food availability is at its greatest and probably at its cheapest. The food advertising is at its strongest. Exercise levels are considerably down, both at schools and during free time and children and their parents don’t do as many activities as they used to so I do think that modern lifestyles do contribute greatly.”

A Government initiative a year ago was that all children were weighed in schools.

“The problem with that it is easy to weigh someone and easy to tell them their body mass index but it’s a lot more difficult to tell them exactly what to do with it and how they can change their lifestyles to actually bring both weight and body mass index down.

I feel that the Government and city council are doing the right thing by targeting pregnant women and families with young children, who are at greater risk of developing obesity.

This will hopefully mean that there won’t be multiple generations of obese youngsters.”

Medics across the UK are now comparing the obesity problem with smoking.

“Many of the health complications that are associated with obesity are in fact similar or the same as the complications associated with smoking.

“We are really dealing with, what has been termed by the International

Obesity Taskforce as a global epidemic of obesity, and they are right. We are dealing with a major problem worldwide. We are even seeing obesity in third world countries, as we are in the western world.

The problem that we are going to be faced with in the future is a massive health burden in the years to come and it’s going to be the scourge of our nation and many others if we don’t deal with it now.”

Fast food lifestyles are to blame for piling on the pounds, according to paediatrician Dr Paul Dimitri, of Sheffield Children’s Hospital

The effects of obesity on the human body

Opinion: Dr Dimitri

Obese children are often branded ‘obese for life.’ But for the super-sizers in

Sheffield, there is a glimmer of hopefor a better future.

“Come on in and take a seat guys, have a drink too because it’s so hot out there,” says Lisa, one of the

helpers.It is 1.30pm and the children are arriving in dribs and drabs from the 30 minute walk back from the leisure

centre, where they have been swimming since twelve noon.

Before this, they went for an hour’s workout at the

gym. No, I’m not at boot camp, but at the

SHINE Academy in Sheffield.

The academy helps obese and overweight children to adopt a

new lifestyle through

educating them about the physiacl and emotional effects that obesity will have on their bodies unless action is taken.

Based in Manor Park, one of Sheffield’s most

deprived areas, SHINE works with

Let it Shine

ten to 17-year olds who have had difficult upbringings and are trying to make changes to their lives by doing something positive to help themselves.

Ex-nurse and counsellor, SHINE’s leader Kath Sharman believes that the key to losing weight is educating the child.

“It is important for the kids to understand why they need to lose the weight, and how they can change their lifestyle with a few simple steps.”

SHINE stands for Self Help, Independence, Nutrition and Exercise. This is exactly what Kath sets out for each child to achieve by the end of the 12-week programme.

“Our motto at SHINE is ‘eat in moderation and balance it with exercise.’ This means that you can pretty much eat what you want as long as you do enough exercise to allow for it.” Said Kath.

During each programme there are psycho-social intervention days which help to boost the self esteem and confidence of the group. These involve music and drama days, which highlight the need to improve the social wellbeing of an overweight child, which will prevent them from feeling alienated from such activities in the real world.

Other elements involve two hours of team sports, such as football, cricket or rounders on Tuesdays and an hour of swimming on Wednesdays. >>

The main day is Saturday, when the children participate in a range of activities between 11am-5pm at the academy.

At today’s session, the children are being shown how to make easy changes to their lifestyles, and learning to make fruit smoothies. Sat at tables in a classroom style set-up, they are taught the basic facts of good nutrition, along with how to effectively maintain weight loss.

Zero confidence

The first programme piloted in 2003 after the Education Action Zone offered Kath £2000 to write

a programme to help obese children. At the time, she was working as a counsellor in schools and noticed that most of the children that had low self-esteem and zero confidence were obese or overweight. This is when she decided that something needed to be done.

At the start of the pilot programme, Kath was obese, weighing 24st. Since 2003, she has managed to lose 11st by joining in with the kids. Initially there were nine pupils, which have now reached about 20 on each 12-week programme.

One of the benefits of SHINE is that it is open to children that do not necessarily have their parents’ support.

“Some of the kids here care for their drug-addicted parents, so it can be very difficult to get the parents engaged on the programme. We are the only academy of this type to take on children without parental support, as we believe that the child should be able to make informed choices about their lives. We also have children with learning difficulties and psychological problems.” Kath said.

The other organisations in Sheffield with similar courses to SHINE, have policies stating that parents must be in agreement for the child to attend..

At the end of the twelve weeks, there is the opportunity for pupils to stay on, if they feel that they can continue their personal development. The existing pupils can become ‘buddies’ to the newcomers and after spending a year at the academy, they can apply to become

classroom assistants. This involves helping the leaders in the classroom, and sitting with the new pupils when they are learning about things such as healthy eating.

“I’ve had kids here that were verging on suicidal when they first arrived, as a result of being obese or overweight. Now they are some of life’s biggest achievers. I find it such an incredible experience watching a child’s confidence and self-esteem grow to the

point where they’re bubbly, life-loving individuals. It’s not an easy process and many struggle along the way, but the end result is fantastic,” said Kath.

The academy boasts its own counselling service, a valuable asset within the programme. “Typically, the waiting list to see a counsellor through the NHS is 12 months. When you’ve got kids struggling to cope with the psychological side of weight loss, it is no good having to wait for that length of time. They need constant access to professional help at all times during the programme,” Kath said.

There are three accredited counsellors on the team, who play a large part in the success of the programme, helping kids through the eating, exercise and behavioural aspects of the course.

During the 12-weeks, the children learn about maintaining weight loss. Today’s hot topic is ‘emotional eating.’ Questionnaires are used to ascertain whether the children find themselves to be this type of eater, before being led

into a discussion about how they can avoid becoming dependant on food, emotionally.

The children also are taught about how to deal with temptation and breaking habits. “If they are properly educated about obesity and how to effectively maintain healthy weight loss, they are more likely to carry on watching their weight after the programme has finished, rather than falling back into a trap.”

Kath takes me aside and stresses the importance of educating the children about the medical side of obesity. She believes that they should be aware, enabling them to make informed choices for themselves about their lives.

Kath also shows me a table stating that in school P.S.H.E. lessons, Britain’s children are taught about anorexia nervosa and bulimia nervosa, but not about obesity.

This must have a dramatic effect on the UK’s rising level of obesity, because children are eating and eating and not realising the consequences of their actions. With this level of ignorance, children have no incentive when it comes to eating healthily and exercising.

Sports coaching

SHINE is run by a group of 17 volunteers, consisting of ten facilitators and seven sports

coaches. The organisation receives a limited amount of funding from youth opportunity funds. In recent years, it has received funding from Children In

Ryan’s story

“I’m 11 and I decided to come to SHINE because I was fed up of being constantly bullied at school for being fat. I was told about it by my dad’s girlfriend, who knows Kath’s husband and decided to look it

up on the internet. This is when I decided that I wanted to come and lose weight. I was nervous at the start but everyone was really nice and helped me settle in easily.

My favourite part of Shine is definitely doing the sports, and I have also enjoyed learning about things such as reading the labels on food packets to find out how much goodness is in that food. I’m really lucky because my parents understand why I want to get thinner and have helped by making me healthier meals at home. Since I’ve been doing the programme, I have become

more active and really enjoy going to the Don Val-ley swimming baths with my mates.

Since I joined SHINE, I have lost enough weight to feel confident at school. This makes me feel happy about myself and why I would recom-

mend it to anybody in a similar position to me. Although there have been days when I felt

like not going and staying in bed, I end up going because I know that it will help me to stop getting bullied if I lose weight. I have only told one of my mates that I go because if I told any of the others, they would probably tease me.I am now in week 13, and will try and

carry on for a while yet, so that I can reach my goal of being normal weight.”

“Some of the kids here

care for their drug-addicted

parents”

Above: Working out in the SHINE gym

Above: 11 year old Ryan

Below: Saturday’s aerobics class

Need and Chily Pep. More recently, the Tudor Trust donated enough funding to provide two part time managers to help with the programme, which will run six times annually as opposed to three, as from September.

This funding has also enabled the organisers to develop a pilot programme for a girls only, ‘black and minor ethnic group.’ This initiative arose after Kath realised these minorities were not able

to attend regular SHINE sessions, due to issues with music and religious factors. The new programme, which is the first of its kind in the UK is running in the Burngreave area of the city, and shows how the organisation is growing.

SHINE works alongside MEND (Mind, Exercise, Nutrition...Do It!) and Watch It!, two other programmes combating obesity in Sheffield.

“MEND only takes kids from the age of fourteen upwards, so they will often refer younger kids to us, while Watch It! takes from the age of seven, so we all work together, finding the best option for each child. This is the only way that we can make an impact on large numbers, by strengthening a partnership and working together across the city,” Kath said.

Pregnant

I asked what Kath thought of the Government and city council’s plans to reduce the level of obesity in

Sheffield over the next ten years.“Firstly, I strongly believe that there

is a bigger crisis on our society’s hands than what people appreciate. In previous years, obesity targets have not been met, so I will be surprised if the level of obesity is noticably reduced. The problem is that the social services put parents off seeking help for their obese/overweight children, for fear of them being put into care. This is where the problem really stems from.”

Kath tells me that she fully supports Sheffield Primary Care Trust’s (PCT) plans to target pregnant women, in an attempt to prevent the onset of obesity. “If the mother is at the least, overweight, then she will almost definitely experience complications during her pregnancy, and the child will be born with heightened risk of developing medical conditions such as diabetes later in life.

The majority of deaths during childbirth have been of overweight or obese women, which sends a big message to the women of this generation considering pregnancy.”

There are also concerns that the

targets set by the Government are aimed at those who are yet to develop obesity, or in the early stages of the disease.

Kath is concerned that the plans to improve park areas and exercise facilities across the city will not help the low self esteem of those already overweight and obese. “This is when the obese population starts thinking about not leaving the house, for fear of being stared at and talked about in the public place, such as a park and the downward spiral takes hold from there.

It seems that once a person becomes overweight or obese, they receive little support from society in returning to normal weight. There is a lack of encouragement and the sufferer is practically branded a lost cause.

“I’d have to say that for the targets to be met, there needs to be a drastic change in schools. Some of the kids that come to SHINE aren’t going to school because they physically don’t fit. The chairs are far too uncomfortable, the toilet doors don’t open wide enough and the classroom tables don’t allow for a large child to sit at them.

A classic case of the Government making a failed attempt at preventing obesity is the introduction of school breakfast. All we hear from the children on the programme is the poor variety available at breakfast.”

Hannah, 13, and Ryan, 11, tell me about the food at the Birley School, where pizzas, giant cookies, chip butties and tuna melts are all regulars and available from 7.30am. “The fruit is always so expensive that I can’t afford it every day so I have to eat the unhealthy stuff,” said Hannah, who has been on the SHINE programme for 17 weeks.

“The teachers take all the fruit salads and healthy food before we can get to it, so we are left with little choice apart from the greasy, unhealthy things,” said Ryan, who decided to join the SHINE programme after being bullied.

Alienation

Kath tells me that she hopes the situation of child obesity in the city will have changed in the next

two to three years, with the right help.She expects there to be a higher

degree of education surrounding the topic, because it is misunderstood by so many people. She feels it is important that children are taught the effects of obesity, mentally, physically and emotionally. She also hopes that there is more support available for those coming forward with their children and accepting that they may be heading towards obesity. There also needs to be a better social awareness, so that obese children aren’t alienated by society.

Kath also stresses that it is not just the public that need educating. “Many

doctors do not understand how to calculate child obesity. There is a big misunderstanding when it comes to Body Mass Index (BMI) because

many medics use the adult BMI chart to calculate, when actually a ‘standard deviation chart’ should be used to calculate child obesity.

This has led to cases where children have been told that they are

verging on obesity, when actually they are super obese. This means far worse health implications and the GP probably is not aware of the situation.

Chelsea’s story

“I joined SHINE when I was 17st. At 14 yeares old, thats pretty big. Three years on, I weigh

11st 1lb. I have got so much from the experience that I decided to apply to be on the committee, which I now chair.

My favourite parts are losing the weight and helping others who are only at the beginning of their journey on the programme. I am studying childcare at college and I really feel that SHINE helps me to understand it better, from a personal experience.

As chairperson, I have made an effort to get make more people aware of the programme, because I want it to be able to make people’s lives as good as it has made mine.

I heard about SHINE through my doctor. At first I was really, really nervous, and scared that people would judge me. It turned out to be fine. I remember my first session, because my next door neighbour, Joseph, was there which made it a bit easier for me.

Joseph is still here too and his mum has even joined by becoming a helper. I’m really pleased that we have been through the programme together.

I honestly believe that without SHINE, I wouldn’t be here right now. It has changed my life and enabled me to lose 6st, build up my confidence and make new friends.”

“Some of the kids that come to SHINE aren’t going to school because they physically don’t fit”

Below: Saturday’s aerobics class