With nearly a quarter of five-year olds starting school overweight or obese, the need for effective action to tackle obesity has never been greater. Just one in 20 children obese at age five will return to a healthy weight by age 11, so focusing efforts on the early years is the most effective strategy. That is why the success of Leeds in lowering its obesity rate has made the news, and why the charity I work for, Henry (Health, Exercise, Nutrition for the Really Young), is so keen to continue its good work there across the country.
At Henry, we have developed an innovative and effective approach, with training for early-years workers and eight-week family programmes delivered in Leeds for 10 years, particularly in more disadvantaged areas. The initiative uses a model that can be adopted anywhere, and so could potentially be rolled out across the country as a key part of obesity-reduction efforts.
The risks of obesity are life-limiting and life-threatening. They include cardiovascular disease, stroke and diabetes. This means that the life expectancy of today’s children may well be shorter than that of their parents. Obesity-related bullying, social discrimination and low self-esteem can emotionally scar children for life. The strong association between poverty and obesity means that rates of obesity are more than twice as high in deprived areas as in more affluent communities, reinforcing health inequalities. This is the bad news.
The good news is that it is easier to prevent or reverse obesity early in life, when children are forming habits and food preferences that can last a lifetime. Parents are often more receptive to support when their children are young than once they are older. Families with young children have much more contact with health practitioners than once children have started school. Equipping parents with the skills, knowledge and confidence to provide a healthy family lifestyle and nurturing home environment is the most effective intervention to tackle child obesity. The Henry programme addresses all aspects of family life, including parenting, family relationships, emotional wellbeing, family routines, nutrition and physical activity. Nationally, more than 14,000 parents have taken part in Henry programmes to transform family life for the better, while training has equipped 13,000 health and early-years practitioners with the skills and confidence to provide effective support to families.
The key to our success is in the quality of support available to parents. Simply providing nutritional and activity guidance is unlikely to result in meaningful change – especially for families dealing with the multiple challenges associated with socio-economic deprivation. We get in alongside families and work with parents to build their confidence and motivation. None of us responds well to being told what to do, particularly when it relates to how we live and how we bring up our children. Regardless of the quality of advice, it is unlikely to be as effective as working in genuine partnership with parents and using our expertise to help them identify the need for change themselves.
“Before the Henry training, when I met a family about whom I had concerns in relation to weight and lifestyle habits, I didn’t feel confident to handle the conversation. I tended to ask them if they knew about their child’s nutritional needs and then direct them to a load of nutritional information,” said one practitioner. “I knew it wasn’t particularly effective as I would see the same families coming back with their next child a couple of years later, and it was obvious they didn’t have a healthy family lifestyle. The Henry training was a revelation. It gave me the insights, skills and confidence I needed to help me have a conversation with parents that actually works.”
When parents sense they have been heard and understood, they are more able to reflect on the kind of changes that will benefit their children. Focusing on a family’s strengths and what’s already going well, before helping parents plan small, achievable steps that will work for their family, is crucial in making these changes a reality. Establishing a healthy lifestyle right from the start is much more effective than trying to change habits later.
Parents’ ability to set and hold boundaries is crucial for a healthy family lifestyle, affecting what, when and how children eat, how active they are, how much time they spend in front of screens and much more. We help parents to develop effective skills and strategies to engage the whole family in healthier eating and activity habits – as well as providing the quality of relationships that children need in order to flourish.
Since 2009, when Henry started working in Leeds, obesity rates at age five have fallen significantly (from 9.4% to 8.8%), while rates for cities with similar socio-demographic characteristics, and as a whole, have remained high. This reduction was primarily in children in the most deprived areas of Leeds, where Henry family programmes are delivered in children’s centres. As a result, the most deprived areas have seen a reduction in obesity, from a prevalence of 11.5% to 10.5%.
There’s no reason not to roll this out across the country, either through central government support, or through local authorities – who currently hold responsibility for public health – investing in the scheme. We’ve got a scheme that works. Now it’s up to our politicians and public health commissioners to invest in change that works.
• Tom Berry is head of business development at Henry (Health, Exercise, Nutrition for the Really Young), working with local authorities on childhood obesity
