I was very disappointed to read the opinion piece below in the latest BMJ. I
generally respect Des Spence's opinions, and I often agree with him. But in
my opinion this piece is really ill-informed victim-blaming.
Fruit is the missile of choice in schoolyards? For some children, that would
be the only time they *see* fruit.
Supermarkets and food corporations merely mirror demand? Yeah, right, like
parents *demand* to have sweets at kid height in checkout aisles, do they?
And supermarkets sell healthy food cheaper in middle-class suburbs because
poor people *demand* to pay more for it?
I do agree that parents need to assert more control over what their kids
eat, but the control that is most needed is much greater regulation of
advertising and marketing. And parents need adequate incomes, stable
housing, food security, not blame.
Melissa
Melissa Raven, Adjunct Lecturer
Department of Public Health, Flinders University GPO Box 2100 ADELAIDE SA
5001 AUSTRALIA
Published 10 June 2009, doi:10.1136/bmj.b2369
Cite this as: BMJ 2009;338:b2369
Views & Reviews
From the Frontline
Cut to the chase
Des Spence, general practitioner, Glasgow
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Television researchers are well spoken and "supportive," but they are often
exploitative too. From talent shows to daytime talk shows, vulnerable people
are sucked into a Victorian freakshow, without even benefiting from the peep
show penny. While channel flicking recently, I was struck by how many
programmes there were on super-obese teens and their operations. The tone of
the presenters remained passive and the comment minimal, for the voyeuristic
spectacle said everything. But my inner voice was screaming, "So, who's
responsible for the fact that kids are becoming obese?"
Let's dispense with some common excuses. It's not poverty that prevents
children from eating well-fruit is the missile of choice in school
playgrounds. Nor is it the supermarkets' and food corporations' fault, as
they merely mirror rather than lead demand. Our society cannot bear to
listen to the truth, and the medical profession is prevented from speaking
it-but child obesity is the fault of the parents. There are extenuating
circumstances, of course, and it is not all wilful neglect. Instead it is
often quite the reverse. For society seems unable to understand the role of
the parent, wanting to equate it with that of friend, which it isn't. The
central theme of parenthood is that our children should respect us, but may
not always like us. However, conflicting expert advice constantly undermines
this parental intuition.
Thus parents are unable to set boundaries for their children, who then eat
what they want, drink alcohol as young teens, watch what they want, and are
never asked to do anything that they don't like. Parents fear that "making"
children do things will make them unhappy and "undermine" their self esteem.
Teenagers end up frozen in a time warp, behaving like toddlers. But as obese
children gain the pain of adolescent insight, they see through parental
praise and reassurance. They hate their body image and themselves and then
revert to their only comfort-food. The significant hormonal impact of
obesity in adolescence is yet to be quantified. But we do know that teenage
unhappiness can spill into adulthood, with many people left struggling in
relationships and with low self worth. The cosmetic scalpel or the self
harming razor blade beckon.
We are failing a generation-who are given everything in childhood only to be
denied everything in adulthood. So doctors need to be more direct and
paternalistic. We need to be more supportive of parents but also absolutely
clear about where the responsibility lies in the duty of care for children.
Such advice might seem Victorian, but parents must challenge their children,
force them to be active, and limit both junk food and portion sizes.
Cite this as: BMJ 2009;338:b2369
http://www.bmj.com/cgi/content/full/338/jun10_3/b2369
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