So that the kilos tumble

For adults, the body mass index is the measure of all things, whereas for children the percentile must be taken into account. This relates height and weight to age. «From a percentile above 90, we speak of overweight, from over 97 of obesity, i.e. extreme overweight,» explains Dr Isabelle Herter. The ETH Zurich nutritionist and her team have published numerous studies on obesity in children.
The ETH research team discovered the problem 15 years ago as an accidental finding. The scientists monitored the iodine supply of the population and recorded height and weight. «While the problem of obese children had previously been an issue in the USA, it had now also arrived in Switzerland and the rest of Europe,» says Dr Herter.

Don't stop the children's urge to move, even if it is sometimes annoying.

Since then, the ETH and the Federal Office of Public Health (FOPH) have conducted a study every five years to monitor the situation. Although the figures have remained stable over time, there is no improvement in sight: around 20 per cent of children are still overweight. However, the proportion of children who are severely overweight has risen to 8 per cent, especially among boys.

Cooking and eating together

The ETH studies show a link between obesity and inactivity. Children and adolescents who spend a lot of time in front of the computer and television are particularly at risk. The results also point to «socio-economic» correlations. Language skills and migration background, education level and family structures play a decisive role here. «Some cultures, for example, equate obesity with wealth, in which case it is not recognised as a problem,» says Isabelle Herter.
For the researcher, the family is the most important starting point: cooking and eating together, joint activities and setting limits for the television and computer help with weight loss, but also with prevention.
Prevention is the first step in treatment, emphasises Dr Joseph Laimbacher. The paediatrician and head physician at the St. Gallen Children's Hospital in Eastern Switzerland is one of the best-known experts in the treatment of overweight children. In 2014, he and his team were awarded the Guido Fanconi Memorial Prize, which honours significant achievements in the field of paediatrics.
Laimbacher has been developing concepts and recommendations since the 1990s, when «the wave spread to Europe». «It wasn't until 2007 that childhood obesity was recognised as a disease,» he says. A predisposition to it lies in the genes. But whether a child actually gains weight depends on other factors such as exercise, eating behaviour, growth phases or socio-economic factors.
For Laimbacher, prevention starts early: «The window of opportunity for the next generation opens prenatally.» Future parents therefore need to be aware of their own weight. This also applies to pregnancy, when you can't eat for two. Once the children are born, they should learn how to eat normally from an early age. «Children also have a natural urge to move,» says Laimbacher and recommends not stopping this, even if it is sometimes annoying. They should get at least 90 minutes of exercise a day.

If weight becomes a constant issue, it puts a strain on the child's soul.

Obesity is often recognised as a problem for the first time during the school medical examination. «This allows us to tackle it at an early stage,» says Laimbacher. According to him, obesity must be treated as it harbours many health risks, such as diabetes, cardiovascular and respiratory diseases and joint problems. Being overweight can also trigger psychological problems or reduce self-esteem, leading to a vicious circle.

So that children can survive in society

Laimbacher recommends the paediatrician or family doctor as the first port of call. He emphasises: «However, the treatment of severe obesity belongs in the hands of trained teams.» These consist of doctors, nutritionists, psychologists, physiotherapists and, depending on the case, social workers.
The St. Gallen Children's Hospital in Eastern Switzerland is a pioneer in the treatment of obesity and offers various programmes. «Before we admit someone, the children have to prove to us that they are motivated, as do the parents,» says Laimbacher. The maxim is good support, not pressure. He advises the parents of affected children against «trying things out» themselves or even following abstruse diet programmes with their children. Realistic goals such as stabilising excess weight are important.
Joseph Laimbacher is convinced: «It's not just about normal weight, but about the children being able to survive in society.»