Obese teens need more help and U.S. expert says surgical solutions should not be dismissed

Feb 18 2008

A recent report which has found Victorian hospitals are having to treat hundreds of obese children each year, has highlighted the seriousness of the obesity epidemic and how ill equipped and under-resourced services treating childhood obesity are.

Young people are now presenting at hospitals needing help to deal with obesity-related illnesses such as type 2 diabetes, cardiovascular disease, high cholesterol and high blood pressure.

Obesity expert, Associate Professor Jeff Walkley, from RMIT University says services treating childhood obesity are extremely limited especially for adolescents and the services that are available are being put under enormous pressure.

Professor Walkley suggests teenagers have different issues to children when it comes to managing their weight and he believes medical interventions such as lapband surgery do not address the behavioural issues that have led to the weight gain in the first place.

He says his research indicates that the most effective approaches are adolescent-focused and family-supported and they involve long-term behavioural change.

Professor Walkley says the services which currently exist for overweight teenagers do not have the resources to follow this kind of model which has been proven to work.

Walkley is one of the key researchers behind RMIT’s highly successful 'Choose Health' program, which uses a groundbreaking approach to weight loss by helping overweight and obese adolescents change their lifestyle and eating habits through cognitive behavioural therapy.

The program has helped more than 150 teenagers lose weight and keep it off and is currently being adapted for adults.

A national survey by the Cancer Council's Centre for Behavioural Research in Cancer of more than 18,400 schoolchildren released last year, revealed that the numbers of overweight and obese children in Australian have doubled since 1985.

One in five children are now considered overweight or obese and it was also revealed that just 14% of students engaged in recommended levels of physical activity, while about 70% exceeded recommended levels of sedentary behaviour.

Last year the Australian Primary Principals Association decided that the curriculum should contain just four "guaranteed" subjects, English, maths, science and social education, and that subjects such as sport and music should be given lower priorities in an effort to 'de-clutter' the curriculum.

Currently, there are eight key areas of learning for Victorian primary students - including sport and languages.

President Leonie Trimper says some schools are quite simply unable to offer such a diverse curriculum and schools have to prioritise.

But many experts have strongly criticised that approach and say sport is more than just exercise as it teaches skills such as problem solving, teamwork and tactics, all valuable in life beyond the schoolyard.

They believe if sport is regarded as non-academic schools will be discouraged from employing qualified people to teach it.

This will put students at risk of not getting the most out of the subject at a time of rising levels of childhood obesity.

At present government schools must provide 20 to 30 minutes of daily physical education for prep to grade 3 students; three hours a week of PE and sport to grade 4 to 6 students; and 200 minutes a week to students up to year 10.

Professor Walkley says while literacy and numeracy are clear priorities, physical education and sport are also critical for involvement in contemporary life, and in assisting children to make good decisions about healthy living.

Professor Walkley, president of the Australian Council for Health, Physical Education and Recreation, says sport needs a strong presence in any comprehensive school curriculum.

While the Prime Minister and the Victorian Premier have both declared obesity a priority area for this year and money will be undoubtedly by pledged for public education programs on obesity, one expert from the United States doubts that the eat less/exercise more mantra will have any effect.

According to Dr. Joseph Proietto, head of the Weight Control Clinic at Austin Health in Texas, USA , and a consultant to the Metabolica obesity clinic, such campaigns though they offer many important health benefits, will only help slightly overweight people get back to normal weight.

Dr. Proietto says they will not cure obesity, regardless of how much money is spent on advertising or education programs.

Dr. Proietto suggests the money would be better spent on funding obesity surgery or appropriate drugs to suppress appetite, as well as research into why so many people eat themselves to death.

Dr. Proietto believes because not everyone becomes obese and the vast majority of obese people fail to achieve long-term weight loss even when they exercise and diet, that there are genetic influences, including chemical action on genes, at work which are responsible for perhaps 75% of obesity.

Proietto advocates a sensible and strategic approach to obesity which includes surgical and pharmaceutical solutions.