Almost a quarter of GPs are seeing children aged four or under who are obese, according to a survey of UK family doctors.
The “alarming” research also found that almost half (49%) of GPs have seen boys and girls up to the age of seven who have obesity, including a handful younger than a year old.
However, four out of five family doctors find it difficult to talk to children or their parents about the condition, in case such conversations make them feel upset, angry or ashamed.
Dr John Holden, the chief medical officer at the medical organisation MDDUS, which ran the survey, said: “These findings are an alarming confirmation of the growing crisis of childhood obesity across the country and the very real difficulties this creates in everyday GP consultations.”
The survey asked 540 family doctors about their experience of managing obesity, the explosion in the use of weight loss drugs and what widespread levels of dangerous overweight means for the NHS.
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Almost one in four (23%) said they had seen children aged zero to four where obesity was a clinical concern.
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Among the doctors, 81% have seen obesity in those between their first 12 months and the age of 11.
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Four in five (80%) find it somewhat or very challenging to talk to the parents of an obese child under the age of 16 about their weight and health, with only 10% saying that is easy to do.
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Nearly two thirds (65%) find it hard to talk to obese young people themselves, with just 20% saying that is easy.
Discussing a child’s weight with their parents is difficult because they may become upset (72%), angry (47%) or make a complaint (24%) or that may cause shame or stigma (74%). Similar concerns hamper such conversations with children, including that they may develop disordered eating habits as a result.
The complex factors that explain obesity, including poverty, lack of access to nutritious food, and children having limited opportunities to be active, means GPs approach conversations about children’s weight “with care and empathy for families under pressure”, Holden said.
“When parents feel judged or blamed, conversations can quickly become emotionally charged and, as our members tell us, can lead to complaints from distressed or angry parents,” he added.
Katharine Jenner, the executive director of the Obesity Health Alliance, a coalition of 65 health and children’s groups, said that the large numbers of GPs who had seen obese infants and young children “is another sign we’re letting children down before they even start school. If we’re serious about prevention, it has to begin in the earliest years, otherwise the damage follow them through life.”
She called for reformulation of food and drink products to make them healthier, restrictions on the marketing of products high in fat, salt and sugar, and better support for families.
GPs also disclosed in the survey that adult patients who should not be using weight loss drugs are putting themselves at risk by obtaining them through deception from private pharmacies. They include people with eating disorders, such as anorexia or bulimia, and those already taking other medications that may interact badly with “fat jabs” and pose a risk to their health.
Most of the estimated 1.5 million people in Britain using GLP-1 drugs to lose weight have obtained them privately, with only a small minority receiving them on the NHS, which has strict eligibility rules.
One GP said GLP-1s are being “accessed privately pretty indiscriminately by many people whose body mass index is not in the obese category”. Another told how a patient with a history of anorexia nervosa had also obtained the drugs privately. Two-thirds (67%) of family doctors have seen patients who have done so despite not meeting eligibility rules.
The findings raise questions about how rigorously private pharmacies are conducting proper checks on people who want to start using GLP-1s, such as checking what other drugs they already take.
Large majorities of GPs surveyed said that obesity was likely to be a defining public health challenge in their career (92%), and that it would significantly affect the NHS’s ability to deliver care (95%). But 59% believe weight loss jabs will save the NHS money – only 22% disagree.
The Department of Health and Social Care did not comment directly on MDDUS’s findings. But a spokesperson said: “Every child deserves the best possible start in life, which is why this government is taking decisive action to tackle childhood obesity.
“We are restricting junk food advertising on television before 9pm and online, a move expected to remove up to 7.2bn calories per year from children’s diets; while giving local authorities new powers to stop fast food shops opening outside schools.
“Through our ten-year health plan, we’re shifting the focus from sickness to prevention to create a healthier nation.”
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