Generation XXL - is this the doomsday health scenario?

Last week saw the publication of shocking headlines about 'Generation XXL', with the news that hospital admissions for UK children related to obesity had risen more than fourfold in the last decade. More hype, another stick for the Nanny state to beat us with or a real cause for concern?

The measurements that define overweight and obesity in children are slightly different for children than for adults. But using the widely accepted 'Body Mass Index' definitions of obesity (a ratio of height to weight, with 18.5-25 being normal, 25-30 overweight and over 30 obese), the proportion of English adults who are obese has more than doubled in 25 years. More than one in four adults are now obese, and since 1993 the proportion of adults in the ideal weight range has dropped from four in 10 to three in 10 for men, and from one in two to two in five for women.

My patients often ask why they should worry - after all, if more than half of Britons are above the 'ideal' weight for their height, doesn't that make it normal? Sadly not - even being in the overweight, rather than the obese, category increases your risk of type 2 diabetes, heart disease and other serious medical conditions.

And the worst is yet to come. The World Health Organisation, which looks at all the health challenges facing the world, including HIV and malnutrition, has declared obesity to be 'one of the most serious health challenges of the 21st Century'. They point out that obese children are much more likely to grow up into obese adults, with all the attendant health problems this brings. But obesity brings problems in childhood too. Early puberty, asthma and some joint disorders are all more common in obese children. What's more, some of the changes leading to heart disease - raised blood pressure, high cholesterol and fatty changes in the lining of the arteries - can start even before adulthood. And that's before we even think about the psychological impact on kids - the low self-esteem, the taunts on the sports field, the desperation to fit into 'normal' clothes. In one study, severely obese children rated their quality of life as low as children with cancer going through chemotherapy . The International Diabetes Federation has called for urgent action on the 'twin epidemics' of diabetes and type 2 obesity among young people. And just for once, the term 'epidemic' is horribly true. According to the latest national survey in England, which measures the height and weight of about one million schoolchildren, one in five children in year 6 (age 10-11) are obese and a further one child in seven is overweight. Even when they start primary school, almost one child in four children is obese or overweight.

Childhood obesity is everyone's problem. Prevention is definitely, as the old saying goes, better than cure, but it's often easier said than done. But there is help at hand for children and their parents. The remarkable MEND programme has helped thousands of UK children to work towards a healthier weight and stay that way. They run fun, interactive programmes for two-four, five-seven, seven-13 or 13-16 year-olds and their families. Of course they want to help in the short term, but it's all about sustainable long-term healthy choices too. They want all of us to realise that healthy eating is never something we can't afford, and that a healthy lifestyle is about more than expensive gym membership. They want to leave a legacy that lasts into the next generation - for all our sakes.

Parents can refer their own child or speak to their GP or health visitor about making a referral. My patients tell me they really do make a difference - and the scales in my consulting room, and the smile on the children's faces agree.

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