Obesity tests: The fat police: Every four-year-old in the country to be officially screened

The Independent
May. 21, 2006

Primary schoolchildren are to be routinely weighed and their parents told if they are obese in a controversial initiative to tackle the worsening health crisis, The Independent on Sunday can today reveal.

Ministers have decided to overrule the Children's Commissioner and their own child health officials, who fear that telling parents the test results will stigmatise some children.

Primary schools are preparing to weigh and measure the height of four- and 10-year-olds during this summer term to help prepare a national "map" of childhood obesity. Individual statistics will only be given to parents who ask for them and no extra help will be offered to children who are found to be overweight or obese.

From next year, however, parents of any obese four- or 10-year-olds can expect a letter telling them their child faces long-term health damage unless they lose weight, prompting allegations that the Government is policing the size of our children. The move came after MPs dismissed as "drivel" claims that telling parents the results could lead to children being bullied.

Caroline Flint, the health minister leading the anti-obesity drive, believes parents are the "first and foremost influence" on their children. She has overruled Professor Al Aynsley-Green, the Children's Commissioner, who fears that obesity screening at four could do more harm than good. Her decision has delighted obesity campaigners, who say the danger to obese children's future health is so great it outweighs any fears that they may be bullied.

But some experts expressed concern that it could distort children's relationship with food and their own bodies. Dr Robin Arnold, of the BMA's psychiatry committee, said he feared there would be increased rates of eating disorders.

The agony aunt Virginia Ironside was sceptical of the need for an official obesity screening programme. "It's not as if being fat is a hidden problem, is it? It all seems a bit Germanic to measure everyone, and it will probably only succeed in getting parents' backs up."
This summer's tests will be done in "light clothes" and children will be told why they are being measured, according to Department of Health guidance issued earlier this year.

But the guidance spells out officials' concerns at the potential for fatter children to be bullied as a result. "Children can be very sensitive about their own size and those of children around them. Measuring height and weight could accentuate this sensitivity and increase the risk of stigmatisation and bullying."

Parents will be given the right to refuse permission for the child to be tested and can ask not to be sent the results next year.

But ministers hope the vast majority will want to be told the results of the tests. "It's about making sure that whatever we do, government supports families to make the right decisions. It is families who first and foremost influence what their children eat and what their children do in terms of exercise," Ms Flint said earlier this year.

It is thought that the minister is studying US trials in which parents are sent one of three letters following their child's measurements being taken. The first congratulates them on keeping their child within health limits, the second raises concerns that they may be getting out of shape, and the third is a stark warning that their child is obese and risks long-term health damage.

Dr Fiona Adshead, the Deputy Chief Medical Officer, told a meeting of the Public Accounts Committee that child health officials had urged ministers not to tell parents the test results. "We had a lot of concerns from child health officials who wanted to caution us against systematically feeding information back to children. The reason they did that is we are not sure we can guarantee effective treatment."

But the committee's chairman, Edward Leigh, dismissed the excuse as "absolute nonsense" and "drivel".