Experts have called for greater monitoring of obese children after a teenager almost ate himself to death.
The boy was admitted to hospital with nutritional failure that nearly killed him.
Following years of obesity, the teenager collapsed at home and needed life-saving treatment. Doctors and social workers were so alarmed they launched a Significant Case Review to investigate how he had slipped through social work safety nets despite his food-related problems being known to the authorities.
The medical emergency can be revealed days after it emerged a teenage boy in England had gone blind and deaf after living on chips, Pringles and sausages. Experts in Scotland say some young obese Scots are being diagnosed with nutritional conditions usually seen in victims of famine because their diet is so poor.
The review, by East Lothian and Midlothian Public Protection Comm-ittee, highlighted a lack of a co-ordinated strategy and concerted action that allowed the boy to deteriorate so badly. Tam Fry, patron of the Child Growth Foundation, and chairman of the National Obesity Forum, is calling for regular monitoring of children.
He said: “Though this case is rare, it would never happen if the weight of all young people was routinely monitored. It is appalling to think we monitor the height and weight annually for animals in zoos but not for children.
“Any trained health or teaching professional should be able to spot concerning traits in the children they come into contact with and refer them to a specialist. For this child to have slipped under the radar is unacceptable.”
The review of the case noted concern there “was no holistic assessment of the family and their ability to effect change.”
The expert investigators concluded the boy’s close relationship with his mother had undermined previous interventions and should have triggered a more effective strategy.
He had missed a large number of school days, which also should have raised the alarm. The review was completed last year but has been revealed amid increasing concern about obesity rates among young people in Scotland and the support they receive.
Professor Mike Lean, head of human nutrition at University of Glasgow, said: “This young person should have been identifiable as being at high risk because of his disordered eating, extreme disabling obesity, and his isolation.
“If he had been severely undernourished, with anorexia nervosa, he could have been taken into medical care because that is classified as a psychiatric illness.
“But vulnerable people with life-threatening obesity are not protected in the same way. It should be possible to remove such people with severe obesity and disordered eating from a home situation that is not safe.”
Community paediatrician Dr Max Davies, officer for health improvement with the Royal College of Paediatrics and Child Health, said: “Nutritional deficiencies are relatively common in children with obesity.
“It is rare for a child to be admitted to hospital with serious illness resulting from this, though. This can happen where there is a pattern of eating a diet of only basic carbohydrates, such as chips. One of the outcomes you measure in severe obesity is school attendance.”
East Lothian Council runs a voluntary scheme to assist parents who struggle to cope with their children’s obesity.
Alex McMahon, director for nursing, midwifery and allied health professionals at NHS Lothian, said: “Our child healthy weight team supports children and families to understand the importance of diet and exercise and work with them to make positive changes.
“The importance of prevention and early intervention in terms of reducing childhood obesity cannot be underestimated and continues to be a key focus of NHS Lothian’s children’s strategy.
“In addition, 25% of school nursing time has been freed up to support children with issues such as weight management and psychological wellbeing.”
East Lothian Council said: “Although the Significant Case Review found evidence of good practice, there are important lessons to be learned, particularly about the importance of focusing on the child’s needs.
“Although this case was unusual, it is important to ensure the extent of the child’s isolation is recognised, as well as addressing the risks posed by diet.“It is a matter of regret that (the patient’s) condition deteriorated as it did.
“The findings of this SCR will be used to improve practice and inter-agency working across all the partners involved.”
The British Nutrition Foundation reports a success in young children beating obesity.
But the story is worryingly different for teenagers. Sarah Coe, nutrition scientist with the British Nutrition Foundation, said: “One in three Scottish 12 to 15-year-olds are now at risk of being overweight and obese.
“Despite the levels of childhood obesity, national dietary surveys show that there are a number of issues with poor intakes of certain nutrients in teenagers who have low consumption of a number of important vitamins and minerals including calcium, iodine, iron and zinc.”
The Scottish Government has pledged to halve childhood obesity by 2030.
Obese Scots diagnosed with disease found in famine victims
Professor Mike Lean said obese Scots have been diagnosed with beriberi, a serious lack of vitamin B1, more often found in famine victims in sub-Saharan Africa.
It can happen when people eat any diet that does not include bread and cereals, the main source of the vital vitamin, medical experts argue.
Prof Lean said: ”It could be a diet with lots of calories to produce obesity but only includes ice cream, or sweets or chocolate.
“Patients have no warning they are seriously ill, but can collapse suddenly.
“We sometimes see this in people with autism, but I have seen a patient, aged 30, who arrived as an emergency in A&E at Glasgow Royal Infirmary, confused, unable to stand and in heart failure.
“He had been obese and tried to lose weight through a diet with no carbohydrates at all and he had beriberi.
“He very nearly died but made a full recovery after we gave vitamin B1, thiamine.
“Vitamin B1 is found in bread and cereals.
“Beriberi is very unusual and can be missed by doctors here.
“It makes patients very ill and develops quickly. Very few other nutritional disorders can cause near death.”