Ms Oberhoffer, how does obesity impact children’s health?
Renate Oberhoffer: Obesity negatively impacts metabolism and joints, and has a huge influence on cardiovascular diseases, which are the leading cause of death worldwide. The body’s vessels age earlier and more severely; even in the case of some children and adolescents we have observed thickened vessels. They are thus obviously prone to having higher blood pressure, a stroke or heart attack at an earlier age.
Ms Ravens-Sieberer, you also study psychological aspects…
Ulrike Ravens-Sieberer: Yes, and from this perspective it’s important to note that children’s quality of life is often reduced, not only due to physical problems, but also because of stigmatisation and social marginalisation. This can lead to negative emotions, withdrawal, and stress. Approaches to prevention and treatment must therefore also strengthen the mental health, self-esteem and social participation of children and actively prevent stigmatisation.
The Policy Brief claims that despite numerous efforts to prevent the disease, it is not becoming less common. What’s not working?
Ravens-Sieberer: Many approaches to prevention are too sporadic, too short term, and too uncoordinated. The Leopoldina paper describes how in Germany there are, to date, only a few prevention strategies that are systematic and coordinated among the relevant stakeholders. Far more common are project-based approaches of limited duration and which do not lead to lasting structural changes. The aim must be to boost participation, quality of life, and environments that promote health, so that healthy choices in everyday life become easier.
Oberhoffer: The programmes are usually aimed at individuals and it’s not exactly made easy for people. More work also has to be done on the relevant environments, such as ensuring that school environments promote exercise, that school canteens provide healthy food, and that school kiosks don’t sell too many sweets.
Are some groups of children particularly affected?
Ravens-Sieberer: Yes, children from families with a low socioeconomic status. This reflects structural framework conditions, such as food environment and food costs, stress levels, living environment, areas for exercise, and available time resources. At the same time, programmes to promote self-control and health-related routines have proven to be particularly effective when it comes to children, as long as the programmes are easily accessible and well implemented.
Ms Oberhoffer, you also deal with early prevention. When should prevention start?
Oberhoffer: From the moment a woman is pregnant. Nowadays, pregnant women gain more weight than they did in the past. Children weigh more at birth, and it’s difficult to then try and reverse that. It is vital that pregnant women get enough exercise, as that already seems to have an effect on the later behaviour of children. Some people believe it’s important to teach girls about health long before they even become pregnant.
Do we also need instruments such as a sugar tax?
Oberhoffer: Indeed, I consider this the most urgent thing. Various associations have been calling for a sugar tax for years, as well as a limitation on the advertising of unhealthy foods, above all for children and adolescents. This would be an important signal from the state that it cares about this issue.
What are the consequences for society if nothing is done?
Ravens-Sieberer: There are wide-ranging health, social, and economic consequences. Obesity can exacerbate social inequality and is linked to long-term health risks. The entails considerable direct and indirect costs for the health and social system.
Oberhoffer: The result will be an epidemic of obesity-related diseases and higher costs than if we change the approach now. People forget that investing more money in the younger generation has an effect later on. And, in my view, the cry to “invest more in child health” is insufficiently heeded. This is both regrettable and short-sighted.
The interview was conducted by Christine Werner.