Page 30 Daily Mail, Wednesday, March 4, 2020
collapse of his hip. It requires
complex surgery, an already fraught
p r o c e d u r e , a n d o n e w h e r e a l l
the risks are heightened by the
patient’s obesity.
What’s more, unless Harry gets his
weight problem under control, the
same thing is likely to happen to his
other hip.
For his mum Sue — who is also
overweight — it’s a wake-up call. ‘I
didn’t realise it was as bad as it was,’
she says. ‘I suppose you see them
every day and you don’t realise how
much weight he’s put on.’
Yet this wake -up call does not
translate into drastic change: while
under the clinic’s supervision, Harry
initially lost 4st, he then regained
two in a pattern that is so horribly
familiar to the unit’s staff that
Professor Hamilton-Shield likens
part of his job as being that of
a detective.
‘We’re trying to work out what’s
within the family that is leading to
the excess weight,’ he says. ‘We don’t
like it — nobody likes it — but we
probe. And sometimes it comes out
and sometimes it doesn’t.’
More often than not, myriad prob-
lems lie in the background, as with
Tommy, a sweet-natured teenager
who, at 23 st, is one of the clinic’s
heaviest patients.
He was referred there in 2018 aged
1 2 and weighing nearly 19 st, but
while he initially lost some weight
under clinic supervision, when
filming commenced last summer, he
had gained 6 st in just five months
taking him to 23 st.E
ven given his 6ft 6in height
he’s morbidly obese, a situa-
tion that has left his mum
esther, 42, in her words,
‘grieving for a child who is still here’.
He’s the second of single mum
esther’s four children — she has
three others aged eight to 18 — and
she recalls how his weight problems
began five years ago when he was
diagnosed first with glandular fever,
then chronic fatigue syndrome.
It meant that her previously active,
healthy boy suddenly spent a large
portion of the day in bed.
‘The lack of activity was a massive
contribution to the weight gain,’
esther recalls.
‘And a lot of the time the house
would be asleep when Tommy was
awake. He’d miss proper meal times
and be grabbing and grazing. There
were mental health issues as well. He
was very depressed and on occasion
he had suicidal thoughts.’
All the while, Tommy’s weight was
creeping up, before finally, in 2018
and weighing nearly 19 st, he was
referred to Bristol’s obesity clinic.
‘I made him several doctor’s
appointments and I highlighted it
with the school nurse but not much
came of it,’ esther says. ‘I was doing
my best, but I just kept being told he
needed to cut down. But it simply
w a s n’ t a s e a s y a s t h a t g i v e n
everything else that was going on.’
That is not, of course, a popular
view, with many people thinking thatobese people simply need to eat less.
‘I know what people think,’ esther
says. ‘It’s so easy to judge. Weight is
a target point for people and it
shields them from looking beyond
that point.
‘I’m a bigger mum so I know people
look at me and think: “Fat mum, fat
kid, they must be eating loads of
junk.” But that’s not the truth.
‘I home cooked healthy meals, but
I couldn’t police what he was
eating 24-7.’
Five-year-old Lily’s mum Lana is
also used to judgmental looks: at 7 st,
her daughter is twice the average
weight for her age — far heavier than
her seven-year-old brother Jaden.
‘Jaden is a normal sized boy, so they
look at Lily and assume I am over-
feeding her,’ Lana says. ‘You can see
the looks when you’re out and about
— that I’ve got no discipline and no
boundaries, which isn’t true. I am
trying to do my best like any mum,
but it’s incredibly hard.’
Particularly tough for Lana, is her
daughter’s voracious appetite which
leads her to ransack the house for
food: everything from raw sausages
from the freezer and even, on one
occasion, toilet paper.H
er ravenous hunger pains
also see her descend into
violent fits of anger and
tantrums.
‘It started from when she was tiny,
eight weeks old. I noticed that no
amount of milk would fill her up, she
was never satisfied with what she
was given,’ Lana recalls.
‘She would wake often in the night
screaming for food. At first I just
assumed she was a really hungry
baby, so, of course, I just gave her
what I thought she needed.’
It meant that by the time Lily was
three, she was so heavy Lana couldn’t
pick her up — and her frame was
matched by her appetite.
‘She would go through all the cup-
boards and the freezers to get any-
thing, every sort of food she could
get her hands on,’ Lana recalls.
‘It was the same at nursery. I would
get calls from the staff saying she
was going into the kitchen trying to
get food. I didn’t really understand it
— why she was the way she was.’
After several visits to the doctor,
her weight gain accelerating and her
behaviour worsening, Lily, then four,
was referred to the obesity clinic,
where she was placed on a strict
calorie-controlled diet.
‘The problem was, that rule book
was ripped up the moment we
walked through the door,’ says Lana.
‘She thought I was starving her
because she’s constantly hungry. It
made me feel like a terrible mum.’
Lily’s constant hunger was also a
worry to the obesity clinic team, who
after several months of supervision
d e c i d e d t o u n d e r t a k e f u r t h e r
investigations to find out if there was
any other reason she was not
losing weight.
Their work led them to a research
institute in Cambridgeshire, where
blood samples revealed Lily has a
rare genetic malfunction that means
her body is unable to process calories
as efficiently as usual and that —
vitally — she feels intense pangs of
hunger equivalent to someone who
hasn’t eaten for three days.
As the consultant gently tells Lana:
‘It’s not her fault she’s hungry.’
It came as a huge relief, giving some
explanation for the difficult past
five years. ‘I’ve carried a lot of guilt,
that it’s somehow my fault, so this
took some of that weight away,’
Lana says.
Yet the news has also proved a
mixed blessing, because at the
moment little can be done to
mitigate against it.
Because Lily is too young for
appetite suppressants or specialist
medicines, Lana can only continue
to try to manage what her daughter
eats. It means working with nurses
and specialist psychologists.
I t’ s a n o t h e r r e m i n d e r o f t h e
complexities of the issues faced by
the clinic, which on occasion resorts
to drastic action to deal with theby Kathryn Knight
T
eenAger Tommy is a gentle
soul, fond of football and
rugby. Yet aged just 14, his
days of playing them are long
gone: topping the scales at23 st, he’s clinically obese and suffers
chronic hip, back and knee pain.
‘I’m too heavy to play football or do rugby,’
he says. ‘When I walk up the stairs at school, at
the top, I’m sweating and my shirt has pretty
much gone see-through. You get called fat.’
Five-year-old Liliane, known as Lily, is also
dangerously overweight. She weighs 7 st and
her appetite is so voracious her despairing
mum Lana has caught her trying to eat raw
sausages from the freezer.
endlessly teased at school because of her
size, she has already asked her mum if she is
going to end up in a wheelchair.
Then there’s 15-year-old Harry, whose 18 st
weight has put such a strain on his hips that
one has collapsed, requiring painful — and
high risk — surgery.
They are some of the 80 outpatients seen
every week at Bristol royal Hospital for
Children’s Obesity Clinic, where a team of
specialists sits at the front line of what is
nothing less than an epidemic. Last autumn,
new figures showed that levels of severe obesity
among primary school age children had
reached an all-time high.
Worse, if they are still obese aged 14, they
are 80 per cent more likely to be living with
obesity as an adult — a condition which
results in more years of unhealthy life, costs
the nHS some £5.1 billion a year and, after
smoking, is the single greatest cause of early
death in the UK.
A damning new study published today reveals
the health of British children is falling behind
those of other wealthy countries, with obesity
a prime factor in the decline.
It means that it is no exaggeration to say the
doctors, nurses and social workers at Bristol’s
child obesity clinic — and similar units
throughout the UK — are battling to stop
young people eating themselves into an early
grave. It’s a battle that has now been capturedon camera for the first time in a thought-
provoking, one-off documentary.
Sensitively filmed, it is a no-holds-barred
look at both the myriad physical and psycho-
logical complexities of this modern phenome-
non and its grim daily realities.
‘I’ve seen children with BMIs of 65, 67 [the
healthy range for adults is between 18.5 and
25] and because being overweight and obesity
have become so prevalent in the country then
people have stopped recognising it as being
different,’ says Professor Julian Hamilton-
Shield, Clinical Lead Paediatric Weight
Management at the Bristol unit.
‘eighty five percent of parents don’t recognise
that their child is overweight — and the ulti-
mate responsibility for the care of that child is
with their parents.’
Fifteen-year-old Harry appears to fall into
this category. His 18 st weight and Body Mass
Index (BMI) of 44 — which means he is
considered extremely obese — have led to the