Childhood obesity increases the greater the weight of the parents and the lower their income and education level, although it also varies greatly depending on the community of residence, so that children from Murcia, Catalonia, Andalusia or the Canary Islands (where overweight affects 25.15% of the population aged 2 to 17, according to a study by the University of Murcia), have rates up to ten times higher than those of Navarra, Aragon or Cantabria.
"The causes are multifactorial and we must understand their complexity: it is not just eating a lot and badly and sedentary lifestyle," Gilberto Pérez, endocrinologist and pediatrician at the Gregorio Marañón Hospital in Madrid and member of the Obesity Area of the Spanish Society of Endocrinology and Nutrition (SEEN), told EFE.
Beyond genetics, which cannot be modified, the most important individual factor is "the example of the parents", their ability to promote a healthy lifestyle and recognize, when there is one, the weight problem in their child, but 70% do not see it. "The main limitation is that many parents - and professionals who care for them - do not detect it. This is how childhood obesity cannot be fought."
According to a 2017 study by researchers from the University of Granada, 90% of parents of overweight children believed they were normal; 63% of parents of adolescents aged 10 to 14 with overweight and 40% of those with obesity did not perceive it either.
Other of their conclusions were that mothers are more likely not to identify that excess; parents with overweight/obesity are more likely not to see it in their children; and families with higher levels of education and better income levels better identified the problem.
Double in low-income families
Many studies place Spain at the top of European classifications: the Aladino, of the Ministry of Consumption, and the Cosi (Childhood Obesity Surveillance Initiative) of the WHO, show prevalences of obesity or overweight in children aged 6 to 9 years of 17.3% and 23.3%, respectively.
During adolescence, according to the Physical Activity, Sedentarism and Obesity in Spanish Youth (PASOS), of the Gasol Foundation, excess weight in Spain is 32.5% (22.8% overweight and 9.7% obesity).
The prevalence, adds Pérez, is also linked to the Body Mass Index of the parents: 17.2% of children from families with normal weight becomes 57% when the BMI of the parents is close to 40%.
And to the income level: the percentage of minors with obesity doubles in households with less income (23.7%) compared to those with more (10.5%).
17 realities
Recently, the Spanish Journal of Public Health has published the study "Approach to childhood obesity. Comparison between autonomous communities", prepared by researchers from the University of Murcia on the Spanish population aged 2 to 17 years, for which it calculates an overweight rate of 18.26% and an obesity rate of 10.3%.
Although the figures for Murcia (25.75%), the Canary Islands (25.15%), Melilla (24.5%) and the Balearic Islands (22.97%) are far from those of Extremadura (11.8%); Navarra and Euskadi (13.5%) and Catalonia (14.8%).
Even greater is the obesity gap, which in Ceuta reaches 17.9%, followed by Murcia (14.2%), Catalonia (12.6%) and Andalusia (12.4%). At the other extreme, Navarra (1.4%), and Aragon and Cantabria (2.5%).
The form and resources to address the problem also differ; the national ratio of pediatricians is 1.21 and 0.65 nurses, but in La Rioja it is 1.55 and 0.89, respectively, compared to 0.84 and 0.54 in the Balearic Islands.
Andalusia, Asturias, the Canary Islands, Cantabria, Castilla-La Mancha, Extremadura and Galicia do not currently recognize nutritionists and nutrition technicians as healthcare personnel.
In this regard, Murcia was a pioneer by offering 9 public positions for nutritionists in recent years, followed by the Valencian Community (7) and Navarra (1); those of senior nutrition technicians were even greater, with Andalusia in first place (23), ahead of Castilla y León (14) and the Foral Community (8).
Homogenize the approach
Only Andalusia, the Canary Islands, Castilla y León, Castilla-La Mancha, the Valencian Community, Galicia, Murcia and Euskadi, in addition to Ceuta and Melilla, have comprehensive plans.
Regarding the healthcare expenditure derived from childhood obesity, only Catalonia periodically carries out an economic analysis, the last of which quantified the additional cost of this disease at 153 euros/person and year (which gives a total of 13.7 million annually in this community).
Likewise, only Castilla y León and La Rioja allocate a specific amount for healthy eating programs (of 14,000 and 29,405 euros, respectively).
For all these reasons, the authors of the study urge those responsible for healthcare management at the national, regional and local levels to channel "their efforts into homogenizing this approach, in order to improve the quality of care and equalize prevention and treatment opportunities."
Mental and physical damage
It is urgent because, as the endocrinologist points out, obesity causes havoc on children's health, whether mental - low self-esteem, stigmatization, bullying, school absenteeism, eating disorders - or physical - increased cholesterol and blood pressure, prediabetes and fatty liver, precocious puberty, joint problems...-.
And because being overweight as a child increases the risk of maintaining it as an adult and that decreases life expectancy.
At SEEN, they advocate for a multidisciplinary approach to the disease "without delay", including psychological support, in which their environment must also be present: parents and caregivers should remind these children "how much they love them, reinforce their positive qualities and not tolerate jokes or comments in relation to their weight."
If they suffer teasing, you have to talk to them, but avoiding criticism because "it does not motivate and can do a lot of damage."
