11 March 2020
Claire Semple: “Childhood obesity needs understanding and compassion, not stigma and blame”
Bristol Royal Hospital for Children clinical psychologist,
Claire Semple, writes about the complexities of childhood obesity,
following on from the Channel 4 documentary '100 Kilo Kids: Obesity
SOS'. Claire is part of Bristol children's hospital's weight
management clinic, the leading childhood obesity service in the UK,
which is featured in the documentary.
There are many factors which contribute to childhood obesity,
making it a complex health issue.
I work as a child and family clinical psychologist at Bristol
Royal Hospital for Children's weight management clinic. I see the
hurtful impact of weight related stigma and blame directed towards
children and parents. This is hugely detrimental to the
psychological wellbeing of children and the willingness of families
to engage in conversations about the challenges they face. These
conversations are crucial to being able to understand the situation
faced by families and establish the best way to support them to
work towards achieving their goals.
The paediatric weight management team feature in a new Channel 4
documentary 100 Kilo Kids: Obesity SOS, which follows three of our
families and their experiences of living with obesity. The causes
of obesity are varied and are often not clearly visible. The young
people featured in the documentary show us that there is not one
single reason for their weight-gain. It's a mixture of lifestyle,
health and emotional factors. The documentary shows that genetic
factors can sometimes play a role too, further tests at a
specialist lab help us to understand that for a five-year-old
featured on the programme who is experiencing constant hunger a
rare genetic condition is a contributing factor.
Their stories demonstrate the complexity of childhood obesity
and that it can be caused by a combination of many factors - easily
accessible, high calorie low cost foods, sedentary activities,
snacking, genetic factors, sleep patterns, portion sizes, lack of
awareness of the calorie content in foods, family mealtime
routines, early experiences with food, to name but a few.
This is a growing problem for society as a whole. Our
relationship with food has and continues to change. We don't just
eat when we are hungry, eating is an activity in itself and part of
our entertainment culture. We eat when we are sad, we eat when we
are bored and we use food as a reward. You can see it is much more
complicated than the common argument "eat less - move more" and
that the causes of obesity are not easy to change. A lack of
understanding of this can lead to negative attitudes and beliefs
known as stigma.
Children who are managing the physical and emotional burden
associated with obesity experience stigma in many ways. Children
are often bullied, excluded and others can hold different
expectations of them when compared with their peers.
The effects of weight related stigma cause children to feel
embarrassed, isolated and ashamed, which can lead to anxiety,
depression and low self-esteem. Young people often use food to
manage these emotions which can result in them eating more and
hiding foods to avoid arguments with parents and further feelings
of shame and embarrassment. Such psychological distress often makes
it harder for young people to socialise with friends, be as active
as others, and have a regular sleep pattern. All of these factors
can also lead to further weight gain and the cycle repeating
itself.
The physical challenges placed upon children and young people by
obesity affect self-confidence and self-esteem. Not feeling able to
play sport for as long as their friends or to be as fast as others
means that children are vulnerable to bullying and this can lead to
them avoiding PE sessions or even avoiding school altogether.
Creating a culture whereby children and young people feel
confident to talk about weight issues is essential to reduce the
associated stigma and increase body confidence and the likelihood
of young people asking for help.
The use of language is an important way to do this, it is
important that young people and families don't feel blamed.
All the families we see want the best for their children. All of
them want to protect their child and use their love to guard them
from society's criticisms. I, along with the whole team of health
professionals, work hard to support families to carefully work
towards a healthier lifestyle.
If young people and their families feel blamed it creates a
negative environment which isn't helpful and can have an impact on
the positive conversations that can ultimately lead to change.
Young people and families have often had difficult experiences
before they seek the help of our service, and it is really
important that we create an environment in which young people feel
understood and parents don't feel judged.
The issues raised in the documentary can feel difficult to talk
about. This can be due to a fear of upsetting children and parents,
creating awkward situations and a feeling of not knowing how to
help. To help children, young people and families it is crucial to
use non-blaming language such asliving withobesityrather than using
stigmatising language such as referring to people asobese, this
allows the opportunity to separate the condition from an
individual's identity. Taking the time to actively listen to
families is essential to understand more about the challenges they
face and the things which make change difficult. That way more can
be learned about what can be done to help and the most appropriate
support can be identified earlier.
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