ECOG – From Past To Present

European Childhood Obesity Group (ECOG) aims to create a developing atmosphere in the field of childhood obesity. A place where important networking is done, research is supported, and education is spread. But how did it all start and why?

Interview With Elizabeth Poskitt

It all began in 1988 when Walter Burniat, a Belgian paediatrician, wrote to Elizabeth Poskitt, a paediatrician in UK, suggesting they met at the First European Congress on Obesity (ECO) in Stockholm to discuss the fact that childhood obesity was largely presented at adult conferences by physicians, epidemiologists, and nutritionists who often had little knowledge of normal childhood growth, nutrition, development or behaviour. The initial contact of these two paediatricians led to a small short meeting at the next ECO in Oxford the following year and a very substantial meeting at the symposium The Obese Child in Ancona, Italy in 1990 and useful networking at the Third International Conference on Obesity (ICO) in Kobe, Japan, a month later.

No Definition Of Obesity In Children

It was at the Ancona meeting that ECOG began to take shape but the first ECOG Workshop, attended by over twenty Europeans working with childhood obesity, was in Brussels in 1991. At this first Workshop, the name, initial constitution, first President (Elizabeth Poskitt) and Board of ECOG were determined. Brief papers on aspects of childhood obesity were followed by prolonged and substantive discussion. It rapidly became apparent that there was no common definition of obesity in children and that adult definitions using BMI alone were inadequate. From this realization there arose the first ECOG project: for an international definition of childhood obesity (Poskitt EME. 1995. Defining childhood obesity: The relative body mass index. European Childhood Obesity Group. Acta Paediatrica 84; 961-3). The Brussels workshop was also associated with something which characterized the early ECOG workshops: an obesity management training session run by ECOG members for local pediatric health workers.

Tried To Find A Common Path

After Brussels, ECOG met annually in places such as Naples, St Polten in Austria, Pecs in Hungary, Ulm in Germany and Katowice in Poland. Workshops were small but full of discussion on topics such as hyperinsulinemia, type 2 diabetes, the metabolic syndrome in childhood, protocols of management, prevention rather than treatment, over which the group tried to find a common European path. National guidelines on management were exchanged but were not entirely compatible since some were for primary care, some for hospital care and some largely concerned with management by very-low-calorie diets (popular in the management of adult obesity in the 1990s). Much of this work came together in a multi-author book written largely by ECOG members (Burniat W Cole T Lissau I & Poskitt E 2002. Child and adolescent obesity. Cambridge, Cambridge University Press). The collation of data on type 2 diabetes mellitus in Europe led to a review article by ECOG members (Malecka Tendera E, Erhardt E & Molnar D. 2005. Type 2 diabetes mellitus in European children and adolescents. Acta Paediatrica 94: 543-6).

“Is The Cure For Childhood Obesity Any Closer?”

In 2000 ECOG was asked to form a Child Obesity Task Force by the European Association for the Study of Obesity (EASO) and the International Obesity Task Force (IOTF). Amongst activities which included raising the profile of childhood obesity at international meetings, the Task Force collected data from ECOG members and published on the prevalence of childhood obesity across Europe. Data showed a north to south increase in the prevalence of childhood overweight across Europe with very high prevalence in some Mediterranean countries (Lobstein T & Frelut ML. 2003. Prevalence of overweight among children in Europe. Obesity Reviews 4: 195-200). A project proposal submitted to the EU which would have involved ECOG members across Europe in a study of aspects of children’s lives with the aim of explaining the geographical distribution of childhood obesity was, unfortunately, not funded.

Over the past fifteen years, ECOG has grown in size along with the growth in interest and activity in the field of childhood obesity. ECOG members now come from all over the world, not just Europe.

Today’s ECOG “Workshops” have increased in size with few opportunities for the intense discussions of those early Workshops. Papers by international experts on childhood obesity are now a common feature of many nutritional conferences and childhood obesity is a “hot topic” for many different conferences. ECOG meetings are no longer unique in what they present. Maybe it is time to re-introduce the small group policy development Workshops not found in the modern ECOG meetings. These can be so important in developing actions in the fields of prevention and management. Yes, obesity research has moved forwards dramatically, but is the cure for childhood obesity any closer? It is the challenge for ECOG to make this so, Elisabeth Poskitt concludes.

Edited by Katrine Möller Voss
Information officer, Childhood Obesity Unit, Sweden,
Malmö, University Hospital