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Too big or too thin?

Obesity in children and teenagers is currently the health topic number 1. Experts estimate that every fourth child in Germany is obese. Obesity does not always disappear when the child grows into an adult. In fact, there is an 80% chance for every obese child that they will turn into obese adults. Obesity, however, is more than just a matter of vanity. It is alarming to see what kind of diseases it can cause in the long term. Even small children can develop common "ailments of the elderly" like diabetes, high cholesterol, high blood pressure, other heart problems or circulatory disorders and also signs of degenerative arthritis.

There are many causes for obesity. Genetic factors have been proven to play a part, although they do not necessarily cause obesity by themselves. Most people underestimate the other causes: constant supply of food as well as lack of exercise. Other reasons include bad eating habits and too little awareness of what constitutes healthy food. Unfortunately, healthy food is often more expensive than other foodstuffs. It is no wonder that children from poorer families are more likely to be obese. People also underestimate the psychological factors which add to or cause obesity. Food is often misused as a means against fear or stress or simply against boredom.

Obesity has existed ever since humans have been around. There were times when it was a sign of being rich and important. Corpulent women were seen as particularly beautiful and desirable. In some countries, this is still the case today. In our Western culture, thin people are now seen as beautiful and the discrimination against obese people has increased. Children and teenagers are under enormous pressure to fit the "ideal" of being thin, and the pressure is very hard to cope with for anyone who isn't.

In many children, this pressure leads to eating disorders. The term "Eating disorder" means that food dominates not only someone's day-to-day life, but also their social relations and their emotional development. Even some primary school children have tried to lose weight by dieting! Since obesity is often associated with a lack of eating discipline, or gluttony, dieting - no matter how absurd and unhealthy it might be - is associated with positive eating habits. Young people who stick to a diet are often supported and praised by friends and parents. If a diet does not help or does not make any difference in the long term - and this is almost always the case - the sense of failure gets stronger and stronger.

Other eating disorders such as bulimia and anorexia are also on the increase. Some young people develop bulimic behaviour, characterised by binge eating with enormous quantities of calories being consumed in a short time. To prevent weight gain, there are periods of vomiting, laxative abuse and excessive exercising. Some young people gain so much control over their eating habits that they become anorexic. They reduce their intake of food to a radical minimum and start losing weight very quickly. However, they are unable to stop starving themselves once they have reached their ideal weight. Even when they are severely underweight, they still feel fat. Permanent starving and the lack of vital nutrients often result in a life-threatening condition. Although it is mainly girls who suffer from bulimia and anorexia, the number of boys suffering from eating disorders has also been on the increase.

Schools are not meant to be therapy institutions. They do, however, play an important part in preventing these problems. If pupils learn about the importance of having a healthy life style, they will be less prone to developing eating disorders.

It is also advisable to discuss the subject of eating disorders in class. Teachers will have to be aware whether and how badly any of the pupils in class might be affected, though. No child should be put under extra pressure.

On the whole, it is desirable that teachers learn to recognise eating disorders in children and teenagers. This is not an easy task, as the cildren concerned often come across as very well adapted and will almost always try and hide their physical and psychological problems.

The best strategy is to develop a relationship of trust with the pupils concerned, which should make it possible to talk directly to them and to their parents. They should be advised to go and seek professional help and teachers could provide them with any useful addresses and contacts. They could also suggest that the school would do everything to support a possible therapy.