It’s off to fat camp for you!

Rotherham Primary Care Trust, which is in charge of the community’s health care, has identified the fattest kids in town and is shipping them off to fat camp. Can you imagine being a child and fingered by your town to be sent away to a residential facility — all because you’re larger than the other kids? And can you imagine the message being internalized by other little kids, who are now worried they could be taken away next if they gain any weight?

As the Sheffield Telegraph reports:

Obese children sent to 'fat camp'

OBESE children in Rotherham are being packed off to a fat camp in the latest bid to tackle the town's massive weight problem... It is forking out for 38 of the worst-affected children to attend the specialist Carnegie Residential Weight Loss Camp, in Leeds, this summer and also promising help to another 2,000 youngsters.

Carol Weir, public health specialist at Rotherham Primary Care Trust which runs community medical services, said: "This level of investment shows the sheer strength of commitment that Rotherham PCT has in tackling childhood obesity in our town. With one in three children in Rotherham overweight and obese, this is a serious issue."

The trust has unveiled a three-year plan targeting families with overweight kids. They will receive high-quality services to improve their health and wellbeing.

This move is part of the Rotherham Primary Care Trust’s Obesity Strategy, authored by John Radford, Director of Public Health, and Carol Weir, Public Health Specialist, and submitted to the Board this March. Using the latest figures from the National Child Measuring Programme, their report said that the number of “obese” kids in K-6 grades in the 2005 school year was 854 (10%) and in the 2006 school year it was 737 (10.3%). This compares to 9.9% across England at large.

This is the serious issue referred to and being used to support residential camps for children, as well as child weight loss treatment for the town’s other kids who fall at or above the 85^th percentile on BMI growth curves. Their strategy report said that extreme measures were necessary because “the Foresight Report suggests that to seriously change the current forecasts will require radical, far reaching and long term strategies.”

The Rotherham Obesity Strategy urged readers to not see obesity as an affliction of poorer people. “Obesity is not exclusively a matter of social class and inequality,” it stated. To suggest that obesity is mostly a feature of lower-income groups, the report said, would misrepresent the society wide character of the “epidemic.” But targeting lower-income groups, it said, could reduce obesity rates in the population as a whole, as was part of the government’s Healthy Weight, Healthy Lives strategy to get population figures back to 2000 levels by 2020.

Healthy Weight, Healthy Lives is a $736 million public health initiative issued by the UK government in January that focuses every aspect of society towards the goal of weight loss — from training school and nursery staff to identify at-risk families; school lunches that promote healthy foods to reduce obesity; teaching healthy cooking to all school children; $148 million for a 3-year marketing campaign “to promote healthy weight;” getting the food industry to lower fats, sugars and fats; public walking campaigns; $59 million for building pilot “Healthy Towns;” employer wellness promotions and making “healthy” workplaces part of companies’ business models; developing a national website to give personal advice to “all on their diet and activity levels, with clear and consistent information on how to maintain a healthy weight;” and greater funding for weight loss services. Its guidance for local areas issued in March, defines “healthy” food choices as greater fruits and vegetables and low-fat, low-sugar and low-salt foods, “especially for children.”

The Rotherham Primary Care Trust's Obesity Strategy gave Carnegie Weight Management the contract to provide the town's child weight loss services for the next three years. The authors said it has a “relationship with Carnegie Weight Management.” The contract includes $271,000 for its Carnegie Clubs and $198,000 for its residential camp. The fat camp has 2 to 7 week-long programs where the kids are bunked in rooms of up to three and follow daily schedules of nutrition classes and physical activities.

The Rotherham Obesity Strategy failed to provide estimates for the anticipated effectiveness of the programs they were recommending, or any evidence of their effectiveness, even those directed at children. This omission is especially glaring given that just this past fall, a qualitative study of the management of childhood obesity was published in BMC Family Practice, in which a representative group of primary care doctors in the 39 general practices that contract with Rotherham Primary Care Trust had concluded that “the evidence base for effective management remains poor.”

Despite the lack of evidence, the UK Government has added obesity to the doctors’ Quality and Outcome Framework contracts. According to the study, Rotherham GPs objected to having childhood obesity targets added to their contracts, “given that the evidence base in this area is so poor.” For instance, they said the latest “Cochrane systematic review of interventions for treating childhood obesity included 18 studies of various different treatments, but found little firm evidence of effectiveness for any of them.”

Nor did the Rotherham Obesity Strategy present much of an analysis of the risks for its proposals. Its risk analysis consisted of one sentence noting only “the risk of inaction” and letting the obesity epidemic go unchecked. Not a single mention or consideration of the risks and costs of the harmful effects of their weight loss interventions.

The Rotherham Obesity Strategy will financially cost the town a total of $5,253,000, according to its authors. In addition to more than $977,000 for childhood obesity programs, $202,000 is earmarked to fund a community weight loss program, $514,000 for specialist weight management; and $3,560,000 for bariatric surgeries.

In a total disconnect, the Rotherham Hospital has resorted to appealing to local people, trying to raise $692,000 it needs to buy a Gamma Scanner, a nuclear diagnostic tool used to detect cancers, brain and kidney disorders and a range of other medical conditions. Government has its health care priorities.

© 2008 Sandy Szwarc

All dollar amounts are U.S. dollars.