Katharina Ó Cathaoir is a graduate of UCC (BCL Law and Irish, 2011) and TCD (LLM International and Comparative Law, 2012). Katharina is currently undertaking a PhD on childhood obesity from a human rights perspective at the University of Copenhagen.
“There is no nice, non-stigmatising way to wish that fat people did not eat [n]or exist”
Obesity is a compelling wake up call for Ireland to act on its obligations to children in respect of their rights to health, food and protection from exploitation. At the same time, any State action must be informed by the principles of non-discrimination and equality, thereby avoiding stigmatisation.
It is estimated that over 20% of children in Ireland are overweight or have obesity, marking at least a doubling in the last 20 years. The effects of childhood obesity are well documented and may include type 2 diabetes, hypertension and cardiovascular disease. Equally, children with obesity report higher instances of depression and social isolation. Thus, the growing concern with regard to childhood obesity at State, European and international levels should come as no surprise.
Under the International Covenant on Economic, Social and Cultural Rights, Ireland has undertaken legal obligations in regard to the right to health (Article 12) and the right to food (Article 11). The former has been interpreted as including not just access to health care but also the right to the underlying determinants of health, one of which being food. The latter is regarded as access to nutritious and adequate food. Although for the present economic, social and cultural rights are not justiciable in Ireland, the State remains under a duty to ensure the “progressive realisation” of these rights through policies and laws (Article 2). These obligations are also expressed under the Convention on the Rights of the Child (Articles 24 & 27), as well as the duty to protect children from exploitation (Article 36). The Committee on the Rights of the Child has already called on States Parties to take action with regard to obesity including exposure to fast food and marketing.
In light of the above, Ireland should tackle the “obesogenic” environment that has been allowed to flourish. The former is defined as “the sum of influences that the surroundings, opportunities, or conditions of life have on promoting obesity in individuals or populations”. While there is no right to be healthy, the State should be instrumental in shaping an environment for children that fosters healthful choices instead of allowing the free market to dictate. In line with the CRC, this must be implemented with respect for parents’ rights and the rights of the child.
One area in which affirmative action may be well placed is the school environment. A recent study has demonstrated the potential healthful impacts of making health a priority in Irish schools. In the United States, studies have shown that some children gain weight three times as rapidly during the summer months. Clearly, schools have the potential to boost the health and wellbeing of all children. It ought to be remembered that an estimated 200,000 people in Ireland suffer from eating disorders. In the Growing up in Ireland survey, 27% of 13 year olds ranked their appearance as below average. Thus, instead of focusing on physical appearance, the emphasis must be on health and wellbeing.
Measures could include increasing the amount of physical education in the school curriculum, incorporating meaningful nutrition education and removing access to high fat, salt and sugar foods from school premises. At present the primary school curriculum allots a minimum of 60 minutes and a maximum of 120 minutes to physical exercise. This is lower than the majority of our European counterparts. Furthermore, this policy is meaningless without adequate resources and training. More than 90% of secondary schools are not meeting the required 120 minutes of physical education. While primary schools have moved to end the sale of soft drinks and sweets, most secondary schools have failed to do so. If schools are dependent on this revenue, there are replacement, more healthful food options which should be explored.
The experiences of stigma of both children and adults should not be overlooked. In a review of the research on obesity stigma, Puhl and Latner found “the stigmatisation directed at obese children, by their peers, parents, educations and others, is pervasive and often unrelenting”. It may exacerbate negative health outcomes. Above all the State must not perpetuate this. Policies and laws should focus on healthful food and exercise for all children, instead of singling out and targeting children with obesity. The message should always be about boosting health, not aesthetics. School wide anti bullying campaigns could also benefit from a weight element given the documented prevalence of bullying on the basis of weight.
 Wann, (2009) www.fatso.com.
 Report of the Taskforce on Obesity (Department of Health, 2005).
 See further, http://www.who.int/dietphysicalactivity/childhood/en/
 Committee on the Rights of the Child, General Comment no. 15 (2013), at para. 47.
 Swinburn, Egger, Raza, ‘Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity’ (1999) 29 Prev Med 563.
 Comiskey et al, Evaluation of the Effectiveness of the CDI’s Healthy Schools Programme (Childhood Development Initiative, 2012).
 Von Hippel et al, ‘The effect of school on overweight in childhood: Gains in children’s body mass index during the school year and during summer vacation’ (2007) 97(4), American Journal of Public Health, 796.
 Stats & Facts, (BodyWhys) www.bodywhys.ie/media/stats-facts/
 Growing up in Ireland, (November, 2012).
 Noreen Flynn, PE & Obesity (INTO Press Releases, 11 November 2011), www.into.ie/ROI/NewsEvents/PressReleases/PressReleases2011/PEandObesity111111/Title,21910,en.php
 Results of the Department of Education and Skills ‘Lifeskills’ Survey, 2012, (Department of Education, Jan 2014).
 Puhl & Latner, ‘Stigma, Obesity, and the Health of the Nation’s Children’, (2007) 133(4) Psychological Bulletin, 557.