Ten percent of six-year-olds in the UK and 17 per cent of 15-year-olds are obese – figures that have doubled since 1982. And this worrying trend shows no signs of abating, thanks to a combination of poor diet and a modern sedentary lifestyle.

Last year, the UK saw its first case of a child developing adult-type diabetes through being overweight. Last year also saw the Royal College of Paediatrics respond, perhaps belatedly, to the problem by issuing guidelines for dealing with childhood obesity.

But with the medical profession beginning to accept diet drugs as a suitable way of dealing with the increasing problem of obesity in adults, is it not simply a matter of time before we start issuing them to children?

A quick fix

Dr Ian Campbell, chairman of the National Obesity Forum, fears that may be the case. “It’s a struggle to know what to do,” he says. “Ideally drugs shouldn’t be used for kids but if the medicine can be shown to be safe, you have to look at it.”

It’s already happening in the States, where diet drugs that suppress the appetite and absorb fats are widely accepted. The US has a far less-regulated drug market than the UK but the fact that people are buying diet pills suggests some parents believe the benefits outweigh the risks.

But not everyone agrees. Edita Kaye – “America’s Favorite Nutritionist” and creator of the “Skinny Pill for Kids” – has recently come under fire in the US. In March, a government committee warned she could face a subpoena unless she replied to concerns over the pill, which contains several diuretics experts fear could cause permanent damage to young children.

Pill culture

Despite the UK’s stricter laws and relative resistance to pill culture, this isn’t just a US issue. Although there are at least a dozen approved diet drugs in the States, there are already two in this country– orlistat (known as Xenical) and sibutramine (known as Reductil).

And, despite a further two – phentermine and amfepramone – being withdrawn in the UK, Dr Campbell reveals they are still available in private practice.

In fact, a wide range of diet drugs are available for obese or overweight people – some originally intended for other conditions including diabetes and depression – and experimental work is already ongoing with children, he explains.

Dodgy side effects

So, how have we got here? Surely tackling obesity is little more than a decent diet combined with regular exercise? Why on earth should we even consider feeding our kids drugs, especially when some have side effects such as constipation, chronic diarrhoea and insomnia?

That is certainly the angle the Royal College of Paediatrics and Child Health, the National Obesity Forum and the NHS are taking.

The Royal College of Paediatrics pointedly avoids mention of diet drugs for kids, talking only of “weight management” through non-chemical means. It also stresses that obesity should be tackled slowly and with the child’s feelings always in mind.

“Negotiate realistic goals,” it suggests. And by that it means “small, progressive, sustainable changes in eating habits, physical activity and inactivity”. Parents “should be involved as much as possible”.

Jack the junk

Dr Campbell agrees entirely, adding that the whole family should adapt its eating habits. “Families should be supportive not critical,” he says. That means collectively cutting down on fizzy drinks and sweets, eating a good breakfast, having regular meals, grilling rather than frying food, and increasing consumption of fruit and vegetables.

It is often easier said than done, however. While most adults fail to stick to diets, it can be doubly hard for children – who are heavily influenced by family habits. The Royal College of Paediatrics also points out that there may be other factors, many psychological – such as low self-esteem, bullying, depression – that lead kids to over-eat, and therefore need to be tackled.

But why are our kids getting fatter? Dr Campbell points to significant cultural changes: “There is a massive pressure on parents to buy sweets and fast food thanks to all the advertising,” he says. “There is an over-abundance of sweet foods at checkouts, in shops, everywhere. And kids now want to play on computers and watch TV.” All this contributes to an unhealthy, fat-heavy diet that creates obesity and is extremely difficult to change.

A last resort

The government is not resting on its laurels, however, and a whole range of educational programs on diet is already in the offing. Ministers are also making great efforts to encourage more sport among schoolchildren. Education about diet is vital although Dr Campbell says that most families “still haven’t got a clue”.

But all the evidence points to an increase in obesity outstripping efforts to reduce it. With the condition posing a serious medical risk to kids, could it be that diet drugs – drugs that are becoming increasingly sophisticated – are the future? Dr Campbell ponders the question.

“Do I favour drugs for children? No. But a broader answer is, if I see them dying of their obesity, then it is something that has to be looked at.”

Further information:

National Obesity Forum
www.nationalobesityforum.org.uk

Royal College of Paediatrics and Child Health
www.rcpch.ac.uk

The Skinny Pill
www.skinny.com 

© HMG Worldwide 2003
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