None of the various articles, editorials and letters you have published on the government’s strategy for obesity has touched on its origins in infancy. While it is necessary to limit the availability and appeal of fattening food and drink, that will do little to prevent children becoming overweight in the first place.
Paediatricians have shown, for example, that having obese parents or introducing solid foods too early leads to obesity in children, but there is no one-size-fits-all method of preventing that. This is hardly surprising. Eating and feeding are, like sex, fundamentals of our intimate lives, not easily altered at will or by instruction. Yet scientists agree that parents have a crucial role to play; even before birth the foetus gets a taste for the foods that mother eats. The newborn child is already part of a culture.What is required in every hospital where babies are born – besides the doctors and nurses already involved – are teams of committed dietitians, social workers and psychologists who can engage families requiring advice, education or therapy, depending on need and risk. Current NHS practice of referring individuals to separate services with waiting lists leaves too many to fall through the net. Some of these will turn up years later with lifelong illnesses such as diabetes, heart disease and arthritis.
Skills to provide perinatal services already exist but are not coordinated nor in great enough numbers. Teams would include staff trained to work with parents who are depressed, also reducing later depression and learning problems in their children. Chronic diseases have developmental origins; lifecycle, not lifestyle, is the target of well-informed policy. A state that knows about child development invests wisely in early years health and education. These will in time pay for themselves several times over. Besides scholastic knowledge, children have to learn about relationships and about looking after their bodies – how to play and how to cook – in studies that grow with the years. The government’s agenda is at best tinkering with markets that know only about buying and selling.
Dr Sebastian Kraemer
Tavistock Clinic, London
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The key to obesity lies in infancy | Letters
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