On Thursday March 2, 2023 the Healthy Caribbean Coalition hosted, “Childhood Obesity in the Caribbean – How do we care for the 1 in 3?” – a webinar aimed to create a space for persons with lived experience, advocates and practitioners to discuss childhood obesity treatment and management in the Caribbean.
The conversation centered around the need to embrace and protect a child’s right to health which should be extended to quality healthcare services and support.
The panelists provided their unique perspectives on how we can actualize caring for the 1 in 3 Caribbean children who are living with overweight or obesity.
Professor Alafia Samuels
Chair of NCD Child and member of the Board of Trustees of the World Obesity Federation
Professor Anne St. John
Pediatrician and Medical Director for Youth Health Heart with the Heart and Stroke Foundation of Barbados
Ms. Michelle Sutton
Health and Wellness Coordinator, Ministry of Education, SKN
- Mr. Komo Phillips, Parent
- Mr. Kareem Smith, person with lived experience
HCY and Counselling Psychologist, Antigua
Pierre Cooke Jr.
HCC Technical Youth Advisor
HCC Advocacy Officer and Coordinator of Healthy Caribbean Youth
The conversation started with centering on the lived experience with perspectives by Jomo Phillips and Kareem Smith – both of them sharing their thoughts on how obesity is viewed in the Caribbean. Kareem shared,
How is obesity viewed in the Caribbean? – a simple answer is “not very good” and from my perspective from a young age, that is because there are a multiplicity of very politically incorrect – sometimes insulting words – and ways that are used to describe children who are overweight and in some circumstances where there are very few real pathways for parents and children to actually address that problem
He also shared that children are exposed to a “tremendous amount of dialogue about their weight” which is not constructive or helpful from friends, family and even physicians. Danielle echoed this sentiment from her own personal experiences with being overweight as a child.
Further Kareem noted that when he was growing up, he didn’t feel as if childhood obesity efforts were prioritized by policymakers which he noted is shifting but emphasized that there needs to be more monitoring and enforcement of recommended policies.
Support for children living with obesity must span sectors of society. Mr. Phillips, emphasized the tremendous support that the Heart and Stroke Foundation of Barbados’ Yute gym has provided for his family and his daughter who lived with obesity. Mr. Phillips noted that the gym provides a variety of different activities that include physical activity, healthy eating and preparing healthy meals. One of the things that he says keeps his daughter going is the ability to bond and engage with other young “people who look like her and have similar struggles but also have fun and enjoy the program as well.”
In transitioning the conversation to the management of childhood obesity, Danielle asked audience members what they thought was critical to properly manage children living with obesity. They said:
In focusing on management, Professor St John highlighted the new American Academy of Pediatrics guidelines for the evaluation and treatment of children and adolescents with obesity.
In referencing the guidelines, she noted,
Those guidelines are not too soon in coming. Over the years in pediatrics, we have really struggled to facilitate parents becoming sensitized , as Kareem mentioned in his experience. We find that doctors [and] healthcare providers are not sensitized that overweight and obesity is an issue, healthwise. A child will visit the office with a cold or cough complaint and the child is overweight. The overweight is not mentioned by the physician, just the acute illness. If you don’t identify something as an issue you don’t try to manage it. The American guidelines of about 90 pages – is quite comprehensive – in essence there is not a lot of new information there. The guidelines place emphasis on the need to examine the child, and the need to identify specific issues, risk factors, genetic factors, and other factors, which play a role in the conditions of obesity and overweight, and then there is a need to treat the obesity and overweight as soon as the diagnosis is made and not to wait until the child is a teenager
Upon reflection of the guidelines and management of obesity, panelists shared a number of sentiments:
Professor Alafia was disappointed that clinical guidelines were being released before prevention guidelines. She emphasized the need to continue with our ongoing childhood obesity prevention efforts including advocating for policies that protect food environments – like regulating the sale and marketing of unhealthy food and beverages to children. It is important to note that these prevention efforts are also critical in the management of childhood obesity.
Mr. Kareem Smith, also agreed that prevention is better than cure and “instilling good habits early in children’s lives” is important. He also noted that technical expertise is critical in guiding children who do live with obesity as the lack of guidance can lead to persons managing their weights in unsustainable or unhealthy ways.
Ms. Sutton spoke about the need to shape school environments and particularly the importance of the school curriculum. She noted that Saint Kitts and Nevis rebranded Physical and Health Education and Health and Family Life Education curricula – expanding them to focus more on the holistic health of a child. She said that these changes are in an effort to move “beyond telling people to do something – it is about empowering them and teaching them the skills sets to be healthy for life”
Mr. Phillips ended the panel by zoning in on the importance of the healthcare system in managing childhood obesity. He said that he has appreciated the passion, concern and care that his daughter’s pediatricians have provided along the journey. However, in general, there needs to be a heightened awareness and sensitivity of the challenges that these children and their families experience. Secondly there is a need for increased resources to support these persons – many more people need similar programs that the Heart and Stroke Foundation Yute Gym provides.
The webinar ended with panelists sharing their wish for childhood obesity prevention and management in the Caribbean.
Ban the marketing of unhealthy products to children because every hundred dollars they spend creates 200 dollars extra in consumption which would not have happened but for the marketing. They need to stop promoting toxic environments to our children.
Professor Alafia Samuels
My wish for the stigma associated with persons to be considered overweight and obese to be removed and for us to focus more on helping and assisting as opposed to labeling.
Ms. Alaina Gomes
My wish, in addition to supporting Prof Samuels, is to have throughout the Caribbean formulation and implementation of schools nutrition policies to encompass students from the age of 4 up to the age of 17 when they leave the school [given] that that is the environment where they spend most of their time. School nutrition policies for all schools throughout the Caribbean.
Professor Anne St. John
My wish is for the parents to understand that they are there to support their children in developing healthy habits – so stop sending the salty, sugary snacks to school and start cutting up some fresh fruits and vegetables that we can send to school for healthy snacking and healthy eating.
Ms. Michelle Sutton
That the rights of children are respected and protected in all of our obesity prevention and management efforts.
Mr. Pierre Cooke Jr.
We need to have our children treated with care and when necessary institutionalizing weight stigma and bias protocols within their spaces so that their health and wellbeing is protected. Our children deserve so much better and I think we can all agree that they deserve the best.
At the highest levels of Caricom – is the political prioritization of addressing obesity and not just language around it but actual action – to implement a package of policies… We need a comprehensive suite of policies recommended by PAHO, WHO, CARPHA and the HCC. So, my wish is that those policies are implemented because we know that it works and we’ve seen it in other countries and we have more to lose than many other places in the world.
The HCC looks forward to continuing to facilitate conversations like these that center around children and their ultimate right to health.