The Globe and Mail
September 30, 2012
Peter Nieman, a well-known pediatrician based at Calgary’s Pediatric
Weight Clinic, says that more often than not, when he sits down with
parents of children who are overweight or obese, they don’t even realize
there’s a problem.
Then, Nieman shows them growth charts and
explains the trajectory their children are on: continued weight gain
resulting in a significantly increased risk for high blood pressure,
Type 2 diabetes, heart disease, stroke and many other serious
“They’re sometimes stunned to see how bad it is,” Nieman said.
research shows the majority of parents, as well as their children, have
an inaccurate perception of what constitutes obesity. Studies have
shown that children that register as overweight according to medical
benchmarks, rarely consider themselves as such, and are rarely
considered overweight by their parents.
Why can’t we recognize the
person sitting beside us at the dinner table, or looking back at us in
the mirror, as overweight? The answer could lie in the fact there are
more overweight adults in Canada than there are individuals considered
to have a “normal” healthy weight. As it becomes more common for
individuals to be overweight, our collective perception of what is
“normal” weight is being skewed.
In short, fat is the new normal.
just some places where the norm is being overweight, so people just see
themselves as melting in with everybody else,” Nieman said. “Everybody
looks like that, so [the feeling is,] what’s the big deal?”
number of Canadian adults who are overweight or obese remains stubbornly
high, at roughly two-thirds of the population. Similar trends are found
in young people: Statistics Canada reported recently that about three
in 10 children and adolescents in Canada are overweight or obese, a
number that has remained stagnant for a decade. The consequences of our
misperceptions are steep. A study published in the British Medical
Journal last week found that obese young people have risk factors for
cardiovascular disease, such as high blood pressure, raised cholesterol
levels and thickening of heart muscles. If they remain obese into
adulthood – a strong likelihood without intense intervention – they face
up to a 40 per cent increased risk of experiencing a stroke or
developing heart disease in the future, the study found.
Maximova, assistant professor of epidemiology at the School of Public
Health at the University of Alberta, led a 2008 study that found 23 per
cent of children and adolescents in Quebec were overweight or obese, but
less than 2 per cent identified themselves as carrying too much weight.
Young people whose parents or peer groups were overweight were
significantly more likely to report having normal weight, even if they
were overweight or obese.
“This means the social norms about what
constitutes a normal weight are changing to accommodate the prevailing
larger sizes,” Maximova said. “That was the disturbing message from our
Few parents ever recognize their child has a serious
weight issue, even if he or she is obese. A study in the Canadian Family
Physician Journal found 63 per cent of parents with overweight children
said their child’s weight was normal; 63 per cent of parents of obese
children classified them as overweight.
Nieman says more than half
of the parents of overweight or obese children he sees are overweight
themselves, he said. A combination of busy lifestyles, reliance on
convenience foods that are high in fat and calories and too little
physical activity all contribute to the issue.
But as excess
weight becomes increasingly normalized, we are less likely to consider
it a problem. “We no longer see the issue,” Maximova said. “We’re no
longer alarmed by it.”
That’s why a number of experts in the
medical community want to shift the discussion from weight to activity.
Instead of telling people about the importance of losing weight, it
could be much more effective to make it easier for people to get out and
be physically active in their communities.
“I’m not so concerned
about their body size,” said Katherine Morrison, a pediatric
endocrinologist and co-director of the Metabolism and Childhood Obesity
Research Program at McMaster University in Hamilton. “I’m very concerned
about their health.”
Mark Tremblay, director of healthy active
living and obesity research at the Children's Hospital of Eastern
Ontario Research Institute, said possible solutions are as simple as
making neighbourhoods more walkable or using public money to create
supervision in public parks, instead of building a new community centre
that may not be accessible to everyone.
Doctors also have an
important role to play. Too few of them speak to parents about their
child’s weight or measure body-mass index and growth on a consistent
basis, even though all the research points to the fact that early
intervention is key to preventing a lifetime of health problems related
“If you have a problem and nobody talks about it …
there’s an elephant in the room,” Nieman said. “It’s going to be more
difficult to treat those children.”
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