Inspiration for this article developed from a recent dietetic training period at a French hospital. The opinions shared in this post are solely my own. The name of this hospital will remain anonymous, but I can attest in my opinion that the health standards in this hospital (including hygiene, meals, nutritional care, patient satisfaction) were average to exemplary.
Read other articles in this series on French hospitals here: French Hospital Chefs and Taste, a Battle with Dietitians, Chromodulated Chemotherapy to Treat Cancer , A Week in A French Hospital and Not Even Sick, and Ketogenic Diet to Treat Epilepsy.
Rates of Childhood Obesity are Leveling Off In France
I have great empathy for obese children. Not only do large kids struggle with their health and self-esteem, but the chances that they will continue to struggle throughout their adulthood are pretty high.
Big as a child, big as an adult.
That is why when I see things that work, I want to share them with you. (Keep reading to the end, the action plan is at the bottom).
There is one country that is making strides in the fight against childhood obesity. The one I live in almost year-round. La France. There are still 16% of the pediatric population that is overweight or obese, but this percentage is staying relatively stable. (See statistics from OECD here).
During my training at a local French hospital, I attended a one-day conference on a free program called RePOP, available for obese French children. This article is Part One about what I learned about childhood obesity in France, what the government does to prevent it. Part Two will focus on this unique program that personalizes an action plan for obese children.
Why are childhood obesity rates leveling off in France?
Don’t get me wrong. I will tell you from direct experience that there are still a lot of overweight and obese children in France. It is not a country filled with the super-thin and eat whatever you want.
But things are happening here. The nationwide battle against the bulge to slow down obesity in France’s population, is working. France has one of the lowest obesity rates in Europe, for both children and adults.
Why? Different reasons:
The government. The culture. The health system. The negative ‘cannot be fat’ stigma in France.
- The French government continues to put significant money and efforts to fight obesity in France.
- The French culture, based on la joie de vivre, emphasizes fresh food and adequate physical activity.
- The socialized health system, paid by the citizen’s taxes, uses a preventive and coordinated approach to health and fighting the rise in obesity.
- The negative stigma attached to being large in France is an unfortunate side effect of a culture that pushes by force the population to take action to keep in a good weight, both on an adult and pediatric level.
The specifics on how France fights the rise of obesity
- National governmental program against obesity called Manger, Bouger. (Program incorporates short public announcements on television and produces printed documents to encourage good healthy eating habits with adequate exercise).
- With changes into the French school lunch program that establishes healthy meal options.
- Adding a tax on soda, called the ‘cola tax’ which has been in effect since January 1, 2012.
- After recommendations from the HAS, La Haute Autorité de Santé, directed to French doctors for obesity screening and detection.
- The program called RePOP, established in 12 areas in France. This is a coordinated multidisciplinary effort for children who meet the obesity criteria.
Directives to the French doctors and health professionals: screen all children for overweight and obesity
The HAS, La Haute Autorité de Santé (French Health Authority) advises the following:
- BMI measured 3 times a year from birth to 2 years old.
- BMI measured 2 times a year after 2 years old.
- Trace the three measurements: height, weight and BMI on the growth charts in the child’s health book, called le carnet de santé.
- Recognize the ‘red lights’ with overweight and obesity in each patient: rebound of early adiposity (called AR -adiposity rebound), or increasing growth curves from birth or rapid weight/BMI changes that move up one growth curve higher.
- Take action if there is a red light.
The systematic surveillance of BMI is recommended, at least 2-3 times a year for all kids and teens-whatever their age, whatever their body seems like subjectively, whatever the reason for the doctor’s visit.
So, I don’t live in France. Why should I care what the French do?
Here is my answer: promote your own prevention and early action.
Perhaps in France the government plays too strong a role in fighting obesity. It is because of the way the social health system, paid by citizen’s taxes, operates.
Isn’t it the most cost-effective way in a social health system to prevent obesity related diseases?
And after screening, if a child is at risk for obesity or is obese, the governmental health system takes action again.
The health system financially takes in charge a patient, with the agreement of the patient and parents, to get this child to stabilize their weight.
Now substitute your own prevention and early action with the national programs available in your country.
While France might be a model on how the government and health system work to stabilize obese rates, you can too, in whatever country you live; as a parent, caregiver, teacher, doctor or person, do your part to help stabilize obese rates in your entourage.
By prevention and early action.
The specifics on personal prevention and early action for childhood obesity rates
- Start thinking early: pregnancy is a time to eat healthy and gain the right amount of weight for you and your baby.
- Breastfeed when possible.
- Take a role in plotting your child’s height, weight and BMI on the growth curves. Talk to your health professional about doing it together and discuss your concerns.
- Do not assume that if your child looks normal weight they are. The best way to look at child’s weight is objectively, weighed without clothes.
- Take early action: by plotting regularly height, weight and BMI on a growth chart, action can happen quickly before your child’s weight goes from normal to overweight to obese.
The earlier a child has an adiposity rebound,(normal is around 6 years old) the higher chances are that they will be obese. The time to be especially vigilant is between your child’s first and second birthday and second to third birthday.
Action Plan called RePOP
The French action plan for obese children is called RePOP.
It takes each child and personalizes an action plan to stabilize their weight, before they reach adulthood.
Want to know more about this unique program? Details in the next article Part Two in a few days.
Even if you don’t live in France, there is something to get out of Part Two, RePOP Program, a personalized multidisciplinary long-term approach to ‘curing’ obesity.
If you like what you have read, please share it with your entourage! The more we work together to help fight the battle against childhood obesity, the more everyone wins.
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