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65
Results and relapse rates vary but all doctors agree that
there are special difficulties involved in treating childhood
obesity. The parents of these children must co-operate fully in
all dietetic treatment and must provide the right emotional
climate of encouragement and praise for success: this may prove
difficult, especially if the parents themselves are overweight
and have failed to achieve weight reduction with a diet. There
is also a danger that individual treatment may increase the
child's sense of isolation from his peers. Even if all conditions
are ideal it is difficult for any clinic to see the
children as frequently as necessary since the numbers involved
are now so great. Equally there are problems in following-up
these children as they should be supervised indefinitely: obesity
is a chronic, not an acute condition.
A group approach to the problem has much to recommend it. On
a strictly practical basis it is possible to see larger numbers
more frequently. Prom a dietetic point of view the group discussion
often reveals hitherto undiscovered nutritional fallacies
which might not be mentioned in an individual interview. Its
greatest advantage, however, is in the sense of companionship
and competition which develops within the group. As the group
develops its own identity, the children wish to lose weight not
only for their own satisfaction and to earn praise from their
parents and the doctor, but also for the approbation of the
group.
The Education Committee resolved to establish an experimental
Weight Control Clinic in Croydon where treatment by diet alone
could be given on a group basis. Previously, overweight children
seen at school medical examinations had been referred to
hospital, or given dietetic advice and followed up at school
inspection clinics. The objects of this new clinic have been to
determine whether greater success could be achieved and also if
greater numbers could be dealt with satisfactorily.
The first meeting was held on June 11th, 1965. This group
consisted of ten girls, six of whom were already attending school
inspection clinics and were not achieving satisfactory weight
reduction, and four who heard of the group at its inception and
asked to join. Hie age range was from 10-16 years and all attend
schools in the Croydon area: permission for them to attend was
first obtained from their schools and their General Practitioners.
All the girls were between 10 - 50% above the weight
estimated for their age and height. They had previously been
medically examined to exclude the extremely rare cases of