It is timely to broach the difficulties and awkwardness surrounding the subject of overweight/obesity. By this I mean, awkwardness on the part of GPs and difficulties for patients and parents. In my own experience I have witnessed a verbal complaint from parents because a conscientious GP addressed the abnormally high BMI of their young child during a consultation about something else. It is no wonder that colleagues may be inhibited in this area.

Yet we know that overweight and obesity are closely associated with serious conditions such as diabetes, high blood pressure, the metabolic syndrome, heart disease and certain cancers. This is all placed in perspective by a study published in the Lancet on August 30, 2014 of worldwide and national prevalence of overweight and obesity between 1980 and 2013.¹ This research shows that 26.5% of Irish girls (up to age 20) are overweight or obese and that the figure for Irish boys is 16%. These figures are above the European average. Shockingly, the study reports that 66% of Irish men above 20 are overweight or obese and that the statistic for Irish women is 51%. The greatest surge in overweight/obesity since 1980 is in the age group 20-40 years and presumably this ‘surge’ begins in childhood.

Interviewed by RTE News following publication of this paper, Donal O’Shea, director of the Weight Management Clinic at St Columcille’s Hospital, Dublin stated that there are 1,300 people on the clinic waiting list and it has the capacity to see only 250 patients per year. The gentleman I referred last week will be seen in about five years! Dr O’Shea went on to say that services for overweight children were poorly resourced and waiting lists were at least as long as for adults. 

This month, we publish a paper by Brendan O’Shea, Emma Ladewig and Tom O’Dowd on ‘Childhood overweight in general practice’, which describes research carried out with a sample of 20% of Irish GPs showing that small numbers of us routinely check children’s weight and that very few consistently raise the matter of overweight children with parents. 

Another wing of the study measured the weights of 500 Irish children in general practice. A telephone survey of parent’s attitudes to weighing was also carried out and was reassuring in that a majority of parents and children were not upset by the weight measurement in the consultation. The doctors involved in this part of the study had experienced a short learning module on correct techniques which must have improved the acceptability of this intervention for parents and children.

I believe that reading this paper and experiencing the eLearning module now available at www.icgp.ie will encourage us (including those who have received parental wrath) to build this easily into our paediatric consultations. Overweight and obesity is rising steadily both nationally and globally. Can we be part of a system which reverses this trend? On the other hand, will resource and contract difficulties for Irish GPs make this aspiration unattainable?  

1. Gakidou E et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. The Lancet 2014; 384(9945): 766-781