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| Child obesity programmes struggle to survive cuts | Child obesity programmes struggle to survive cuts |
| (7 months later) | |
| As evening falls in Union Street in the centre of Oldham, the problems affecting the health of local children become clear. | As evening falls in Union Street in the centre of Oldham, the problems affecting the health of local children become clear. |
| In the words of Neil Wise, a leader of childhood obesity programmes, the street becomes "one long neon light". UK Fried Chicken faces Kansas Fried Chicken, which is two doors down from Raja's Tastiest Halal Pizza and next but one to Halal Fish and Chips. And it's very cheap. | In the words of Neil Wise, a leader of childhood obesity programmes, the street becomes "one long neon light". UK Fried Chicken faces Kansas Fried Chicken, which is two doors down from Raja's Tastiest Halal Pizza and next but one to Halal Fish and Chips. And it's very cheap. |
| Wise said: "You can get two pieces of chicken and chips for £2. We have got a Pound Bakery. A child said to me: 'We have been to the Pound Bakery for breakfast.' I said why not have two pieces of toast and save 50p? He said we don't get one pasty for £1 – we get two." | Wise said: "You can get two pieces of chicken and chips for £2. We have got a Pound Bakery. A child said to me: 'We have been to the Pound Bakery for breakfast.' I said why not have two pieces of toast and save 50p? He said we don't get one pasty for £1 – we get two." |
| In a sports centre in Oldham, Wise and the programme co-ordinator Adele Stanton are running a two-hour after-school, after-work course for Mend, which stands for Mind, Exercise, Nutrition, Do It. Originally devised by doctors at Great Ormond Street Hospital and the Institute of Child Health, it is the only child weight-loss programme with real proof of efficacy in randomised clinical trials. Its 10-week courses aim to re-educate entire families about their eating habits, teach them about nutrition, cooking and food labels and encourage them to get interested in exercise. | In a sports centre in Oldham, Wise and the programme co-ordinator Adele Stanton are running a two-hour after-school, after-work course for Mend, which stands for Mind, Exercise, Nutrition, Do It. Originally devised by doctors at Great Ormond Street Hospital and the Institute of Child Health, it is the only child weight-loss programme with real proof of efficacy in randomised clinical trials. Its 10-week courses aim to re-educate entire families about their eating habits, teach them about nutrition, cooking and food labels and encourage them to get interested in exercise. |
| A group of families is learning about sugar, but not at a desk. Stanton and Wise keep them moving. Both parents and children are running hard on the spot to mimic the short-lived burst of energy that sugar-heavy breakfast cereals like Frosties deliver and then slumping on the floor to imitate the mid-morning low when the energy runs out. | A group of families is learning about sugar, but not at a desk. Stanton and Wise keep them moving. Both parents and children are running hard on the spot to mimic the short-lived burst of energy that sugar-heavy breakfast cereals like Frosties deliver and then slumping on the floor to imitate the mid-morning low when the energy runs out. |
| Then they pretend to eat Weetabix and switch to steady running. The adults join in with enthusiasm, freed up to leap about by the presence of their kids and other adults playing the fool. | Then they pretend to eat Weetabix and switch to steady running. The adults join in with enthusiasm, freed up to leap about by the presence of their kids and other adults playing the fool. |
| "You can't encourage your child to change their lifestyle and eating habits if you don't do it yourself," says Chris Bayes, who is there with his 13-year-old daughter Natalie. "So we are all doing it. | "You can't encourage your child to change their lifestyle and eating habits if you don't do it yourself," says Chris Bayes, who is there with his 13-year-old daughter Natalie. "So we are all doing it. |
| "We are only in week three so there is not much physical difference yet, but it is good that we can get to the next meeting and say I have done this, this and this. We will certainly be healthier even if we haven't lost any weight." | "We are only in week three so there is not much physical difference yet, but it is good that we can get to the next meeting and say I have done this, this and this. We will certainly be healthier even if we haven't lost any weight." |
| Mend is so successful that it has been taken up by Australia, Canada and the US, but nearly folded in Britain in December. At its high point, said Paul Sacher, the chief research and development officer, Mend had courses running in 350 locations. But the number of tenders put out by primary care trusts for child obesity programmes dropped from 12 in 2011 to just three in 2012. More than half the obesity specialists advising the trusts were either made redundant or quit after the government announced public health funding would be transferred to local authorities this April. | Mend is so successful that it has been taken up by Australia, Canada and the US, but nearly folded in Britain in December. At its high point, said Paul Sacher, the chief research and development officer, Mend had courses running in 350 locations. But the number of tenders put out by primary care trusts for child obesity programmes dropped from 12 in 2011 to just three in 2012. More than half the obesity specialists advising the trusts were either made redundant or quit after the government announced public health funding would be transferred to local authorities this April. |
| "There was no planning for protecting services like Mend during the transition," said Sacher. The National Institute for Healthcare and Clinical Excellence (Nice) recommends the type of programmes Mend offers for overweight children. "Only about 1% of overweight and obese children have been offered them," he says. | "There was no planning for protecting services like Mend during the transition," said Sacher. The National Institute for Healthcare and Clinical Excellence (Nice) recommends the type of programmes Mend offers for overweight children. "Only about 1% of overweight and obese children have been offered them," he says. |
| Sacher feels that there is little interest from a government convinced that being overweight is the individual's own responsibility. "It's totally off the agenda. I have been working in the field since 2000. Under Labour, it was very high profile. It was what everybody was talking about. Under this current government, you very rarely hear it being mentioned – and then it's lip service." | Sacher feels that there is little interest from a government convinced that being overweight is the individual's own responsibility. "It's totally off the agenda. I have been working in the field since 2000. Under Labour, it was very high profile. It was what everybody was talking about. Under this current government, you very rarely hear it being mentioned – and then it's lip service." |
| Obesity in children is flattening off, he says, but only in middle-class white children. "In all levels of deprivation and minority ethnic groups, it is still rising worryingly." | Obesity in children is flattening off, he says, but only in middle-class white children. "In all levels of deprivation and minority ethnic groups, it is still rising worryingly." |
| By mid-December, "we were emptying the offices, preparing to lock the doors," said Sacher. But Mend was rescued at the 11th hour when it was acquired by MyTime Active, another social enterprise although with a revenue stream from golf courses and leisure centres. | By mid-December, "we were emptying the offices, preparing to lock the doors," said Sacher. But Mend was rescued at the 11th hour when it was acquired by MyTime Active, another social enterprise although with a revenue stream from golf courses and leisure centres. |
| One in three primary school leavers is now either overweight or obese, according to the National Child Measurement Programme data for 2011-12. | One in three primary school leavers is now either overweight or obese, according to the National Child Measurement Programme data for 2011-12. |
| Kaneez Akhtar has four children. Her second daughter is overweight. Like many other parents, she got a letter from the school after children in year six were weighed and measured. | Kaneez Akhtar has four children. Her second daughter is overweight. Like many other parents, she got a letter from the school after children in year six were weighed and measured. |
| Her daughter is 10 and weighs seven stone (44kg). "She is the same weight I was when I got married," says Akhtar. "My sister is chubby and used to be bullied at school and I don't want my daughter to be bullied like that. | Her daughter is 10 and weighs seven stone (44kg). "She is the same weight I was when I got married," says Akhtar. "My sister is chubby and used to be bullied at school and I don't want my daughter to be bullied like that. |
| "She is hungry all the time. If she is hungry she will go into the fridge and help herself. She will have something fattening like samosas." | "She is hungry all the time. If she is hungry she will go into the fridge and help herself. She will have something fattening like samosas." |
| Akhtar likes to cuddle up on the sofa with her children when they come home from school with tea and biscuits. But it's not one biscuit, she says. She will eat the whole packet. "I have been like that since I was small," she says. When she was 16 and earning money, she would give her mother her wages but keep £2 to £3 that went on snacks. | Akhtar likes to cuddle up on the sofa with her children when they come home from school with tea and biscuits. But it's not one biscuit, she says. She will eat the whole packet. "I have been like that since I was small," she says. When she was 16 and earning money, she would give her mother her wages but keep £2 to £3 that went on snacks. |
| Food treats set up habits that are hard to shift. Kids then spend their pocket money the same way. | Food treats set up habits that are hard to shift. Kids then spend their pocket money the same way. |
| "We have had lots of parents unaware that the children were going out and buying snack food until they saw the wrappers," says Stanton. "They were spending money they were supposed to be saving." Akhtar has a solution. She has bought her children a money box that can only be opened with a tin opener. Spending £2 is too easy. When you have £50 saved up, she says, kids will not spend it on sweets. | "We have had lots of parents unaware that the children were going out and buying snack food until they saw the wrappers," says Stanton. "They were spending money they were supposed to be saving." Akhtar has a solution. She has bought her children a money box that can only be opened with a tin opener. Spending £2 is too easy. When you have £50 saved up, she says, kids will not spend it on sweets. |
| Tonight's Mend group is of mixed affluence. Incomes are low in Chadderton, on the edge of Oldham, but it is not the most deprived area. Some parts of Oldham have no fitness centres or gyms that Mend could use for courses. Those who live there must either travel or lose out. | Tonight's Mend group is of mixed affluence. Incomes are low in Chadderton, on the edge of Oldham, but it is not the most deprived area. Some parts of Oldham have no fitness centres or gyms that Mend could use for courses. Those who live there must either travel or lose out. |
| Most of the children head for the swimming pool for the second hour of activity. They must pass six vending machines, which are stuffed with fizzy drinks and chocolate bars. Families wanting to change their behaviour need to develop enormous willpower. The world around them is not going to help. | Most of the children head for the swimming pool for the second hour of activity. They must pass six vending machines, which are stuffed with fizzy drinks and chocolate bars. Families wanting to change their behaviour need to develop enormous willpower. The world around them is not going to help. |
| Many of the children are lacking in confidence, says Wise. Most are getting bullied. Each child fills in a questionnaire about how they see themselves. "A mum said to me 'can I get a copy of this? His dad is always putting him down,'" he says. | Many of the children are lacking in confidence, says Wise. Most are getting bullied. Each child fills in a questionnaire about how they see themselves. "A mum said to me 'can I get a copy of this? His dad is always putting him down,'" he says. |
| Wise, who used to play American football in a national league, says that life has changed since he was young. "When I was a child, I was moving all the time. But streets are built up and everybody has two cars." | Wise, who used to play American football in a national league, says that life has changed since he was young. "When I was a child, I was moving all the time. But streets are built up and everybody has two cars." |
| Mend is not just about losing weight but about changing habits. Weight loss is not good for children, says Stanton – they need to maintain their weight and grow into it, while developing healthier habits. The families scrutinise food labels and are astonished by the amount of sugar and saturated fat they find. | Mend is not just about losing weight but about changing habits. Weight loss is not good for children, says Stanton – they need to maintain their weight and grow into it, while developing healthier habits. The families scrutinise food labels and are astonished by the amount of sugar and saturated fat they find. |
| They play games, allotting sugar cubes to pictures of fizzy drinks. And they are introduced to a whole range of activities, from climbing to cycling as well as swimming and walking. | They play games, allotting sugar cubes to pictures of fizzy drinks. And they are introduced to a whole range of activities, from climbing to cycling as well as swimming and walking. |
| In another part of town, 15-year-old twins Chris and Ben Warrington are proof of what Mend can achieve. Today they are slim, keen, fit cyclists – unrecognisable from the portly pair of nine-year-olds in a living room photo. | In another part of town, 15-year-old twins Chris and Ben Warrington are proof of what Mend can achieve. Today they are slim, keen, fit cyclists – unrecognisable from the portly pair of nine-year-olds in a living room photo. |
| "We were getting bullied at school by a pair of nasty twins," said Ben. "They were calling us fatty." The most they used to do was go to the park and play with light sabres, he said. Now, when they are not mountain biking, they are in the gym. | "We were getting bullied at school by a pair of nasty twins," said Ben. "They were calling us fatty." The most they used to do was go to the park and play with light sabres, he said. Now, when they are not mountain biking, they are in the gym. |
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