Doctors on front line of tackling childhood obesity but more training and resources needed

Doctors are feeling unable to tackle growing problem of childhood obesity due to a lack of training and capacity according to new research.

In a paper published in the British Journal of General Practice, researchers from the University of Birmingham conducted in-depth interviews with healthcare professionals (HCPs) to understand their experiences of supporting families to tackle childhood obesity.

One participant in the study said:

“I had one mum and her child was overweight, but she was a young parent and she actually didn’t know how to cook the dinners and, yeah… we spent a lot of time with her giving her worksheets, how to cook, make potato and beans rather than going to the fish and chip shop.”

Among key themes that were discussed, professionals shared their frustrations with a lack of time and training to support families, including limited availability for specialist services and lack of access to routinely collected data on children’s weight. HCPs also shared their concerns about damaging trust by highlighting weight concerns about children, and many said that they were aware of cultural considerations when bringing up weight.

Miranda Pallan, Professor of Child and Adolescent Public Health in the Institute of Applied Health Research at the University of Birmingham and senior author of the paper said:

“This study brings a fresh awareness about the pressures that healthcare professionals face, including the limitations that they face in trying to provide preventative care for young people. Through the series of interviews with doctors, primary care nurses and school nurses, we have been able to see some clear barriers that prevent effective advice and support for families to tackle the growing epidemic of childhood obesity.

“While we should not expect doctors to be spending lots of time teaching families how to cook healthy, balanced meals, the study does highlight that healthcare professionals need more support and dedicated time to enable them to give practical advice and in some cases refer to more specialist services.”

Doctor on the front line: “No-one is actually talking about the root causes with parents”

Dr Ellen Fallows is a sessional GP in North Oxfordshire and has a particular interest in supporting families to address childhood obesity. Also holding roles in teaching and as Vice-President of The British Society of Lifestyle Medicine, Dr Fallows regularly works with families who are struggling to understand where to go to get support, but with no specific paediatric weight management services locally often has to draw on her own expertise to provide advice.

Dr Ellen Fallows said: “Everyone thinks it is everyone else’s problem, no one is actually talking about the root causes with parents – which is predominantly food quality. This is due to lack of time, knowledge and incentives for healthcare professionals. There are good and free training resources out there that really should be routinely provided as a first port of call.

“Childhood obesity is a really serious problem that could have lifelong implications and GPs could be ideally placed to lead the work to address it. However, without the training and a mandate to support people with self-care to address root causes, it will continue to be a challenge to make a meaningful difference for the many families who are looking for help.”

Lack of trust in BMI

Healthcare professionals also raised the issue of the use of BMI centiles for assessing weight problems in children. Different healthcare professionals raised different concerns, with doctors and primary care nurses noting that they are less familiar with BMI centiles, and that BMI is not a good measure for younger children.

Another participant said:

“we used to use the [height and weight] centile charts and actually the BMI will put a lot more children in an overweight category than the centile charts will.”