WHAT WE NEED TO DO MORE
Initial strategies should aim for slower weight gain first, then target a healthy weight as the child grows.
In my experience, a significant proportion of overweight children appear to come from families with a family or parental history of obesity, lower socioeconomic strata, or lower levels of education. If this can be confirmed, then we can focus our energies on it.
The intervention for these children is already in place. They range from school to community interventions and tertiary health care facilities. School interventions are free and those of the Health Promotion Board (HPB) are affordable.
If finances are a barrier, a medical social worker can help many low-income families. The most common and most difficult obstacle to overcome is motivation. A laissez-faire attitude towards the health of the child, a weak commitment to stick to the treatment plan, a low participation in the intervention sessions are all too common.
For the intervention to be successful, the whole family must be mobilized. However, each other member of the family may have different competing priorities, making family treatments even more difficult.
Collaboration, perhaps between MS-HPB, ECDA and MOE, resulting in a multi-ministerial effort, is likely to be the most responsible, efficient and tax effective.
Here are some gaps that can be filled: Increase community initiatives after office hours programs and develop programs that nurture a child’s natural predilection for play, thereby incorporating exercise into their routine. It is imperative that we do not stigmatize the overweight child as this will likely lead to a negative self-image and potentially to future eating disorders.
The 2020 iteration of the Department of Health’s survey shows that the adult obesity rate has reached its highest level since 2010, with 10.5% of Singapore residents being obese. Our nation has declared war on diabetes and adult diabetes is linked to obesity.
Let’s tackle this problem of childhood obesity as a priority. It is far better to prevent a war than to wage one.
Dr Lim Yang Chern is a consultant pediatrician at the Thomson Pediatric Center (Jurong East).