Rising numbers of children in homeless or direct provision accommodation are being treated for morbid obesity.
The nation’s only specialist children’s clinic for treating obesity in Children’s Health Ireland at Temple Street has seen a worrying rise in the numbers of the vulnerable children over the past two or three years.
It is currently estimated that there are around 70,000 Irish children affected by obesity which is linked to a series of distressing conditions.
Dr Grace O’Malley, Lead for the Obesity Service in Children’s Health Ireland at Temple Street Hospital, said they are seeing more children with obesity who are homeless.
Cramped rooms with no cooking facilities
“It makes things far more challenging because whatever plan we put in place - everything is against the families to try and implement it, if they have no accommodation," she said.
“I can empirically say it has definitely increased over the past two or three years and this observation should be confirmed through a formal study."
Dr O’Malley, who also leads a research team at the Royal College of Surgeons in Ireland, said it is extremely difficult for parents to feed their children healthy food in cramped hotel rooms with little or no cooking facilities.
She said: “From the homelessness aspect it’s just being able to have access to cook and store food or to sit at a table together. That stability and continuity is vital to support health and development.
You can’t do a shop for food if you don’t know where you are going to be tomorrow or the next day.
“It’s much harder to have wholefoods and vegetables. If you don’t have refrigeration it’s hard to keep dairy.
“So quick, cheap, high-calorie food makes the most sense but may provide less nutrition.
“It’s not a parental decision not to do the right thing. This is a decision operating within the confines of restricted choice and the child’s little body reacts to this stress.”
Society’s role in childhood obesity
She said the discussion needs to shift from parental blame and look at society’s role in childhood obesity.
The W82GO Child and Adolescent Weight Management Service offered nearly 3000 patient appointments to children in 2017 and 2018 with the majority treated for morbid obesity while 227 were new patients.
The clinical specialist physiotherapist said the clinic at Temple Street Hospital is also seeing more children with obesity who are living in direct provision centres.
She said: “Obesity in children living in direct provision is also an emerging issue because of the types of food that are provided.
“It’s a big shift to come from your traditional staple foods to this western diet.
“For some of the families, the types of food they would have to eat wouldn’t necessarily be the best for them.
“Migrating into a new country can bring many changes including new practices around food culture, the types of food available and the way people eat.
“Some research suggests a higher risk of obesity in children whose mothers have immigrated into Sweden for example.
The State has a duty of care to nourish people not to just give them calories and it’s important to understand that children can be overweight but still malnourished.
“One of the basic roles of a parent is to feed and nurture their children. You need to have adequate nutrition, space and facilities to grown and develop physically.”
The obesity expert said families should have the basic right to cook their own type of food in these centres.
“To be able to give your child the type of food they are used to is a massive thing so that they will eat and be satisfied by it. Having access to food at different times is also important especially for children and mothers who are breastfeeding.
“I imagine many of these children are quite traumatised as well after their experiences so eating food familiar to them is very important.”
'Inedible and inappropriate'
Data from the World Health Organisation COSI study led in Ireland by UCD suggests that nearly 2% of children are estimated to be severely obese with the rates higher in areas of disadvantage.
A 2014 report by Nasc in Ireland reported that food provided in direct provision was often described as inedible and inappropriate.
“As a society we really need to do more to reduce social inequality so that every child has the same exposure to health-enhancing environments regardless of where they live, where they are from or what level of education their parents have”, said Dr O’Malley.