WHAT WE NEED TO DO MORE OF
Initial strategies should aim for a slower weight gain first followed by targeting to reach a healthy weight as the child grows.
From my experience, a significant proportion of overweight children appear to be from families with a family or parental history of obesity, from lower socio-economic strata or lower educational backgrounds. If this can be confirmed, we can then focus our energies there.
Intervention for such kids is already in place. They range from school to community interventions and tertiary healthcare facilities. School interventions are free and those by the Health Promotion Board (HPB) interventions are affordable.
If finances are a barrier, a medical social worker can help many low-income families. The most common and challenging barrier to break through is motivation. A laissez-faire attitude towards the child’s health, poor commitment in sticking to the treatment plan, poor attendance at intervention sessions are all too common.
For intervention to succeed, the whole family needs to rally together. However, every other member of the family may have different competing priorities making family-based treatments even more challenging.
A collaboration, perhaps between MOH-HPB, ECDA and MOE – culminating in a multi-ministry effort will probably be most fiscally responsible, efficient and effective.
Some gaps that can be addressed include: Increasing community-based initiatives after office-hour programmes and developing programmes that nurture a child’s natural predilection for play thereby embedding exercise into their routine. It is imperative we do not stigmatise the overweight child as this will likely lead to negative self-image and potentially leads to future eating disorders.
The 2020 iteration of MOH’s survey indicates that obesity rate among adults has risen to the highest level since 2010, with 10.5 per cent of Singapore residents found to be obese. Our nation has declared a war on diabetes and adult-onset diabetes is associated with obesity.
Let’s address this problem of childhood obesity as a priority. It is far better to prevent a war than to fight one.
Dr Lim Yang Chern is consultant paediatrician at the Thomson Paediatric Centre (Jurong East).