The Wardman Wire

Via the Conspirators and Sandy Szwarc:

Researchers in England have inadvertently shown how silly the crisis of childhood obesity has become and how unrealistic the definitions are of overweight and obesity in children. We continually hear parents accused of being in denial and incapable of recognizing their children’s weight “problems.” It turns out, few doctors can correctly identify children in the overweight and obese categories, either.

…

Researchers, led by Dr. Sally Smith at York Hospitals National Health Service Foundation Trust in York, UK, used photographs of 33 children, aged 10-17 years and a variety of BMIs, taken in exactly the same lighting, pose and distance. The photos were randomly numbered and faces concealed to protect their identities. Eighty healthcare professionals, including 30 pediatricians, 20 general practitioners and 30 pediatric nurses in the Yorkshire region were recruited and shown the photos and asked to match them in six weight categories based on the new BMI-based child growth curves.

The authors just reported their findings in Archives of Disease in Childhood. Only 29.5% of the medical professionals correctly assessed the children in the 91st-98th percentile and only half could correctly identify the largest children above the highest 98th percentile. Their accuracies were similar to studies on mothers.

Leaving aside the questionable utility of Body Mass Index for assessment of obesity without a healthy scepticism and some common sense (i.e., people with big muscles are not obese even when the BMI figure says so), we are back to:

This study suggests that it is not appropriate to rely on informal assessment to identify obesity and highlights the need for health care professionals to be aware of their lack of accuracy in this regard.

Personally, I expect them to know that when they leave their Med School – or even before they start there. “Evidence-based medicine” is fine – but we have to start with an assumption of at least a basic human competence and self-knowledge.

There’s something unsettling in all of this, and I can’t decide whether it is unnecessary research projects, questioning why there is talk of “clinical observations” of obesity – which is presumably in a setting where scales are available, or in the inevitable knee-jerk “we need more training” conclusion of the bureaucratic paperwork-factory (cf the playbook of the response to any major or minor Government mess since 1997):

Their interpretation of their study’s findings was to call for the need for formal training of medical professionals to enable them to better recognize and manage obesity.

Unnecessary observations leading to “concerned” conclusions justifying a call for expenditure that is spurious. Ouch. And that’s without the impact on people that Sandy Szwarc spends her time writing about.

Worth a read.