Meeting NewsPerspective

Pediatric obesity still seen as a result of ‘bad habits’

LAS VEGAS — An unhealthy diet and lack of physical activity are still considered by the public to be the most influential factors in pediatric obesity development, according to presented at ObesityWeek.

“In the U.S. and U.K., most people do not understand that severe childhood obesity is a biological condition driven mostly by genes and environmental factors that activate it. Instead they presume it simply results from bad habits. In France and Italy, people are more likely to ascribe it to the food environment — specifically to junk food marketing,” Ted Kyle, RPh, MBA, founder of ConscienHealth and board member of The Obesity Action Coalition, told Endocrine Today. “These findings are important because false presumptions frequently get in the way of taking effective action to reduce the health impact.”

Kyle and colleagues recruited 1,001 adults from the U.S., 1,001 adults from the U.K., 1,001 adults from France and 1,015 adults from Italy to complete an online survey in April 2019. The survey asked participants to choose what they believed to be pediatric obesity’s primary cause with options of “poor diet and exercise habits,” genetics and physiology,” “poor parenting” and “excessive marketing of junk food.”

Poor diet and exercise habits was selected by 55.5% of participants in the U.K., 52.7% in the U.S., 49.9% in France and 32.6% in Italy. A slightly higher proportion of the respondents in Italy (34.8%) attributed severe obesity among young children to junk food marketing, which was chosen by 23.7% of participants in France, 16.4% in the U.S. and 16.1% in the U.K. Poor parenting was selected by 26.9% in Italy, 20.8% in the U.S., 18.8% in the U.K. and 13.9% in France. Only 12.6% of participants in France, 10.2% in the U.S., 9.7% in the U.K., and 5.7% in Italy selected genetics and physiology.

“I'm surprised that in all four countries, most people don't understand that biology and genetics are a primary drivers of obesity, especially severe obesity,” Kyle said. “It's also surprising that attitudes in France and Italy are so different from the U.K. and the U.S.”

The researchers also recruited 1,003 adults from the U.S. for a secondary analysis. Half of the participants were asked to explain what they thought might be behindobesity caused by diet and exercise, with options including “poor parenting,” “few options for healthy food and exercise,” genetics and physiology” and “the children themselves.” Poor parenting was selected by 53.8% of participants, whereas 29.6% attributed it to few options for healthy food and exercise, 10.7% to genetics and physiology and 5.9% to the children themselves.

The other half of the secondary cohort asked how strongly they agreed or disagreed with the statement, “Parents are at fault when severe obesity occurs in young children” Among these participants, 27.6% strongly agreed with the statement and 7.6% strongly disagreed with the statement.

“Ascribing obesity to bad habits leads to ineffective strategies for addressing it. Thus, the rates keep rising despite considerable efforts to reverse the trend,” Kyle said. “Clinicians need to equip themselves to educate their patients and families about the biological basis for severe obesity and refer them for effective care. People direct a tremendous amount of blame at parents and that gets in the way of seeking care that will actually help.” – by Phil Neuffer

Reference:

Kyle T, et al. T-OR-2008. Presented at: ObesityWeek 2019; Nov. 3-7, 2019; Las Vegas.

Disclosure: Kyle reports professional fees from Novo Nordisk and Nutrisystem.

LAS VEGAS — An unhealthy diet and lack of physical activity are still considered by the public to be the most influential factors in pediatric obesity development, according to presented at ObesityWeek.

“In the U.S. and U.K., most people do not understand that severe childhood obesity is a biological condition driven mostly by genes and environmental factors that activate it. Instead they presume it simply results from bad habits. In France and Italy, people are more likely to ascribe it to the food environment — specifically to junk food marketing,” Ted Kyle, RPh, MBA, founder of ConscienHealth and board member of The Obesity Action Coalition, told Endocrine Today. “These findings are important because false presumptions frequently get in the way of taking effective action to reduce the health impact.”

Kyle and colleagues recruited 1,001 adults from the U.S., 1,001 adults from the U.K., 1,001 adults from France and 1,015 adults from Italy to complete an online survey in April 2019. The survey asked participants to choose what they believed to be pediatric obesity’s primary cause with options of “poor diet and exercise habits,” genetics and physiology,” “poor parenting” and “excessive marketing of junk food.”

Poor diet and exercise habits was selected by 55.5% of participants in the U.K., 52.7% in the U.S., 49.9% in France and 32.6% in Italy. A slightly higher proportion of the respondents in Italy (34.8%) attributed severe obesity among young children to junk food marketing, which was chosen by 23.7% of participants in France, 16.4% in the U.S. and 16.1% in the U.K. Poor parenting was selected by 26.9% in Italy, 20.8% in the U.S., 18.8% in the U.K. and 13.9% in France. Only 12.6% of participants in France, 10.2% in the U.S., 9.7% in the U.K., and 5.7% in Italy selected genetics and physiology.

“I'm surprised that in all four countries, most people don't understand that biology and genetics are a primary drivers of obesity, especially severe obesity,” Kyle said. “It's also surprising that attitudes in France and Italy are so different from the U.K. and the U.S.”

The researchers also recruited 1,003 adults from the U.S. for a secondary analysis. Half of the participants were asked to explain what they thought might be behindobesity caused by diet and exercise, with options including “poor parenting,” “few options for healthy food and exercise,” genetics and physiology” and “the children themselves.” Poor parenting was selected by 53.8% of participants, whereas 29.6% attributed it to few options for healthy food and exercise, 10.7% to genetics and physiology and 5.9% to the children themselves.

The other half of the secondary cohort asked how strongly they agreed or disagreed with the statement, “Parents are at fault when severe obesity occurs in young children” Among these participants, 27.6% strongly agreed with the statement and 7.6% strongly disagreed with the statement.

“Ascribing obesity to bad habits leads to ineffective strategies for addressing it. Thus, the rates keep rising despite considerable efforts to reverse the trend,” Kyle said. “Clinicians need to equip themselves to educate their patients and families about the biological basis for severe obesity and refer them for effective care. People direct a tremendous amount of blame at parents and that gets in the way of seeking care that will actually help.” – by Phil Neuffer

Reference:

Kyle T, et al. T-OR-2008. Presented at: ObesityWeek 2019; Nov. 3-7, 2019; Las Vegas.

Disclosure: Kyle reports professional fees from Novo Nordisk and Nutrisystem.

    Perspective
    Ozair Abawi

    Ozair Abawi

    The study by Kyle and colleagues clearly shows that there is still a lot of effort to be undertaken to battle the social stigma of pediatric obesity. A large amount of scientific evidence links pediatric obesity to myriad genetic and environmental factors, such as genetic and hormonal predisposition, socioeconomic status, food environment, adverse life events and psychosocial factors influencing children, their parents or both. Moreover, it has recently been postulated that individual variability in response to obesity treatment is influenced not only by biological factors, but also by behavioral, environmental and psychosocial factors (MacLean PS, et al. Obesity. 2018;doi:10.1002/oby.22154).

    From our clinical experience, we know the many sad stories of our patients and their caregivers regarding the weight stigma they were confronted with. It often leads to a significant patient delay and less effective treatment. The study by Kyle and colleagues shows how important it is for us as caregivers to incorporate a broad diagnostic strategy in our workup to identify patient-tailored treatment facilitators and barriers and, by doing so, provide our patients with the best possible tools to challenge the obesity stigma. This can have a tremendous positive effect on children and adolescents suffering from obesity, even patients with severe obesity caused by monogenic disorders (Kleinendorst L, et al. BMJ Case Rep. 2017;doi: 10.1136/bcr-2017-221067). Moreover, in selected patients presenting at a tertiary pediatric obesity center, we could even show that in a subgroup of patients their obesity could be explained by an underlying medical cause, eg, a genetic, cerebral or medication-induced cause of obesity. Kyle and colleagues show the importance of education on the causes of obesity, not only for the patients themselves and their environment, but also at the level of the general population, policy makers and caregivers themselves.

    • Ozair Abawi, MD
    • PhD candidate
      Obesity Center CGG
      Department of Pediatric Endocrinology
      Erasmus MC-Sophia Children’s Hospital
      Rotterdam, the Netherlands

    Disclosures: Abawi reports no relevant financial disclosures.

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