Childhood obesity increases the higher the weight of the parents and the lower their level of income and education, although it also varies greatly depending on the community of residence. Children from Murcia, Catalonia and Andalusia have rates up to ten times higher than those from Navarra, Aragón or Cantabria.
“The causes are multifactorial and we must understand their complexity: it is not just about eating a lot and poorly and a sedentary lifestyle,” explains Gilberto Pérez, endocrinologist and pediatrician at the Gregorio Marañón Hospital in Madrid and member of the Obesity Area of ??the Spanish Society of Endocrinology and Nutrition. (SEEN).
Beyond genetics, which is not modifiable, the most important single factor is “the example of parents”, their ability to encourage a healthy lifestyle and recognize, when there is one, the weight problem in their child, but 70% don’t see it. “The main limitation is that many parents – and professionals who care for them – do not detect it. Thus, childhood obesity cannot be fought.”
According to a 2017 study by researchers at the University of Granada, 90% of parents of overweight children believed they were normal; 63% of parents of adolescents aged 10 to 14 who were overweight and 40% of those who were obese did not perceive it either.
Other conclusions were that mothers are more likely to not identify this excess; parents who are overweight/obese are more likely to not see it in their children; and families with a higher level of education and better income levels identified the problem better.
There are many studies that put Spain at the top of the European rankings: the Aladino, from the Ministry of Consumer Affairs, and the Cosi (Childhood Obesity Surveillance Initiative) from the WHO, show prevalence of obesity or overweight in children from 6 to 9 years of 17.3% and 23.3%, respectively.
During adolescence, according to the Physical Activity, Sedentarism and Obesity in Spanish Youth (PASOS), by the Gasol Foundation, excess weight in Spain is 32.5% (22.8% overweight and 9.7% obese). Prevalence, Pérez adds, is also linked to the parents’ Body Mass Index: 17.2% of children from families with normal weight becomes 57% when the parents’ BMI approaches 40%.
And at the level of income: the percentage of children with obesity doubles in households with less income (23.7%) compared to those with more (10.5%).
Recently, the Spanish Journal of Public Health has published the study “Addressing childhood obesity. Comparison between autonomous communities”, prepared by researchers from the University of Murcia. The research analyzes the Spanish population between 2 and 17 years old, for which it calculates an overweight rate of 18.26% and an obesity rate of 10.3%.
Although the figures for Murcia (25.75%), the Canary Islands (25.15%), Melilla (24.5%) and the Balearic Islands (22.97%), are far from those of Extremadura (11.8%); Navarra and Euskadi (13.5%) and Catalonia (14.8%). The obesity gap is even greater, which in Ceuta reaches 17.9%, followed by Murcia (14.2%), Catalonia (12.6%) and Andalusia (12.4%). At the other extreme, Navarra, (1.4%), and Aragón and Cantabria (2.5%).
The way and resources to address the problem also differ; The national ratio of pediatricians is 1.21 and 0.65 nurses, but in La Rioja it is 1.55 and 0.89, respectively, compared to 0.84 and 0.54 in the Balearic Islands.
Andalusia, Asturias, the Canary Islands, Cantabria, Castilla-La Mancha, Extremadura and Galicia do not currently recognize nutritionists and nutrition technicians as healthcare personnel.
In this aspect, Murcia was a pioneer by offering 9 public places for nutritionists in recent years, followed by the Comunitat Valenciana (7) and Navarra (1); those of senior nutrition technicians were even higher, with Andalusia in first place (23), ahead of Castilla y León (14) and the regional community (8).
Only Andalusia, the Canary Islands, Castilla y León, Castilla-La Mancha, Comunitat Valenciana, Galicia, Murcia and Euskadi, in addition to Ceuta and Melilla, have comprehensive plans.
Regarding the health expenditure derived from childhood obesity, only Catalonia periodically carries out an economic analysis, the last of which quantified the additional cost of this disease at 153 euros/person per year (which gives a total of 13.7 million annually in this community).
Likewise, only Castilla y León and La Rioja allocate a specific amount for healthy eating programs (14,000 and 29,405 euros, respectively).
For all these reasons, the authors of the study call on those responsible for health management at the national, regional and local levels to channel “their efforts into standardizing this approach, in order to improve the quality of care and equalize opportunities for prevention and treatment.”
It is urgent because, as the endocrinologist points out, obesity wreaks havoc on children’s health, whether mental – low self-esteem, stigmatization, bullying, school absenteeism, eating disorders – or physical – increased cholesterol and blood pressure, prediabetes and fatty liver, precocious puberty, joint problems…-.
And because having excess weight as a child increases the risk of maintaining it as an adult and this decreases life expectancy.
At SEEN they advocate a multidisciplinary approach to the disease “without delay”, including psychological support, which must also include their environment: parents and caregivers should remind these children “how much they love them, reinforce their positive qualities and not tolerate jokes or comments regarding their weight.
If they are teased, you should talk to them, but avoid criticism because “it doesn’t motivate and can hurt them a lot.”
