Dr. Adele Keating:

The Deputy asked a number of questions. There is huge stigma attached to obesity and professionals find it very difficult to address it with families. I work in an endocrinology department where we see patients with clinical obesity. We have children who are at the very extreme end of things and what we find is that there are very few community services that intervene with such families because of the stigma attached to addressing obesity with families at a primary care level. There is a real difficulty when it comes to where we refer on in the provision of of community resources and services. The problem is probably twofold wherein professionals do not believe they have the skills to address it and it is also stigmatising to address it with families. One of the big issues is accessibility in order that families can receive support.

On eating disorders and obesity, there is a qualitative difference in the psychological underpinnings and the treatments used for both groups. Sometimes eating disorders can be taken more seriously by services because the risk is seen as more immediate, whereas with obesity the risks are longer term and perhaps not as immediately evident. They are not offered the level of support somebody who presents with anorexia nervosa or bulimia.

On prohibition, I completely agree. We always advocate, when working with this population, that everything be in moderation. It is about looking at treats as treats and how we support families to do this when they are under severe pressure to provide treats constantly.