Two news stories on the apparently growing problem of childhood obesity hit the headlines this week.
The Mirror splashed on “shock figures” today which show “up to 74 children were taken into care over the last five years because they are obese”.
Earlier this week the Press Association reported new figures from the Health and Social Care Information Centre (HSCIC) which show a 12 per cent rise in the number of under-16s admitted to hospital for obesity in England.
Damning statistics, on the face of it, but public health minister Jane Ellison gave the Mirror a different take on the situation: child obesity is in fact “levelling off”, she said.
What’s really going on?
“Up to 74 children have been taken into care in the last five years because they are obese”.
Daily Mirror, 28 February 2014
The Mirror sent freedom of information (FoI) requests to 206 councils with responsibility for child protection in England and Wales. They got 128 usable replies but some local authorities only provided approximate figures.
The paper said the final tally “suggests as many as 74 were taken into care, but the real figure could be much higher”.
Nottinghamshire County Council recorded the most children taken into care (seven), according to the report. The next highest was Oxfordshire with three.
But both those councils take issue with the accuracy of this story.
Nottinghamshire told us they were asked about cases where overfeeding was “one of the factors” in social services’ decision to intervene.
But it wasn’t necessarily the main factor. These were children who had a number of welfare issues, their weight being just one of them.
A council spokesman said she could say “categorically” that obesity was not “the only reason” why social workers took action in any of the seven cases.
She also said it was inaccurate to say that the children were “removed from their families”, as the article claims. The children were put on child protection plans, but none of them was actually removed from the family home.
Oxfordshire County Council also told us that the three youngsters it referred to in the FoI response had multiple problems. Their weight “was a factor but not the main factor”.
A spokesman told us they had made this clear in correspondence with the newspaper.
Portsmouth City Council, also named in the Mirror piece, said: “We would clarify that obesity alone would not be seen as a reason to take a child into care.”
It also can’t be right to say, as the Press Association, did, that the 74 children were “morbidly obese”. As far as we can see, detailed information about how much the children weighed was generally not disclosed, and in any event, there is no standard definition of morbid obesity in childhood.
So the whole thing is starting to look a bit shaky, if the councils we spoke to are to be believed. The children weren’t necessarily taken away from their parents, and their weight wasn’t necessarily the main issue.
“There has been a 12 per cent rise in the number of under-16s admitted to hospital for obesity in the last year, figures show.”
Press Association, 28 February 2014
This is absolutely true, but a bit of perspective is in order.
Here are the latest stats from the HSCIC on hospital admissions for under-16s in England where obesity was the primary diagnosis.
Now you could of course focus on the bad news here: there was indeed a 12 per cent rise in admissions from 2011/12 to 2012/13 (495 cases rising to 556). And this was in a year where admissions in most other age groups went down.
But let’s look back over the last 10 years. There were nearly 40 per cent more hospital admissions in 2008/09 than in 2012/13.
Last year’s total was the fourth lowest in the last decade. There’s no long-term evidence of a growing trend here.
And the total numbers of children being hospitalised are so small – 556 is about about 0.005 per cent of the total under-16 population – that a small fluctuation in cases creates a big swing in percentage terms.
Note that while the numbers of under-16s being hospitalised for obesity has not changed dramatically over the last 10 years, the number of people of all ages has: it’s gone up nearly tenfold.
So children make up a much smaller proportion of the total intake of dangerously overweight patients now than they did 10 years ago.
Are hospital admissions the best way of getting a handle on this problem? When the numbers we have to play with are so small, probably not.
The bigger picture
There are two main data sets for childhood obesity in England: the Health Survey for England and the National Child Measuring Programme (NCMP).
Both show similar trends: obesity rates levelling off or decreasing very slightly since about 2006, a trend we are seeing in other high-income countries like the United States, while developing countries are suffering an child obesity boom.
Here’s are the latest health survey figures, which cover 2-15-year-olds in England:
The equivalent figures from the NCMP are more complex, but the headline is a similar slight recent decline in obesity rates for most age groups.
Experts have warned us to not to trust these numbers absolutely. The NCMP doesn’t cover every child in the country, missing about 7 per cent of schoolchildren. Are the parents of the fattest children the most likely to opt out of taking part?
But if we believe the figures, it looks like we have reached a plateau with childhood obesity.
Does this mean we should all stop worrying about the issue? Not according to most experts in the field, who warn about a host of health and social problems
Dr Emma Boyland from the University of Liverpool’s Institute of Psychology, Health and Society told us: “The general pattern seems to be a levelling-off. Things haven’t got any worse. But it’s not a reason to celebrate.
“It may have levelled off but it’s levelled off at a rate that is too high.”
It remains the case that about one third of children in England, Scotland and Wales are either obese or overweight, according to national health surveys.
And international comparisons are not flattering, with Scotland and England right at the top of some league tables published by the International Association for the Study of Obesity.